New research shows that fat around the waist is more closely linked to psoriasis than overall body fat—raising critical questions about prevention and care.
Key Points at a Glance
- Central (abdominal) fat is more strongly linked to psoriasis risk than general body fat
- This association holds true regardless of genetic predisposition
- Women appear particularly affected by fat distribution
- Findings support measuring waist circumference in clinical assessments
- Study involved over 330,000 people in the UK Biobank database
Not all body fat is created equal—and a new study suggests that where fat is stored on the body could play a crucial role in developing psoriasis, a chronic inflammatory skin condition. The research, published in the Journal of Investigative Dermatology, reveals that belly fat, more than total body fat, is a significant risk factor for psoriasis, particularly in women.
Drawing on data from over 330,000 participants in the UK Biobank, including more than 9,000 individuals diagnosed with psoriasis, researchers used a combination of traditional and advanced imaging methods to measure 25 distinct markers of body fat. The study found that central adiposity—fat stored around the abdomen—has a much stronger association with psoriasis than overall body mass.
Dr. Ravi Ramessur of King’s College London, the lead investigator, explains, “Our research shows that where fat is stored in the body matters when it comes to psoriasis risk. Central fat—especially around the waist—seems to play a key role.” This conclusion marks a shift in focus away from generalized obesity toward a more targeted understanding of fat distribution.
The discovery is particularly noteworthy because it transcends genetic predisposition. Even individuals without inherited risk factors for psoriasis were shown to be more vulnerable if they carried excess abdominal fat. This highlights the potential of central fat as an independent and modifiable risk factor.
Dr. Catherine H. Smith, senior author of the study, underscores the urgency: “As rates of obesity continue to rise globally, understanding how different patterns of body fat influence chronic inflammatory conditions such as psoriasis is important. Our findings suggest that central body fat contributes to psoriasis risk irrespective of genetic predisposition and reinforces the importance of measuring waist circumference and proactive healthy weight strategies in psoriasis care.”
The implications of these findings extend well beyond academic interest. In clinical settings, they advocate for a broader diagnostic lens—one that includes assessing waist circumference alongside BMI when evaluating psoriasis risk. They also offer public health practitioners a clearer path for early intervention strategies, especially in women who appear disproportionately affected by fat distribution.
The study also suggests potential biological mechanisms linking visceral fat to immune dysfunction and chronic inflammation, although these remain to be fully understood. Ramessur and colleagues point out that the strength and consistency of the association between central fat and psoriasis were surprising, indicating possible unexplored pathways in disease development.
Adding to the conversation, an editorial by Dr. Joel M. Gelfand from the University of Pennsylvania emphasizes the therapeutic potential of drugs currently used for obesity and diabetes. Incretin-based therapies, particularly GLP-1 receptor agonists, are emerging as promising treatments not only for metabolic disorders but potentially for psoriasis itself.
“The strong relationship between psoriasis and obesity and the emerging promise of glucagon-like peptide-1 receptor agonists (GLP1RA) for reducing psoriasis morbidity is a call to action,” Gelfand notes. He advocates for clinical trials evaluating GLP1RA monotherapy in psoriatic disease, stressing that our current paradigm—focusing solely on skin and joints—is no longer adequate.
However, it’s important to note that the findings are based on a population of White British ancestry, which limits the generalizability. Future studies incorporating more ethnically diverse groups and dermatologist-confirmed cases will be critical for validating and refining these insights.
In the meantime, this study reinforces the growing understanding that psoriasis is more than skin-deep. It is a complex condition interwoven with metabolic health, and now—evidently—with the physical geography of our body fat.
Source: Elsevier
