Emerging research is reframing how dermatologists should perceive psoriasis – not only as a dermatologic condition but also as one closely tied to metabolic health. Recent data from the UK Biobank and insights highlighted by Healio Dermatology underscore that central obesity may be a more critical predictor of psoriasis risk than overall body mass. This paradigm shift invites dermatologists to broaden their clinical lens and integrate metabolic risk assessment into patient care.
Abdominal Fat and Psoriasis: Unpacking the Link
A large-scale analysis involving over 330,000 UK Biobank participants, including approximately 9,000 individuals with psoriasis, revealed that waist circumference, waist-to-hip ratio and MRI-based measures of visceral fat correlated more strongly with the presence of psoriasis than total body fat percentage alone. These associations were particularly pronounced in women.
Implications for Clinical Practice and Risk Stratification
This evolving evidence compels dermatologists to redesign risk assessment models. While BMI remains a useful measure, it may underrepresent risks in patients with normal BMI but elevated visceral fat. Incorporating waist measurements into routine exams can identify at-risk patients earlier. Likewise, discussing abdominal obesity during history-taking opens the door to conversations about lifestyle modifications, such as diet, exercise and targeted therapies.
Visceral fat is metabolically active and positively correlated with pro-inflammatory cytokines that exacerbate psoriatic inflammation. Highlighting this mechanistic link can empower clinicians to prescribe tailored interventions, including weight loss strategies and referrals to nutritionists or exercise programs, to support both skin and systemic health.
Emerging Therapeutic Opportunities
An accompanying editorial, authored by Joel M. Gelfand, MD, MSCE, of the University of Pennsylvania, underscored that current psoriasis therapies largely focus on skin and joint involvement. However, he argued that GLP-1 receptor agonists, such as semaglutide (Ozempic®, Wegovy®) and tirzepatide (Mounjaro®), deserve consideration for their dual benefits on weight and inflammation.
This insight challenges dermatologists to explore adjunctive metabolic therapies as part of a multidisciplinary psoriasis management strategy. While further clinical trial data are needed, preliminary outcomes suggest these agents may offer therapeutic value beyond glycemic control, potentially mitigating psoriasis severity as well.
Integrating Abdominal Adiposity into Patient-Centered Care
Dermatology professionals can begin implementing these findings by incorporating waist circumference measurements in clinics and educating patients on how central obesity amplifies psoriasis risk. For high-risk individuals, such as women with elevated waist-hip ratios, considering metabolic referrals alongside traditional topical or systemic psoriasis therapies may yield better long-term skin and cardiometabolic outcomes.
Additionally, collaborating with primary care colleagues, endocrinologists, and nutritionists will enable a comprehensive care model that addresses the multifaceted nature of psoriasis. This approach aligns with LiVDerm’s commitment to science-backed, holistic care strategies that bridge dermatologic and systemic health.
Sources:
