Is Obesity Linked to HS?
Our expert explains what we know—and don't know—about the influence of weight on hidradenitis suppurativa.
Can weight loss help improve HS? Christopher Sayed, M.D., associate professor of dermatology at the University of North Carolina at Chapel Hill, addresses the connection between obesity and hidradenitis supprativa (HS).
There have been a lot of studies now looking at comorbidities with hidradenitis trying to figure out what certain things are linked to it. Smoking often comes up, that's been known for a long time. Probably obesity is the second most common thing that people think of as being associated with the disease or disease severity. It's hard sometimes to know exactly where that influence is happening. There are patients who end up developing hidradenitis and then it becomes painful to do things like exercise. Maybe there's some weight gain that happens for that reason.
On the flip side of that, it might be that increasing weight contributes more to disease being active. I think it's probably some of both. Things like skin-on-skin friction end up being a trigger for a lot of patients. When that's increased in patients that have higher weights, that probably does contribute to more disease flares over time or more advanced disease over time. It also may have to do something with the responses to medications being different in patients who have higher overall weight. There is clearly a link there, where patients who are overweight are more likely to have more severe disease.
How much the impact of weight-loss affects HS is not as clear, though. It is probably helpful for some patients, but there are others who lose a lot of weight, who go as far as having things like gastric bypass surgery and still have very active disease. There are also plenty of people who are thin and have HS. It's one of those things that if it's possible to modify in some ways, can potentially be helpful, though.