The Potential Benefits of Sustaining a Healthy Weight for Psoriasis — and How to Do It

If you have psoriasis, one of the most important steps you can take to control the condition and help make treatment more effective is to lose excess weight.

“We think of psoriasis as just a skin disease, but we now know that it's associated with a variety of other illnesses, including diabetes, heart disease, high blood pressure, and other metabolic disorders,” says Apple Bodemer, MD, an integrative dermatologist at UW Health and associate professor of dermatology at the University of Wisconsin School of Medicine and Public Health in Madison. “Psoriasis is a whole-body disease, and when we carry around extra weight, we're stimulating inflammation over the entire body.”

This inflammation affects the body in many ways. “Our fat cells make a lot of hormones that increase inflammation, and there's some evidence to say that this worsens psoriasis,” says Eden Lake, MD, a dermatologist with the Endeavor Health Medical Group in Skokie, Illinois.

• Manage psoriasis symptoms
• Reduce flares
• Decrease the need for psoriasis medications
• Improve psoriasis treatment outcomes

“A lot of medications for psoriasis are also going to be less effective if you are at a higher weight,” says Dr. Lake, who says that she's had patients whose medications stopped working adequately after weight gain. “If we can get them back down to a healthy weight and decrease that inflammatory load … then those same treatments that stopped working might be more effective again,” she says.

Research shows that losing even 5 percent of your body weight can reduce the severity of psoriasis. That means if you weigh 200 pounds, losing 10 pounds can make a big difference.

“Studies show that it doesn't have to be a lot of weight to improve your psoriasis,” says Dr. Bodemer, because even small increments of weight loss can help decrease the inflammatory load, which helps control psoriasis.

Strategies you can try to lose excess weight include:

Exercise

Sneaking in exercise throughout the day is a great way to build active habits in small, achievable increments. One key aspect of maintaining a healthy weight is regular exercise. “Having regular exercise be part of your life has a really potent anti-inflammatory effect,” says Bodemer.

Start with small changes and incorporate them into your routine. You could try:

• Get up. during commercial breaks when you're watching TV and move around — do some push-ups or squats against the wall, or go up and down stairs in your home, then increase reps if you can, Lake suggests.
• Join a weight-loss support group. or find a buddy to inspire you, cheer you on, and work out with you, says Bodemer.
• Use a smartwatch. or wearable fitness tracker to set reminders to move around every hour or so, and set realistic and attainable fitness goals. “You're going to be a lot more satisfied if you're reaching your goals and surpassing them than if you're constantly missing them — that's going to discourage you very quickly,” says Lake.
• Find something you like doing. such as walking with a friend or tending to your garden, do something physical that's enjoyable for you “so that it's sustainable and not just a quick ‘one and done, this didn't work for me, I'm going to stop,'” suggests Lake.
• Be careful. and follow your healthcare provider's advice. If you have psoriatic arthritis, check with your doctor or physical therapist to see what types of exercise are right for you. They may recommend precautions such as avoiding activities that require prolonged standing or walking or that put too much stress on your hips, spine, and knees.

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Eat a Healthy Diet

Another habit that can help you stay at a healthy weight is to eat more fruits and vegetables, says Bodemer. She suggests replacing the pro-inflammatory high-fat, high-sugar, processed foods that are common in the American diet with plant-based foods like nuts, seeds, oils, vegetables, beans, whole grains, and legumes.

Some pro tips to keep in mind: Instead of trying to cut out everything you love, try to make healthier choices to satisfy your cravings, suggests Lake. For instance, swap soda for carbonated water with mashed-up berries or slices of lemon, or have a small amount of healthy dark chocolate or frozen chocolate-covered banana bites instead of a candy bar. “It's about making healthier choices that are still really satisfying [so you can] stick with it,” she says.

Get Enough Sleep

According to Bodemer, “sleep is a time when the inflammation dials down in our body.” Consider using tools that can promote healthy sleep such as nighttime meditation apps or breathing exercises.

Cut Alcohol

While the research on alcohol and psoriasis is not definitive and often contradictory, if you're going to imbibe, do so in moderation and opt for wine over sugar-laden cocktails, Lake says.

• Being overweight can make psoriasis worse by increasing inflammation in the body, so losing excess weight is one of the best ways to improve symptoms.
• The key to shedding extra pounds is to focus on making small, durable changes in your lifestyle choices so that you can sustain healthier habits in the long-term.
• Increasing daily activity in small increments, cutting out alcohol, eating an anti-inflammatory diet, and getting enough sleep can all help you to lose weight and potentially reduce psoriasis symptoms.