Weight loss alone not sufficient to maintain psoriasis remission
MedWire News: Weight loss alone is not sufficient for maintenance of moderate-to-severe psoriasis in obese individuals, suggest study results.
Chronic plaque psoriasis is linked with obesity in up to a third of all cases, with some reports suggesting that complete remission of the skin disorder can occur after substantial gastric-band-induced weight loss, say the researchers.
To investigate this possibility further, Micol Del Giglio (University of Verona, Italy) and colleagues sought patient opinions about links between diet and psoriasis, and whether consumption of a "hypoenergetic" diet could be sufficient for maintenance of psoriasis remission in obese individuals.
A survey asking whether diet could have an influence on psoriasis severity was sent to 200 patients, aged 53 years on average, with a mean body mass index (BMI) of 28 kg/m2 and with moderate-to-severe psoriasis.
For the second part of the study, 42 obese (BMI=30 kg/m2 or above) psoriasis patients who were in remission were assigned to a low-calorie diet (1200-1500 kcal/day women, 1300-1600 kcal/day men; n=22) or any dietetic guidance (controls; n=20) for 24 weeks.
The results of the questionnaire showed that 62% of responders felt that following a diet regime could improve their psoriasis, while 77% wished to follow a suggested dietary program.
Patients in the intervention arm of the study had lost a significant 9.0% of their bodyweight and 4.6 BMI points on average at 24 weeks compared with no significant weight loss or BMI reduction in patients in the control group.
However, no significant differences in remission maintenance were seen between the two groups. Indeed, both groups displayed progressive deterioration of psoriasis severity that was significant from week 12 onwards after stopping methotrexate therapy.
The researchers concede that their study was limited by its small size and say that further work is needed to confirm their findings.
"However, weight reduction alone may not be sufficient to maintain remission of moderate-to-severe psoriasis after this has been obtained with methotrexate therapy," write Del Giglio et al in Dermatology.
"Nonetheless, a dietary approach to obese patients with psoriasis may still provide very important beneficial effects," they add.
By Helen Albert