A major systematic review shows weight-loss interventions significantly improve psoriasis severity and quality of life. Learn how diet, exercise, and medications can help manage psoriasis.
Psoriasis is a chronic inflammatory skin disease affecting more than 60 million people worldwide. Beyond red, scaly plaques, psoriasis deeply affects quality of life, mental health, work productivity, and social relationships.
What is less widely discussed is the strong link between psoriasis and excess weight. Research shows that approximately 80 percent of people with psoriasis are overweight or obese. Higher body weight is associated with increased disease severity, poorer treatment response, and reduced quality of life.
Patients frequently ask whether lifestyle changes, especially weight loss, can improve psoriasis symptoms. Until recently, clinical evidence was scattered and limited in scope.
A new systematic review and meta-analysis published in the Journal of the European Academy of Dermatology and Venereology provides the most comprehensive answer to date.
This large systematic review evaluated whether weight-loss interventions improve psoriasis severity and quality of life in adults with psoriasis.
The researchers assessed changes in:
Importantly, people living with psoriasis helped select the outcomes, ensuring relevance to real-world patient priorities.
Psoriasis is driven by immune system dysregulation and chronic inflammation. Obesity also causes persistent low-grade inflammation due to inflammatory molecules released by adipose tissue.
Excess body fat increases circulating cytokines such as TNF-alpha and interleukins, which are known contributors to psoriasis pathophysiology.
Higher body weight also reduces the effectiveness of systemic psoriasis treatments, limits medication choices, and increases the risk of side effects from drugs such as methotrexate and acitretin.
This biological overlap suggests that weight loss may improve psoriasis by reducing systemic inflammation and improving metabolic health.
The review included a wide range of weight-loss approaches, reflecting real-world treatment options.
Most studies focused on dietary changes, including:
Some studies combined diet with structured physical activity such as supervised walking programs or aerobic exercise.
Three trials evaluated weight-loss medications, including:
These medications belong to the GLP-1 receptor agonist class, which promotes appetite suppression and metabolic improvement.
No randomized trials of bariatric surgery were included, although observational studies suggest surgery may produce even larger improvements in psoriasis severity.
Across all included studies, weight-loss interventions resulted in an average additional weight loss of approximately 6 to 7 kilograms compared to control groups.
This weight change was treated as a process measure, meaning it reflected how effectively the intervention worked rather than being the primary outcome.
Importantly, greater weight loss was generally associated with greater improvements in psoriasis outcomes.
The Psoriasis Area and Severity Index is a standard clinical tool that measures redness, thickness, scaling, and body surface involvement.
Across 14 comparisons, weight-loss interventions led to a significantly greater reduction in PASI scores than usual care.
Against an average baseline PASI score of approximately 13, this reduction represents a meaningful clinical improvement.
Achieving PASI75, defined as a 75 percent reduction in disease severity, is a major treatment goal in psoriasis management.
The study found that participants undergoing weight-loss interventions were:
While PASI50 and PASI100 outcomes also favored weight-loss interventions, fewer studies reported these endpoints, limiting statistical power.
One of the most important findings of this review relates to quality of life.
Seven trials assessed changes in the Dermatology Life Quality Index, a patient-reported measure of how skin disease affects daily life.
Weight-loss interventions resulted in:
These results directly address a major concern among clinicians that weight-loss efforts might reduce quality of life. Instead, the evidence shows the opposite.
People living with psoriasis were involved in selecting study outcomes and interpreting results.
Patients reported that:
This patient involvement adds real-world relevance and reinforces the clinical importance of the results.
While the findings are strong, several limitations should be noted.
Despite these limitations, the certainty of evidence was rated high for PASI and DLQI outcomes.
This study supports integrating weight-loss interventions into routine psoriasis management for people with excess weight.
Weight loss should be considered:
Structured programs with professional support are far more effective than advice alone. Referral to weight-management services may provide both dermatological and metabolic benefits.
High-quality evidence now confirms that weight-loss interventions can reduce psoriasis severity and meaningfully improve quality of life in people with psoriasis and excess weight.
For patients, this offers empowerment and motivation. For clinicians, it provides strong support for addressing lifestyle factors alongside medical treatment.
As psoriasis care continues to evolve, combining dermatological therapy with evidence-based weight management may offer the most effective and patient-centered approach.
Morrow S, Hawkins P, Griffiths CEM, Tektonidis TG, Harriss E, Scragg J, Jebb SA. Impact of weight-loss interventions on psoriasis severity: A systematic review and meta-analysis. Journal of the European Academy of Dermatology and Venereology. Published online December 19, 2025. doi:10.1111/jdv.70247
