Studies in adults have suggested that psoriasis precedes and may induce the development of obesity, but a research letter published in JAMA Dermatology suggests the opposite.
In a pilot study that involved 27 kids, Lauren Becker, MD, and colleagues from Northwestern University found that being overweight or obese preceded psoriasis by at least two years in 93% of children with psoriasis.
Overall, 25 of 27 (93%) patients enrolled in the study were overweight or obese at one and two years prior to psoriasis onset. One year after onset, 92% of the study participants were overweight or obese and that total climbed to 100% by year two following psoriasis onset.
Among the two patients who were not overweight or obese at the time of study enrollment, one experienced a significant gain in BMI percentile within one year after psoriasis onset (from the 56th to the 83rd percentile) and was overweight (90th percentile) one year after psoriasis onset.
The second patient’s BMI increased from the 75th percentile to the 94th percentile at one year after onset and had reached the 95th percentile by two years post onset.
Family may also play a role in the association between obesity and psoriasis, according to the researchers. Children with psoriasis who had increased adiposity frequently had immediate family members who were obese (48%) and had psoriasis (41%).
Children with familial obesity developed psoriasis earlier than those without (mean age 7 years versus 10 years at onset, respectively; P=0.02), the researchers pointed out.
“Weight-loss programs are more successful in children 6 to 12 years old than in adolescents and when healthy diet and physical activity become a family activity. We recommend early lifestyle counseling of families with psoriasis (especially those with obesity),” the researchers concluded.