People with higher body weights may be more likely to have inflammatory skin conditions like hidradenitis suppurativa (HS). However, that doesn’t mean your body weight caused HS or that losing weight will make your skin lesions disappear. Anyone can have HS at any size.
In this article, we’ll discuss the research on HS and weight loss and the relationship between body weight and HS symptoms.
Some research indicates that weight loss may lessen HS symptoms. One study found that total body-weight loss of at least 15 percent following bariatric (weight loss) surgery was associated with reduced HS severity. Although some study participants with HS experienced less-severe skin issues, others who didn’t have HS reported more skin problems after surgery, largely due to complications from excess skin.
The study authors also noted, “Although patients suffering from HS are often overweight, slender patients also suffer from HS, and further weight loss would in all probability not improve their symptoms.”
There’s still a lot to be learned about the relationship between HS and body weight. Many current studies are small and have a variety of factors influencing their findings. For example, the study noted above was a questionnaire asking about past experience — meaning people reported on their condition after the fact. The findings were based on 45 completed questionnaires.
Having a higher body weight is often discussed as a contributor to HS. While the relationship isn’t fully understood, some of the ways higher body weight can worsen HS include friction where skin meets and systemic inflammation. Skin that rubs together may be more prone to HS symptoms, like abscesses. Higher weight may mean having more or deeper skin folds, along with the potential for skin irritation and infection.
Having a higher weight is linked to higher levels of inflammation. Since HS is an inflammatory disease, some researchers believe higher body weight could increase the frequency and severity of HS flare-ups due to this higher baseline inflammation level.
Body weight also affects hormone levels. Hormones are believed to play a role in HS, so it’s possible that higher body weight worsens HS symptoms for some people.
Ultimately, not everyone with HS has a high body weight, and not everyone with a high body weight has HS. While some evidence suggests that weight loss can improve symptoms of HS, it is not a cure. HS is complicated and influenced by genetic, hormonal, and environmental factors. Disease management requires a comprehensive and individualized approach.
Members of myHSteam have had a range of results from losing weight. Some have found weight loss makes their HS symptoms less severe while others don’t see any changes.
“I’m doing intermittent fasting to lose weight,” explained one member. “I sleep better, feel better, have a better mood, and my HS is better. It seems great for calming things down. This has worked for me in the past when other measures to lose weight didn’t.”
Another said, “I lost 85 pounds about 10 years ago. I saw a difference with the flare-ups when I lost the weight 😊.”
However, one member shared, “Biggest boil yet. They say, ‘Lose weight, it will get better.’ I’ve lost 100 pounds. They are less frequent but worse.” In response, a member wrote, “I feel your pain. I lost a good bit of weight, but it still flares up.”
Another member commented that their smaller body size has not stopped them from experiencing symptoms. “I am 120 pounds. I’ve been this way all my life. Still, my breakouts are insane!”
If you think you would benefit from losing weight, talk to your doctor. You can discuss if and how weight loss could affect your overall health. You can also discuss your risk of other health problems that are associated with higher weights, like metabolic syndrome, heart disease, and diabetes. Meeting with a qualified health care professional is the best way to get medical advice about weight loss.
There are significant health risks to consider when thinking about gastric bypass or weight-loss medications, including excess skin that may require surgical removal and other potential side effects.
It’s also important to consider the benefits and risks of dietary changes. Extreme diets may put your body under additional stress, negatively affecting your quality of life and doing little to help your skin or well-being. If you are interested in making changes to your current diet, your doctor can refer you to a registered dietitian for help with planning healthy, balanced meals.
If you feel like weight loss is becoming an unhealthy obsession or causing disordered eating habits, seek help from a health care or mental health provider. It’s important to note that anyone can experience disordered eating, regardless of weight or gender.
There’s no official diet for HS. However, some early research suggests that cutting back on sugar and dairy may help reduce HS symptoms.
There is also some evidence that supports following a Mediterranean diet, which leans heavily on fruits, vegetables, and lean proteins. These foods are high in nutrients and provide lots of essential vitamins and minerals. They also tend to be lower in calories.
It’s possible that reducing your intake of added sugar, sodium, and trans fats by cutting back on processed foods will also lead to weight loss. Even if your weight remains stable even after making more nutritious food choices, you may still gain health benefits and overall well-being.
If you make a dietary change, making note of your HS symptoms in a journal can help you track any changes in your skin.
One myHSteam member shared, “I find a whole food, plant-based way of eating to be very helpful. I eat veggies, fruit, legumes, nuts, seeds, and whole grains. I avoid animal products, highly processed foods, refined sugars and flour, oils, and added salt. I don’t have a severe case of HS, but haven’t had any significant flare-ups in years after eating this way.”
Another important part of a healthy lifestyle is physical activity. Unfortunately, sometimes HS symptoms can become a barrier to exercise. You may worry that sweating will lead to flare-ups in the armpits or other areas. Skin lesions, pain, and swelling can lead to mobility problems that make it harder to participate in physical activities you enjoy.
Brainstorm with your dermatologist or ask to meet with a physical therapist who can help you find exercise options that work for you. Wearing sweat-wicking athletic gear may help make your exercise session more comfortable.
On myHSteam, the social network for people and their loved ones living with hidradenitis suppurativa, more than 35,000 members come together to ask questions, give advice, and share their stories with others who understand.
Have you noticed that weight loss or weight gain affected your HS flares? What have you found that makes life with HS easier? Share your experience in the comments below, or start a conversation by posting on your Activities page.