Weight reduction alone may not be sufficient to maintain disease remission in obese patients with psoriasis: a randomized, investigator-blinded study.

BACKGROUND: The relative risk of psoriasis and its severity are directly related to the body mass index. OBJECTIVE: To investigate the effects of a hypoenergetic diet to maintain disease remission in obese patients. METHODS: A questionnaire was administered to 200 patients with moderate-to-severe chronic plaque psoriasis asking whether diet could influence psoriasis severity. Forty-two obese patients in remission (PASI improvement ≥75%) for at least 12 weeks after methotrexate therapy were randomly assigned to receive a hypocaloric diet or free diet for 24 weeks, and were then followed up for an additional 12 weeks. RESULTS: Most of the patients considered that a diet regimen could influence their psoriasis, and desired to enter a dietary program. Obese patients who were in disease remission and entered a hypocaloric diet regimen showed a significant body weight reduction after 12 weeks which was maintained at week 24. However, patients under hypocaloric and free diets did not significantly differ in the maintenance of psoriasis remission, with relapse observed already at week 12, but with a trend in favor of the intervention group. CONCLUSIONS: Body weight reduction alone may not be sufficient for maintaining remission of moderate-to-severe psoriasis in obese patients.