Updated: Jun 30
How many of us have left the doctor’s office feeling like HS is our fault due to our weight? Let’s set the record straight with regards to the weight issue.
There are numerous studies that indicate that this disease is more severe and more common in those who are overweight and many studies show improvement in those who have lost weight. These are the statistics and information that are being giving to the doctors and being spoken about at medical conventions.
Anyone, at any weight, can have HS. Weight has very little to do with this disease, despite the statistics, however, it is understood why doctors are always discussing weight in conjunction with HS. Please understand that the medical field is continuously tells those who are overweight, even if by a few pounds, that losing weight may help with hidradenitis, and in some cases it is true.
Medical personnel are not trying to hurt your feelings when discussing weight loss and are not calling you fat; they are not saying HS is a fat person's disease. The are also not saying that your HS is going to go away completely or be cured by weight loss. Some physicians tell you this with hopes of helping to control the symptoms of this disease. In all honesty, sometimes they don't know what else to do, they have very few tools to work with when it comes to HS and the correlation with weight has been driven into their heads for decades.
Below are some facts regarding weight and HS. Please keep this in mind the next time you’re at the doctor and the subject arises. Over the years, several studies have explored the link between obesity/overweight, metabolic syndrome, and HS. Nowadays, overweight/obesity are considered to have a leading role in the pathogenesis of several diseases. Regarding HS, overweight/obesity seem to play a role on multiple fronts:
First, overweight/obese individuals have more and larger skin folds, whereby skin-skin contact occurs, enhancing mechanical friction. Mechanical friction contributes to HS development by promoting follicular occlusion and by triggering rupture of dilated follicles in a genetically susceptible individual. The higher than usual skin temperature and humid microclimate (local tissue temperature and moisture) in skin folds which favor bacterial growth.
Secondly, bacterial infection has long been suspected to play a secondary role in the pathogenesis of HS, as the bacterial colonization leads to a series of pathogen-associated molecular pathways, which may contribute to perpetuating and exacerbating local inflammation.
Thirdly, obesity causes a low-grade, subacute, systemic inflammatory state. This inflammatory state produces increased circulating levels of pro-inflammatory cytokines, such as TNF-α. TNF-α is a pro-inflammatory cytokine that plays an important role in the control of lipid metabolism and interferes with the signaling of insulin, whose circulating levels are increased with obesity/overweight and is decreased with weight loss. Insulin has an important role in homeostasis and physiology of the skin and has protean cutaneous manifestations (skin manifestations). An increase in TNF-α in skin lesions of patients with HS has been demonstrated and suggests a key role of this cytokine in the pathogenesis.
We have 50 hormones in our body and there are several ways our hormones contribute to our weight and diseases; poor diet, nutrition, and being overweight are on the list. We know that for many people hormones affect how our HS acts and are a trigger for many. Losing weight can help bring your hormones back to their optimal levels.
If you've always been thin, have always had HS, recently put on weight for whatever reason, and have seen no change in your condition, make sure that they are aware of that. Educate them that weight may not be a factor with you. The same scenario applies if you’ve always been overweight and are now thin and have seen no difference in your condition. Help educate them with the real life scenarios, not just the statistics that are given to them.
Despite study findings and despite the statistics; it does not make HS any less personal. We are their statistics and we are their study finding participants; make your voice heard.
The best method is to strive for a better and more healthy lifestyle, no matter what illnesses or conditions we have.
This is an awareness article for educational purposes only and is not intended to replace the advice of your doctor or other health care provider.
Written by Denise Panter-Fixsen
Edited by Brindley Kons