How many times have you been told that losing weight will cure your Hidradenitis Suppurativa (HS) or that being overweight is the cause of your condition? We’ve heard it from doctors, support groups, our own mothers… It’s time to set the record straight and debunk some common misconceptions about weight and HS.

Retain this to Memory:

  • You do not have HS because you are overweight.
  • You are not to blame for your HS.
  • HS can affect people of any weight.

Now, let’s delve into the science behind weight and HS, followed by the lived reality of managing this chronic condition.

The Science Behind Weight and HS

While being overweight does not cause HS, it can influence the severity of the disease. Research consistently shows that HS tends to be more severe in individuals who are overweight or have obesity. However, it’s important to note that weight loss does not guarantee improvement in HS symptoms for everyone, though many have reported some relief.

Factors Linking Weight to HS Severity:

  1. Increased Skin Folds and Friction:
    Overweight individuals often have more skin folds, which create areas of friction. Friction can lead to follicular occlusion and trigger the rupture of dilated follicles in people genetically predisposed to HS.
  2. Microclimate for Bacterial Growth:
    Warm, moist conditions in skin folds can foster bacterial overgrowth, potentially worsening inflammation. Although bacteria aren’t the primary cause of HS, their presence can exacerbate symptoms.
  3. Systemic Inflammation:
    Obesity triggers a low-grade, chronic inflammatory state, marked by elevated levels of pro-inflammatory cytokines like TNF-α. This inflammation may worsen HS lesions, as TNF-α is a known contributor to the disease’s pathogenesis.
  4. Hormonal Dysregulation:
    Weight can influence hormonal imbalances that exacerbate HS symptoms. Hormones such as insulin and androgens, often affected by weight, play a role in the disease’s severity and triggers.

The Realities of Weight Loss and HS

  • Does Weight Loss Help?
    Some patients experience a reduction in HS severity with weight loss, while others do not. Weight loss can lead to excess skin folds, which might still trigger friction and worsen symptoms.
  • Surgery and HS:
    Weight loss surgery, such as gastric bypass, can be life-changing for overall health. However, it is not a guaranteed solution for HS and should not be pursued solely for this purpose. Discuss options thoroughly with specialists before making a decision.

Addressing Weight and HS in Your Life

Many individuals with HS gain weight due to reduced mobility, pain, or exercise-induced flares caused by friction and sweating. Here’s how you can navigate these challenges:

  • Talk to Your Doctor: If you’ve noticed a pattern with weight changes and HS symptoms, share your observations. This can guide a personalized approach to managing your condition.
  • Focus on Health, Not Blame: Whether you’re underweight, average weight, or overweight, the focus should always be on creating a healthier lifestyle—not assigning blame for your HS.
  • Consider Hormones: If you suspect hormonal imbalances are impacting your HS, ask your doctor about testing and treatment options.

Moving Toward a Healthier Lifestyle

Ultimately, the goal is to improve overall health and well-being, regardless of the impact on HS. A balanced diet, regular movement tailored to your abilities, and stress management can enhance your quality of life.

Remember, HS is a complex condition influenced by multiple factors, and you deserve compassionate care and evidence-based advice on your journey.

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