Have you ever been diagnosed with psoriasis, and later told you had a “mild” dysfunction of another?
You think it’s nothing serious, so you move on. Until one day, it isn’t mild anymore.
One of my patients lived this reality.
He was fine, or so he thought. Psoriasis was his main concern—itchy, scaly, frustrating, but manageable. Then, during a routine screening, he was told he had mild diastolic dysfunction. No major red flags. No urgency. So, he carried on. Until the morning he collapsed from a heart attack.
After stabilizing him, the immunologist asked a question no one had considered before: “Has anyone checked your visceral fat?“
That’s when the real story unfolded.
Most people associate psoriasis with immune dysfunction & genetics. But a recent study from King’s College London confirms this connection: visceral adiposity, especially in the central abdomen, is independently linked to psoriasis and early heart dysfunction—even in people who seem metabolically “normal.” This isn’t just about your weight. It’s about what your body is silently storing, and how it’s responding beneath the surface—long before symptoms force you to listen.
It’s Not About How Much You Weigh—It’s About How Much and Where the Fat Sits
We’ve been conditioned to focus on the scale.
But when it comes to health risks like psoriasis, the number on the scale often tells us very little. What matters far more is where fat is stored—and how it behaves inside the body.
This is where visceral fat becomes a key player.
Visceral fat is not the soft fat you feel under your skin. It’s the deep, internal fat that wraps around your organs—your liver, pancreas, and intestines. Unlike subcutaneous fat, which is mostly inert, visceral fat is biologically active. It secretes inflammatory chemicals, disrupts hormonal balance, and impairs immune regulation.
Visceral fat doesn’t just sit there. It sends signals. And those signals fuel chronic inflammation—exactly what psoriasis thrives on.
That’s why someone with a “normal” BMI can still be at risk. You may look fit on the outside but carry dangerous levels of internal fat that silently inflame your system from the inside out. The recent study out of King’s College London confirms this:
Waist circumference, waist-to-hip ratio, and trunk fat—all markers of visceral fat—had a much stronger link to psoriasis than total body weight or BMI.
This means:
A lower weight doesn’t guarantee lower the risk of Psoriasis
Visceral fat is a modifiable driver of systemic inflammation
Tracking fat distribution is more informative than tracking weight.
So rather than asking, “How much do I weigh?”
A better question is: “How inflamed is my body, and where is that inflammation coming from?”
In many cases, the answer starts with fat you can’t see—but your immune system can absolutely feel.
How Inflammation from the Fat Becomes a Skin Disease
It’s one thing to say fat and psoriasis are connected.
But here’s what actually happens beneath the surface—how the fat stored around your abdomen becomes the fuel for a full-blown inflammatory skin condition.
Central Fat Doesn’t Just Sit There—It Sends Signals
Fat around your midsection, especially visceral fat, is not inert.
It’s metabolically active, meaning it constantly sends out chemical messengers called pro-inflammatory cytokines—like IL-6, TNF-alpha, and CRP (C-reactive protein). These act like fire-starters in your system.
The more central fat you carry, the louder and more frequent these inflammatory signals become.
The Immune System Responds—But Overreacts
Your immune system is built to respond to threats. But when it’s constantly exposed to low-grade inflammatory signals from visceral fat, it begins to misfire.
This chronic stimulation pushes the immune system toward dysregulation—the hallmark of autoimmune diseases like psoriasis.
In this inflamed state, immune cells begin to attack healthy skin tissue, leading to:
- Rapid skin cell turnover
- Red, scaly patches
- Persistent irritation and flares
Psoriasis Becomes the Visible Tip of a Deeper Problem
What you see on your skin is just the surface-level outcome.
The real issue is systemic: your body is on constant high alert, and the source of that alert is often centered in your abdomen.
This is why people with higher central fat—not necessarily higher weight—are more prone to psoriasis.
The skin becomes a messenger. But the message starts with internal inflammation—and central fat is often the source.
What You Can Do About It
1. Investigate your terrain—not just your symptoms
Psoriasis is not the problem; it’s the result.
To reverse it, you have to ask: What made my body inflamed to begin with?
This could involve:
- Hidden infections
- Poor detoxification pathways
- Nutrient deficiencies
- Chronic stress responses
Finding answers requires someone who knows how to connect the dots across systems—not just treat isolated symptoms.
2. Restore mitochondrial function to rebuild your metabolism
Your mitochondria are your body’s energy engines.
When they’re sluggish:
- Fat accumulates
- Healing slows down
- Inflammation escalates
Improving mitochondrial efficiency increases metabolic flexibility—your body’s ability to switch between burning fat and glucose efficiently, a core element in reducing inflammation and chronic disease risk.
3. Address microvascular health to protect your heart and tissues
Many chronic patients experience microvascular rarefaction—a deterioration of tiny blood vessels that limits nutrient and oxygen delivery at the cellular level.
This contributes to diastolic dysfunction and slows tissue recovery.
Restoring microvascular health is essential for long-term healing and energy production.
4. Overcome anabolic resistance—shift from weight loss to fat loss
It’s not about the number on the scale.
What matters is losing the right kind of fat—particularly the central, inflammatory fat that surrounds your organs.
That means:
- Preserving lean muscle
- Improving strength and mitochondrial capacity
- Avoiding the metabolic crash of calorie-cutting or over-exercising
5. Reduce your total inflammatory burden
This is about more than avoiding triggers.
It’s about creating a biological environment where inflammation simply can’t take hold.
That means:
- Modulating immune responses—not suppressing them
- Stabilizing blood sugar
- Supporting gut and liver detox pathways
- Resolving chronic low-grade infections