Feeding the Fire: Fat, Inflammation, & Psoriasis

What if the most inflammatory driver of psoriasis isn’t on the skin at all, but deep in visceral fat? We sit down with Dr. James Song to unpack how adipose tissue acts like a hormone-secreting organ, releasing cytokines that can fuel psoriasis and psoriatic arthritis. From the brain’s weight “set point” to genetics linking obesity and psoriasis risk, we reframe weight as biology—not a moral failing—and explain why that matters for treatment.

We break down fat types, the cytokine cascade connecting metabolic health to skin disease, and what GLP-1 and GLP-1/GIP therapies may be doing beyond weight loss. The conversation also tackles biologic response in higher BMI patients, emerging combo trials, and real-world issues like access, cost, and compounded medications—ending with a practical, whole-system roadmap that protects both skin and heart health.

Thank you Eli Lilly for sponsoring this episode.