Study Links Childhood Obesity to Increased Risk of Atopic Dermatitis

Early childhood obesity may play an important role in the development of immune-mediated skin diseases (IMSDs) such as alopecia areata (AA), atopic dermatitis (AD) and psoriasis, a new study published this month shows.

The research analyzed data from more than 2 million South Korean children screened between 2009 and 2020, and followed them from ages 4 to 12, examining the relationship between body mass index (BMI) and the onset of immune-mediated skin diseases.

Children classified as obese, or those with BMI in the 95th percentile or higher range, showed a 12%t higher risk of developing AD compared to their normal-weight peers, while overweight children, defined as a BMI percentile of 85th to 94th, had a 13% increased risk. The study also demonstrated that this relationship is dynamic: The children who reduced their BMI during the study period also lowered their risk of developing AD.

“This implies that managing weight changes and regulating body weight during childhood may influence the development of subsequent AD,” wrote first author Seong Rae Kim of the Department of Dermatology at Seoul National University College of Medicine, and colleagues. “Prevention of excessive weight gain and purposeful weight loss, including adopting healthy diet strategies in children with obesity to prevent AD, particularly before school age, should be promoted.”

While the exact mechanisms behind this association remain unclear, the researchers hypothesize that excess adipose tissue may trigger proinflammatory effects, potentially disrupting skin barrier function and immune balance. The researchers recommend promoting weight maintenance in normal-weight children and encouraging healthy weight loss in overweight or obese children as potential strategies to reduce AD risk.

Kim and colleagues noted some limitations in their research, including the study's retrospective nature and reliance on BMI as the sole measure of obesity. They call for further research using more diverse adiposity measures and investigating the long-term impacts of childhood obesity on AD. Interestingly, the study did not find significant associations between obesity and other immune-mediated skin diseases like AA or psoriasis, possibly due to their lower incidence rates in the study population.

The study, titled “Childhood Obesity, Weight Change, and Pediatric Immune-Mediated Skin Diseases,” was published in the Journal of Investigative Dermatology.