A higher body weight has been linked to inflammatory skin conditions like hidradenitis suppurativa (HS). However, body weight is not the direct cause of HS, and losing weight does not guarantee that skin lesions will disappear. HS can affect people of all sizes, and while weight loss may help some individuals manage symptoms, it does not guarantee improvement and is not a cure. Some research suggests that losing weight can reduce disease severity in certain cases, but its effects vary from person to person.

In this article, we’ll explore what’s known about HS, weight loss, and ways body weight may affect HS symptoms. We’ll also look at newer weight loss medications that could be helpful for people with HS.

Research on HS and Weight Loss

Some research suggests that losing weight might help reduce HS symptoms. One study found that people who lost at least 15 percent of their body weight after bariatric (weight loss) surgery experienced less severe HS. However, not everyone saw improvements — while some participants with HS had fewer skin issues, others without HS developed more skin problems after surgery, mainly due to complications from excess skin.

The study authors also noted, “Although patients suffering from HS are often overweight, slender patients also suffer from HS, and further weight loss would in all probability not improve their symptoms.”

A 2024 study found that people with obesity who had never had HS were much less likely to develop it after undergoing bariatric surgery. For those who already had HS, bariatric surgery slightly reduced the chance of it coming back, but the difference wasn’t big enough to be sure.

Links Between HS and Body Weight

Although experts don’t fully understand the link between HS and body weight, having a higher body weight may make HS worse in a few ways. For example, skin rubbing together can lead to more HS symptoms, like abscesses. Higher body weight can also contribute to systemic inflammation, which means the immune system stays overactive throughout the body and can make HS symptoms worse. Having a higher body weight can also affect the structure of collagen, a protein that helps keep skin strong. This can make the skin weaker and slow down healing from cuts or injuries. In addition, more or deeper skin folds may increase the risk of skin irritation and infection.

A larger body weight also affects hormone levels. Hormones are believed to play a role in HS, so excess body weight might make HS symptoms worse for some people.

HS is a complicated condition affected by genetics, hormones, and environmental factors. Everyone’s treatment is different, and weight loss doesn’t always make a difference.

Glucagon-Like Peptide 1 Drugs and HS

People with HS may wonder if glucagon-like peptide 1 (GLP-1) receptor agonist drugs could help. GLP-1 drugs are most commonly used to treat type 2 diabetes and obesity. Semaglutide (sold under brand names including Ozempic, Wegovy, and Rybelsus) is a common example.

GLP-1 drugs mimic the action of GLP-1, a hormone naturally found in your body. These medications:

• Stimulate insulin release, which helps lower blood sugar
• Have anti-inflammatory effects
• Increase feelings of fullness after eating

Early research suggests that semaglutide might help people with HS, but the evidence is still very limited. A small study with 30 people found that semaglutide reduced HS flares and improved quality of life. However, bigger studies are needed to be sure. While these drugs show promise, they are not a standard treatment for HS.

Additional studies of other GLP-1 drugs, including liraglutide (Saxenda, Victoza), have shown promising results. In one small study, 14 people with HS who took liraglutide for three months experienced reduced HS severity and improved quality of life. However, because these studies had small sample sizes, more research is needed before GLP-1 drugs can be considered a standard treatment for HS. If you’re interested in trying one, talk to your healthcare provider.

Members of myHSteam on Weight Loss

Members of myHSteam have had a range of results from losing weight. Some have found weight loss makes their HS symptoms less severe, while others don’t see any changes.

One member said, “I lost 85 pounds about 10 years ago. I saw a difference with the flare-ups when I lost the weight 😊.”

However, another member shared, “​​Biggest boil yet. They say, ‘Lose weight, it will get better.’ I’ve lost 100 pounds. They are less frequent but worse.” In response, a member wrote, “I feel your pain. I lost a lot of weight, but it still flares up.”

Another member commented that their smaller body size has not stopped them from experiencing symptoms. “I am 120 pounds. I’ve been this way all my life. Still, my breakouts are insane!”

Considering Weight Loss

If you think you would benefit from losing weight, talk to your doctor. You can discuss if and how weight loss could affect your overall health, as well as if it would improve your HS symptoms. Specifically, you can discuss your risk of other health problems that are associated with higher weights, like metabolic syndrome, heart disease, and diabetes. Meeting with a qualified healthcare professional is the best way to get medical advice about weight loss.

There are significant health risks to consider when thinking about gastric bypass or weight loss medications, including excess skin that may require surgical removal and other potential side effects.

It’s also important to think about the benefits and risks of dietary changes. Extreme dieting is not recommended. It can add stress to your body, negatively impact your well-being, and may not improve HS. If you’d like help making dietary changes, a registered dietitian can provide personalized nutrition advice.

If you feel that weight loss is becoming an unhealthy obsession or leading to disordered eating behaviors, reach out to a healthcare or mental health professional. Anyone, regardless of weight or gender, can experience disordered eating.

The Best HS Diet for You

There is no official diet for HS, but some research suggests that eating less sugar, dairy, and processed foods may help manage symptoms. A healthy diet, like the Mediterranean diet — rich in fruits, vegetables, and lean proteins — may also help reduce inflammation. Even if changing your diet doesn’t lead to weight loss, it can still support your overall health and well-being.

If you make a dietary change, making a note of your HS symptoms in a journal can help you track any changes in your skin.

One myHSteam member shared, “I find a whole-food, plant-based way of eating to be very helpful. I eat veggies, fruit, legumes, nuts, seeds, and whole grains. I avoid animal products, highly processed foods, refined sugars and flour, oils, and added salt. I don’t have a severe case of HS, but haven’t had any significant flare-ups in years after eating this way.”

Exercising With HS

Another important part of a healthy lifestyle is physical activity. Unfortunately, sometimes HS symptoms can become a barrier to exercise. You may worry that sweating will lead to flare-ups in the armpits or other areas. Skin lesions, pain, and swelling can lead to mobility problems that make it harder to participate in physical activities you enjoy.

Low-impact exercises like walking, swimming, or stretching can help with mobility and mood.

However, if you have severe HS lesions, some activities, like biking, might cause friction or irritation. A doctor or physical therapist can help you find exercises that work best for you.

Brainstorm with your dermatologist or ask to meet with a physical therapist who can help you find exercise options that work for you. Wearing sweat-wicking athletic gear may help make your exercise session more comfortable.

Talk With Your Doctor

Managing HS looks different for everyone. While weight loss or new medications may help some people, they aren’t the right solution for everyone. Since HS is a complex condition with many factors, it’s important to find what works best for you. Before making changes to your diet, exercise routine, or treatment plan, talk to your doctor about the best options for your health and well-being.

Find Your Team

On myHSteam, the social network for people and their loved ones living with hidradenitis suppurativa, more than 45,000 members come together to ask questions, give advice, and share their stories with others who understand.

Have you noticed that weight loss or weight gain affected your HS flares? Have you thought about or tried using a GLP-1 drug for your HS? What have you found that makes life with HS easier? Share your experience in the comments below, or start a conversation by posting on your Activities page.