Immune-Mediated Inflammatory Disease and Obesity Bootcamp Presented at SDPA

At the 2025 Society of Dermatology Physician Associates (SDPA) Fall Conference in San Antonio, Texas, a session was presented on November 5, titled ‘IMID and Obesity Bootcamp.’1

Laura Bush, DMSc, PA-C, led the presentation of this SDPA session. This SDPA bootcamp series was crafted with the aim of providing advanced practice providers (APPs) with specialized, multidisciplinary information as well as practical skills for the management of immune-mediated inflammatory diseases (IMID).

Such diseases include psoriasis, obesity, psoriatic arthritis (PsA), and inflammatory bowel disease (IBD). In the bootcamp’s description on the SDPA’s website, the goal of improving the ability of clinicians in dermatology, gastroenterology, rheumatology, and different metabolic specialties to provide comprehensive, patient-centered care was highlighted.

“Obesity is an abnormal accumulation of adipose tissue that poses a health risk,” Bush explained. “It amplifies comorbid conditions, so it’s going to make other things that are comorbid with obesity worse. It’s going to affect the outcomes of our treatments we give for those conditions…About 20 percent of people who lose the weight can actually keep it off long-term, and often the patients will view this as a personal failure.”

One of the main elements of Bush’s presentation during this session was the notion of PAs and NPs using words that do not stigmatize patients living with obesity. She highlighted a personal anecdote about a family member who experienced stigmatization from her clinician after giving birth to 4 children, related to comments about obesity. Bush noted the need to take away the fear of stigma among such patients through encouragement.

Bush also highlighted the link between inflammation, psoriasis, and obesity. She noted the 66% increase in odds among patients with psoriasis of also being with obesity. Additionally, the lack of desire to go outside to join in public-facing activities due to fears of psoriasis-related stigmatization can contribute to patients’ obesity rates, lack of exercise, and the vicious cycle of inflammatory disease.

In her session, Bush further noted the epidemiologic link to IBD and PsA. Higher body mass index (BMI) at age 18 was also shown in research described in this talk to increase the risk of Crohn’s disease, Bush noted. In general, treatments for inflammatory conditions such as psoriasis can work less well and require medication dose increases if a patient is living with obesity.

“The efficacy of things we have, like TNF inhibitors, don’t quite work as well,” Bush said. “...It’s really highlighting that it’s not only worsening the disease state, but it’s making the treatments we have not work as well.”

Psoriasis, in particular, can lead to limited social interactions and feelings of social isolation, Bush explained. Additionally, there are financial issues faced by such patients, including increased healthcare costs. Later, several other speakers were included as presenters for the session, including Erin Darguzas, NP.

“The size of adipocytes is much larger in obesity,” Darguzas said. “...When we consume excess calories, the ones we don’t use get stored in those cells. Too many calories then make the cell enlarged, or hypertrophic. That causes a cascade of responses in the white adipose tissue.”

Darguzas highlighted the chronic, low-grade inflammation observed in white adipose tissue among patients with obesity. She further noted clinical manifestations of the obesity-IMID connection are conditions such as psoriasis and PsA, as well as the more commonly observed impacts, such as cardiovascular issues. Amanda Mixon, PA-C, and Jennifer Hernandez-Parra, APRN, also provided information during this session on the topic.

“I want everybody to leave knowing that obesity is a chronic illness, just like diabetes, just like all of these things we treat,” Mixon expressed. “When I’m talking to patients, it can be really hard to initiate that conversation, where you’re having this discussion [about obesity]...I often find that when you actually say that, they do want to talk about it. We’re taking the stigma out of the room.”

Mixon highlighted the importance of not blaming patients for having obesity or any other condition, adding the need for a multidisciplinary approach. In addition to the use of weight loss drugs as a potential inflammatory cytokine reducer, Mixon pointed to the Mediterranean diet and a 500 to 750 calorie deficit as helpful for many patients to whom she had spoken. Hernandez-Parra spoke on the topic as well.

“You can barely say the word [GLP-1], and on your social media, ads are popping up,” Hernandez-Parra explained. “But when are we prescribing these medications to patients? We consider it for sure with a BMI greater than 30…What are the main [obesity-related] comorbidities that we can get the medications for, per most insurances? You’re looking at those with previous heart attack and stroke, you’re looking at moderate-to-severe obstructive sleep apnea, at your MASH patients, and then your patients with type 2 diabetes.”

For any additional information on topics in dermatology presented at the 2025 SDPA Fall Conference, view the latest conference coverage.

The quotes contained in this summary were edited for the purposes of clarity.

References

1. Bush L, Darguzas E, Mixon A, Hernandez Parra J. IMID and Obesity Bootcamp. Presented at the Society of Dermatology Physician Associates (SDPA) Fall Conference, November 5-9, San Antonio, TX.