Screening for Eating Disorders in Psoriasis Patients: A Multicenter Cross-Sectional Study.

Abstract

Background: Psoriasis is widely recognized as a systemic inflammatory condition associated with numerous comorbidities. Among these, eating disorders (ED) and ED-related behavior, defined as restrictive or dysfunctional attitudes toward food, have been increasingly reported in patients with psoriasis. Aim of our study was to evaluate the prevalence of ED-related symptoms in psoriasis patients with excess body weight and to explore their association with body mass index (BMI) across the overweight and obese ranges.

Methods: A multicenter, cross-sectional study was conducted on adult patients with psoriasis and BMI ≥25 kg/m². ED-related symptoms were assessed using the Binge Eating Scale (BES ≥17) and Eating Attitudes Test-26 (EAT-26). Screening positivity required a positive result in at least one questionnaire. Patients were stratified into four BMI categories. Variables were compared using standard non-parametric tests, and logistic regression assessed predictors of screening positivity.

Results: A total of 104 patients were included. Overall, 13 patients (12.5%) tested positive in at least one questionnaire. No statistically significant differences in the proportion of screening-positive patients were observed across the BMI categories or between the overweight and obese groups. Similarly, the mean BES and EAT-26 scores did not differ significantly between groups. Logistic regression analysis confirmed that BMI was not a significant predictor of ED-related screening positivity (OR = 0.942, 95% CI: 0.813-1.091). Spearman's analysis showed no significant correlation between BMI and BES scores (ρ = 0.031, p = 0.753) but a weak negative correlation between BMI and EAT-26 scores (ρ = -0.211, p = 0.032).

Conclusion: Approximately one in eight psoriasis patients with excess body weight screened positive for ED-related symptoms. BMI category was not a predictor of ED-screening positivity. The weak negative correlation between BMI and restrictive eating attitudes indicates that dysfunctional eating behaviors may be more pronounced in patients with milder excess weight.