Evaluation of eating behaviors in patients with hidradenitis suppurativa: A case-control study

Hidradenitis suppurativa (HS) is a chronic inflammatory debilitating disorder that can result in significant morbidity. In addition to medical and surgical treatments, lifestyle modifications such as smoking cessation and weight control have an important benefit in HS management. These modifications can be challenging for both the patient and the clinician. The differences in eating behavior of HS patients compared to the general population are mostly unknown. Defining these differences in HS patients may help to develop more effective weight loss strategies. In our study, we aim to describe differences in eating behavior in HS patients compared to the normal population. 140 patients with HS and 140 age, gender and body mass index-matched healthy controls were included in the study. For each HS patient, Hurley and the investigator's global assessment scores were defined by a dermatologist. For each participant, Hamilton depression scale (HAM-D), Hamilton anxiety scale (HAM-A), and Dutch eating behavior questionnaire (DEBQ) were assessed by a psychiatrist. HAM-D scores were found to be significantly higher in HS group (p < 0.001), whereas HAM-A scores did not show a significant difference between HS and control group (p = 0.744). Emotional eating scores were significantly higher in HS patients compared to the control group (patients: 3.14 ± 0.96, controls: 2.29 ± 0.96, p < 0.001). Similarly, external eating scores were markedly elevated in HS patients compared to controls (patients: 3.38 ± 0.66, controls: 2.82 ± 0.73, p < 0.001). However, in terms of restrictive eating, there was no significant difference between the two groups (p = 0.783). In regression analysis, depression and anxiety scores were found not to have a significant effect on restrictive, emotional and external eating scores. Furthermore, in HS patients, a moderate positive correlation was found between emotional eating and external eating (p < 0.001). In conclusion, HS patients have tendency for emotional and external eating behavior independent from depression and anxiety.