The Metabolic-Dermatologic Axis: GLP-1/GIP Agonists as Emerging Immunometabolic Therapies for Obesity-Associated Skin Disease

Obesity is increasingly recognized as a systemic determinant of dermatologic disease rather than merely a comorbidity accompanying skin disorders. Excess adiposity promotes insulin resistance, adipose-tissue dysfunction, chronic low-grade inflammation, altered immune responses, vascular abnormalities, mechanical stress, and impaired tissue repair, thereby influencing the development and severity of inflammatory and metabolic dermatoses. Psoriasis, hidradenitis suppurativa (HS), psoriatic arthritis (PsA), acanthosis nigricans, intertriginous disease, and impaired wound healing exemplify conditions in which metabolic and cutaneous pathways are closely interconnected. This relationship provides the biological basis for the concept of a metabolic-dermatologic axis, in which adipose tissue, systemic metabolism, immune activation, and cutaneous inflammation interact bidirectionally.