Psoriasis has been associated with obesity, hypertension, diabetes mellitus, and metabolic syndrome, and has recently been proposed as an independent risk factor for myocardial infarction. The underlying mechanisms of these associations are complex, but the “obesity of psoriasis” may be a key link. The hormone leptin stimulates endocrine activity in adipose tissue and is a hypothalamic modulator of food intake, body weight, and fat stores. In this case-control study, Chen et al demonstrated that psoriasis was independently associated with hyperleptinemia and that hyperleptinemia was associated with a higher risk of developing metabolic syndrome. Body weight loss could potentially become part of the general treatment of psoriasis, especially in patients with obesity.