As a pulmonologist, I work with all kinds of people who are working to manage asthma. For many of them, excess weight is part of the equation.
People with a body mass index (BMI) of 30 or higher are more likely to have asthma. And people who develop asthma as young children are more likely to have excess weight later on.
Managing asthma and excess weight can be challenging, but it is important. Carrying extra pounds is also linked to more severe asthma symptoms — as well other health concerns.
Here’s what I want my patients to know.
The obesity-asthma connection
The statistics are telling: The higher the BMI, the higher the risk of asthma. In fact, relative risk is about 30% higher with every 5-point increase in BMI. And nearly 60% of adults with severe asthma have a BMI of 30 or higher.
And, while we don’t yet know why, the link between BMI and asthma risk is even higher for women.
Both obesity and asthma have increased over the last several decades. So, does asthma cause weight gain, or does having excess weight lead to asthma?
As I tell my patients, it’s not just a question of “Which came first, the chicken or the egg?” For some people, asthma came first. But for other people, the extra weight came first.
We do know that excess weight can make asthma symptoms worse. People with obesity:
- Often have asthma that is less controlled than that of people with a BMI that’s in the normal range
- Tend to use more asthma medications but experience more severe symptoms
- Are more likely to need oral glucocorticoids to control asthma, despite these medications having weight gain and metabolic dysfunction as side effects
- Are 2 to 4 times more likely to be hospitalized due to asthma
- Often experience a decreased quality of life as a result of asthma medications (like inhaled corticosteroids) being less effective
- Can be caught in a cycle in which asthma makes it difficult to exercise, which in turn makes it difficult to maintain a healthy weight
At Temple, we often work with people who face these challenges in our Asthma Program. And we strive to understand the whole picture.
Other ways weight and asthma are linked
Extra weight in the chest and abdomen may constrict the lungs, making it more difficult to breathe. And studies have shown that excess fat tissue produces inflammatory substances that may affect asthma. But that’s only part of the big picture.
People who have excess weight and asthma tend to have other medical conditions, too. And these conditions can affect asthma:
- Depression. People with a BMI over 30 are more likely to develop depression. In turn, the condition is associated with more severe asthma symptoms. It’s also common for depression to make it more difficult to control asthma.
- Obstructive sleep apnea (OSA). Untreated or undertreated OSA can make asthma worse. It can also reduce functional lung capacity. Snoring, waking in the night, and daytime sleepiness should all be discussed with your care provider.
- Gastroesophageal reflux disease (GERD). Heartburn increases in people who have obesity and asthma. GERD may trigger asthma for some people. Sour taste in the mouth, vomiting, and chest pain may occur as well.
- Metabolic syndrome. About 60% of people who are categorized as obese may be affected by this condition. It’s marked by abdominal obesity, insulin resistance, high blood pressure, and high triglycerides. Metabolic syndrome can contribute to the development of asthma. It can also lead to a greater decrease in lung function.
This may sound daunting, but there are healthy ways to move forward.
Strategies for managing obesity and asthma
At Temple Health, our Asthma Program focuses on practical strategies for better symptom control. We work across disciplines with a variety of specialists. This collaboration helps us develop a treatment plan that addresses your needs and works with your life.
That treatment plan can include lifestyle changes, like personalized diet and exercise programs. If you smoke, we have experts who can help you quit. If depression is part of the equation, we can connect you with providers who specialize in mental health. That’s the great thing about receiving care at Temple Health: You have a team of multidisciplinary experts dedicated to your well-being.
I often have patients ask, “Does losing weight help asthma?” While it’s not a magic treatment, getting to and maintaining a healthy weight can decrease asthma symptoms and improve overall health. With that in mind, your Temple Lung Center team might connect you to the experts at the Temple Bariatric Program to help manage your weight.
Get expert care for your asthma now
If you are living with asthma, we are here to help. The Temple Asthma Program provides comprehensive care. We’ll work with you to identify and address your health concerns that impact your asthma control — including weight and weight-related health conditions.
Making an appointment is simple. Call 800-TEMPLE-MED (800-836-7536) or request an appointment online.
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