From the Guidelines
Weight loss is recommended for obese patients with asthma as it can improve asthma control. According to the British guideline on the management of asthma 1, a small randomized parallel group study has shown improved asthma control following weight reduction in obese patients with asthma. This suggests that losing weight can lead to better asthma management, which is crucial for reducing morbidity, mortality, and improving quality of life.
Key Points to Consider
- Weight reduction can lead to improved asthma control in obese patients with asthma, as shown in the British guideline on the management of asthma 1.
- Even modest weight loss can make a significant difference in symptom management, as excess weight can put pressure on the lungs and diaphragm, making breathing more difficult.
- A combination of healthy eating and regular physical activity is recommended for achieving weight loss, with a focus on fruits, vegetables, lean proteins, and whole grains, and at least 150 minutes of moderate exercise weekly.
- It's essential to work with healthcare providers to develop a safe weight loss plan while maintaining proper asthma management, including using asthma medications as prescribed before physical activity if needed.
Clinical Implications
- Healthcare providers should recommend weight loss to obese patients with asthma as part of their asthma management plan, as supported by the British guideline on the management of asthma 1.
- Patients should be encouraged to start slowly with exercise and work with their healthcare providers to develop a personalized weight loss plan that takes into account their asthma management needs.
From the Research
Asthma and Obesity
- Asthma and obesity are major public health problems, with obesity being associated with a high incidence of asthma and poor asthma control 2, 3, 4.
- Weight loss in obese individuals with doctor-diagnosed asthma is associated with a 48%-100% remission of asthma symptoms and use of asthma medication 2.
- Studies have shown that weight loss in obese asthmatics improves asthma control, including objective measures of disease activity, and is associated with improvements in level of lung function and airway responsiveness 2, 3, 4.
Effects of Weight Loss on Asthma Symptoms
- Weight loss has been shown to improve asthma-related quality of life and, to some degree, asthma control in both children and adults with obesity and asthma 3.
- Surgically induced weight loss has resulted in significant improvements in asthma severity, use of asthma medication, dyspnoea, exercise tolerance, and acute exacerbations, including hospitalizations due to asthma 2.
- Diet-induced weight loss has also been shown to improve asthma control and quality of life in obese adults with asthma, with significant increases in forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) measurements 5.
Mechanisms and Implications
- The mechanisms by which weight loss improves asthma control are not fully understood, but may be related to improvements in airway hyperresponsiveness and inflammation 4.
- Weight reduction should be a cornerstone in the management of obese patients with asthma, as it has potentially important implications for the future burden of asthma 2, 4.
- However, obese patients are less likely than non-obese patients to achieve asthma control with an inhaled corticosteroid (ICS) or an ICS combined with a long-acting beta2-agonist (LABA) 6.