Resolve to Control Asthma First, Then Focus on Weight Loss

By Gary J. Stadtmauer, MD, FAAAAI, and Y. Claire Wang, MD, ScD

A Dangerous Relationship
The link between asthma and obesity

Asthma can prevent you from exercising, leading to weight gain. Overweight and obese patients, in turn, tend to have more severe asthma.

Each New Year, millions of Americans commit to lose weight. But for many, asthma may stand in the way of reaching their goals.

Obesity is a growing epidemic in the United States, with as many as 30 percent of adults and 15 percent of children considered obese. Millions more are overweight.

For a person with asthma, losing weight has extra challenges. When asthma acts up, you can’t exercise. But even when asthma is under control, you may feel short of breath minutes into a workout. That’s because the excess weight you carry compresses your lungs, limiting how much air you can breathe in and narrowing your airways.

Obese asthma patients tend to have more severe asthma and are more likely to be hospitalized. Research suggests that this increased severity is due to greater airway inflammation and reduced effects of asthma medications in obese patients.

Obesity also increases the risk for sleep apnea, which leads to daytime fatigue and inactivity, further challenging efforts to lose weight. Sleep apnea also provokes inflammation and irritability in the bronchial tubes — leading to increased asthma symptoms. More research is needed, but there appears to be a vicious cycle between asthma, obesity and sleep apnea.

Exercise is an important part of any weight loss program, but if asthma is not well controlled it is impossible to work out to your full potential. If you are obese, then not only can proper asthma management help you with weight control but weight loss can in turn improve your asthma.

Gary J. Stadtmauer, MD, FAAAAI, is an allergist/immunologist based in New York City.  Published in the Winter 2009 AAAAI Advocate 

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