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Asthma Control Requires Weight Loss Management in At-Risk Individuals

Although studies have shown an association between obesity and increased asthma incidence, the role of obesity in asthma control is less clear. Now, researchers have addressed that issue by tracking asthma control and Body Mass Index (BMI) in a large, real world cohort of 10,233 adults.

“We identified adults with persistent asthma in 2006, continuous health plan enrollment in 2007 and 2008, with a BMI measurement in 2006 and 2007. That BMI was categorized and analyzed alongside asthma control outcomes in 2008,” co-author Michael Schatz, MD, MS, FAAAAI, said.

Asthma control outcomes included asthma hospitalizations or emergency department visits, oral corticosteroid prescriptions linked to an asthma encounter and prescriptions for more than seven short-acting beta-agonist canisters.

“We found an increased risk of emergency department visits or asthma related hospital stays in overweight (26-40%) and obese individuals (36-57%). We also found that obese patients are likelier to use seven or more short-acting beta-agonist canisters,” co-author Robert Zeiger, MD, PhD, FAAAAI said.

A number of reasons could explain the relationship between poor asthma control and obesity, including:

* Gastroesophageal reflux disease

* Depression

* Reduced corticosteroid responsiveness

* Adipokines or cell signaling proteins secreted by body fat

* Direct effects on pulmonary functions

The size of this study allowed the investigators to account for some of these factors (gastroesophageal reflux disease, depression, and inhaled corticosteroid treatment) as well as other factors that influence asthma control (age, gender, smoking and socioeconomic status). This large study will provide medical professionals a more comprehensive understanding of the association between elevated BMI and poor asthma control. It is important because the Centers for Disease Control and Prevention reports that more than one in three adults over the age of 20 are obese. Similarly, more than two in three adults over the age of 20 are overweight or obese.

“While further studies will be needed to better define the amount of weight loss necessary to improve asthma outcomes, it remains clear that physicians managing overweight and obese patients with asthma should actively encourage and facilitate weight loss interventions,” Schatz explained.

The study was published on May 11, 2015 in The Journal of Allergy and Clinical Immunology: In Practice (JACI: In Practice), an official journal of the American Academy of Allergy, Asthma & Immunology (AAAAI). It should be noted that this study was supported by a research grant from Merck and Co. Inc.

More information on asthma is available at AAAAI.org. The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 6,800 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.