Abstract
Obesity is a major risk factor for the development of asthma, and the prevalence of
obesity is higher in people with asthma than in the general population. Obese people
often have severe asthma—recent studies in the United States suggest that 60% of adults
with severe asthma are obese. Multiple mechanisms link obesity and asthma, which are
discussed in this article, and these pathways contribute to different phenotypes of
asthma among people with obesity. From a practical aspect, changes in physiology and
immune markers affect diagnosis and monitoring of disease activity in people with
asthma and obesity. Obesity also affects response to asthma medications and is associated
with an increased risk of co-morbidities such as gastroesophageal reflux disease,
depression, and obstructive sleep apnea, all of which may affect asthma control. Obese
people may be at elevated risk of exacerbations related to increased risk of severe
disease in response to viral infections. Interventions that target improved dietary
quality, exercise, and weight loss are likely to be particularly helpful for this
patient population.
Keywords
airway reactivity - oscillometry - exacerbation - weight loss - diet - co-morbidities
- viral infection - gastroesophageal reflux disease - obstructive sleep apnea - depression
- type 2 inflammation
