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Semin Respir Crit Care Med 2022; 43(05): 662-674
DOI: 10.1055/s-0042-1742384
Review Article

Obesity and Asthma

Anne E. Dixon
1   Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vermont
,
Loretta G. Que
2   Department of Medicine, Duke Health, Rm 279 MSRB1, Durham, North Carolina
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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


Publication History

Article published online:
17 February 2022

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