The link between obesity and asthma

I wrote here about 1.5 years ago that I was going for gastric bypass surgery. At that time I was also experiencing "Eosinophilic asthma" and a couple months before my surgery I was started on a biologic drug, (still not sure why they call it a "biologic" but the name of the drug was Nucala). I noticed a slight improvement and was told it could take a few months to really work but what really brought about significant relief was going on the liquid 600 calorie/day diet for 1 week before the surgery which is aimed at shrinking your liver and maybe other organs so it is easier for them to do the surgery. After a few days on the diet I noticed that I was breathing a lot better. A few months after the surgery I saw my pulmonologist and he told me about the link between obesity and asthma.

No one had ever mentioned that before!!!! I developed asthma as a kid and I was not overweight so I personally am aware that excess weight is not the only cause of asthma. Also after reading about the different types of surgery I chose the actual bypass rather than the one where they just make a small pouch in your stomach because it seemed as if this would be a good way to keep stomach acids from traveling back up your throat and getting into the lungs. The surgeon agreed with me.

So anyway now I am down 77 pounds and I am 100% happy that I had the surgery. I also can only eat small portions at a time which can be a bit of a pain if you go to a nice restaurant or have dinner at someone's house. BUT little portions are good for people with asthma anyway so it is all OK.

I have not had to use my nebulizer in many months - can't remember when I used it last. I use the rescue inhaler occasionally. I still take the daily inhaler, (Symbicort) but truthfully I forget a lot. And I have not taken the Nucala in about 5 months. (Dr. knows about the Nucala)
---------------------------------------------------------------------------------------------


"People with a BMI of 30 or more have a much higher risk of having asthma than those with a lower BMI. Seven percent of adults with a BMI in the normal range have asthma but 11 percent of adults with a BMI classified as obese have asthma. And, for reasons we don't yet understand, this seems particularly a problem for women - nearly 15 percent of women who are obese suffer from asthma.

It's not entirely clear why carrying extra weight should cause asthma. Certainly extra weight around the chest and abdomen might constrict the lungs and make it more difficult to breathe. It's probably a lot more complicated than that though. Fat tissue produces inflammatory substances that might affect the lungs and a number of studies have suggested that these substances affect asthma.

What we do know is that obese patients often use more medications, suffer worse symptoms and are less able to control their asthma than patients in a healthy weight range.

Research performed by the American Lung Association Airways Clinical Research Centers Network (ACRC) —the nation's largest not-for-profit network of clinical research centers dedicated to asthma and chronic obstructive pulmonary disease (COPD) —has shown that people with asthma and a BMI over 30 do not respond in the same way to medications as people with a lower BMI. Obese people with asthma have worse asthma control when treated with theophylline, a drug used in therapy for asthma that relaxes bronchial smooth muscle. Other research groups have reported that obesity reduces the effectiveness of medications like inhaled corticosteroids.

Another problem identified in ACRC research is that people suffering with both obesity and asthma more often have other medical problems that might affect asthma. People with a BMI over 30 tend to have depression more often than leaner people and depression is associated with worse asthma symptoms. Another medical problem that is more common in overweight or obese people is obstructive sleep apnea. People with obstructive sleep apnea and asthma also appear to have more severe asthma symptoms than people with asthma without obstructive sleep apnea.

Extra weight increases the risk of having asthma and having more severe, difficult to control asthma. So what's the solution? Losing weight can be hard for anybody and might be particularly challenging if asthma makes it difficult to exercise. The ACRC is hoping to research ways that might help people with asthma lose weight. In the meantime, eating a healthy diet and avoiding a lot of fat in your diet might be helpful. Some research suggests that eating food high in fat worsens airway inflammation in people with asthma. Walk more, try to get some exercise every day – it will help your weight and it will also help you breathe.

----------------------------------------------------------------------------------------




https://www.lung.org/blog/the-link-between-asthma-weight#:~:text=Certainly%20extra%20weight%20around%20the,that%20these%20substances%20affect%20asthma.