How Are Asthma and Obesity Linked?

By: 
Dr. Christopher McGowan
October 17, 2022

As the impact of obesity continues to increase in the United States and around the world, so also does the prevalence of a variety of obesity-related diseases and disorders. The precise reasons for the link between obesity and these other conditions continues to be explored in clinical trials, but the evidence is clear that carrying extra body weight makes a person more susceptible to heart dysfunction, systemic digestive problems, and respiratory health problems, among others. One connection that has seen much more study in recent years is the link between obesity and asthma. 

What Is Asthma?      

Asthma is a chronic inflammatory disease that affects the bronchi (airways) of the lungs. When asthma-related inflammation is present in the lung’s airways, it decreases lung volumes by narrowing these breathing passages; this then makes it more difficult to exhale. It is estimated that around 1 in 13 Americans has asthma, which equates to more than 20 million adults and five million children. Indeed, incidence of asthma often first develop during childhood, and though it might improve during one’s teenage years, for many people it lingers long into adulthood. 

During normal breathing, the muscles that surround the airways in the lungs are relaxed and allow air to move freely and quietly. This norm is also true for asthmatic patients until an asthma attack is triggered. During such an event, the muscles tighten and narrow the airways, thus constricting the flow. In some cases, the lining of the airways become inflamed and swollen, adding to the difficulty breathing. Also, because of the airway inflammation, the body produces sputum that coats the inner lining of the lungs and further complicates breathing. 

Symptoms of Asthma

The experience of having asthma can be very different from person to person depending on the severity of the condition. In addition to a general difficulty breathing that is characteristic of asthma, there can be a number of other specific signs and symptoms: 

  • tightness or pain in the chest or thorax
  • shortness of breath
  • wheezing when exhaling (particularly common in pediatric asthma)
  • worsened coughing or wheezing during a respiratory illness
  • difficulty sleeping brought on by coughing, wheezing, or other symptoms

Depending on the person, asthma symptoms may be present all the time or only during a discrete asthma attack. For many people, these symptoms can get worse at night while trying to sleep or while doing an exercise that increases breathing intensity. Each person who suffers from asthma likely has their own unique combination of triggers and sensitivities that can make attacks happen more frequently or make symptoms more severe. 

What Causes Asthma?

The precise cause of asthma isn’t currently known, but it is thought to be a combination of environmental and genetic factors. Decades of research and treatment have identified a variety of these environmental triggers:

  • air pollution like industrial emissions, automobile exhaust, and smoke from wildfires
  • airborne allergens can include pollen, dust mites, pet dander, or mold spores
  • household pests
  • tobacco smoke 
  • vigorous aerobic exercise 
  • potent odors from chemicals or other home or occupational sources 
  • respiratory infections
  • cold air 
  • stressful or emotional situations 
  • sulfites and preservatives that are added to some foods and beverages
  • gastroesophageal reflux disease (GERD)

The risk of asthma is increased if the person has a blood relative with biomarkers for asthma, but it’s also not a guarantee of developing the condition. Workers who have regular exposure to chemicals and other allergens are also at increased risk. The same is true for people with atopy in general—that is, the tendency to have exaggerated immune responses to otherwise harmless environmental substances; in asthma patients this is known as airway hyperresponsiveness.  

The Connection Between Asthma and Obesity

Another significant risk factor in the development of asthma is obesity, and many studies have shown that the prevalence of asthma is notably higher in obese children, adolescents, and adults. Moreover, obesity is also linked with more severe symptoms and poor asthma control. While the connection between the two conditions is well documented, it’s not entirely clear why obesity should increase the risk for asthma. Below are some explanations that have been theorized. 

  • Lung constriction: it’s possible that carrying extra weight in the chest and abdomen may put pressure on the lungs and affect lung function
  • Inflammation: there is also evidence that adipose tissue produces proteins called adipokines (such as leptin) that are thought to increase systemic inflammation in the lungs and elsewhere 
  • Cardiometabolic factors: obesity-related factors like high cholesterol and diabetes are also known to generally make breathing more difficult 
  • Immune function: obesity has been shown to lead to reduced immune function that may add to the exaggerated immune response inherent in asthma 
  • Medication: recent research shows that some obese patients also do not respond as well to many types of asthma medication like steroids or corticosteroids when compared to non-obese patients with a lower body mass index (BMI) 
  • Sleep apnea: it has been established for many years that obesity increases the risk of obstructive sleep apnea, a condition that also makes someone more susceptible to asthma

What Are the Benefits of Losing Weight?

While the connection between weight gain and asthma is undeniable, the underlying mechanism that connects the two conditions is still being actively researched. Nevertheless, there is already sufficient evidence to support the idea that losing excess body weight can potentially prevent the onset of asthma or decrease the symptoms of severe asthma. One cohort study, for example, showed that obese asthmatics who lost weight had both improved pulmonary function and a general improvement in their quality of life. 

Yet while weight loss should be an integral part of any asthma treatment plan, the benefits of losing weight go even further. Even beyond the aesthetic benefits or weight loss that most people are eager to reap, the truth is that the reduction of excess body weight can improve blood pressure, triglyceride levels, insulin resistance, and mobility. Additionally, weight loss has been linked with reduced risk of obesity-associated comorbidities like heart disease, type 2 diabetes, metabolic syndrome, and certain types of cancer.

Find a Long-Term Weight Loss Solution

Because one of the effects of obesity is to increase the chances of developing asthma and make it harder to control, losing weight is an important component of asthma management and limiting the need for medical interventions. But even apart from the association with asthma, being an obese adult or child brings any number of physical and emotional challenges. Traditionally, anyone struggling with obesity has been strongly encouraged to simply eat less and exercise more in order to lose weight and feel better. The truth is, though, that it’s much easier said than done. 

At True You Weight Loss, we are eager to help you begin your weight loss journey with a new approach that prioritizes long-term solutions. To that end, we are proud to offer alternative weight loss procedures that can help you gradually adapt your eating and physical activity habits in a way that makes sustainable success much more likely. With minimally invasive, non-surgical options like ESG or an ORBERA® gastric balloon, you can finally find the freedom you’ve been waiting for. To learn more about how we can help, please contact us today to request a consultation.

Dr. Christopher McGowan
Dr. Christopher McGowan
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