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Review
. 2017 Apr;17(2):123-130.
doi: 10.1097/ACI.0000000000000339.

The effect of obesity, weight gain, and weight loss on asthma inception and control

Erick Forno  1 , Juan C Celedón
Affiliations
Review

The effect of obesity, weight gain, and weight loss on asthma inception and control

Erick Forno et al. Curr Opin Allergy Clin Immunol. 2017 Apr.

Abstract

Purpose of review: There is ample and growing evidence that obesity increases the risk of asthma and morbidity from asthma. Here, we review recent clinical evidence supporting a causal link between obesity and asthma, and the mechanisms that may lead to 'obese asthma'.

Recent findings: Although in some children obesity and asthma simply co-occur, those with 'obese asthma' have increased asthma severity, lower quality of life, and reduced medication response. Underlying mechanistic pathways may include anatomical changes of the airways such as obstruction and dysanapsis, systemic inflammation, production of adipokines, impaired glucose-insulin metabolism, altered nutrient levels, genetic and epigenetic changes, and alterations in the airway and/or gut microbiome. A few small studies have shown that weight loss interventions may lead to improvements in asthma outcomes, but thus far research on therapeutic interventions for these children has been limited.

Summary: Obesity increases the risk of asthma - and worsens asthma severity or control - via multiple mechanisms. 'Obese asthma' is a complex, multifactorial phenotype in children. Obesity and its complications must be managed as part of the treatment of asthma in obese children.

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Conflict of interest statement

Conflicts of interest: None.

Figures

Figure 1
Figure 1. Multifactorial effects of obesity on childhood asthma
The figure depicts several mechanisms by which obesity affects asthma and asthma morbidity, with particular emphasis on pathways that have been the focus of research over the past 1–2 years, as described in this review.
See this image and copyright information in PMC

References

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