Obesity in Asthma: Approaches to Treatment
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There is mounting evidence that obesity is associated with asthma, both of which are seeing a dramatic increase in prevalence. Not only is obesity a risk factor for the development of asthma but it is also associated with poor asthma control. Asthma phenotypes associated with obesity include early-onset allergic asthma and late-onset non-allergic asthma. The pathogenesis of the linkage is complex; obesity causes a variety of mechanical, metabolic, and immunological changes that can affect the airways. The treatment of asthma in obesity can be challenging, as obesity is associated with poor response to standard controller medications. A tailored approach that involves combining pharmacologic and non-pharmacologic therapies including weight loss, dietary interventions, and exercise, along with identification and treatment of obstructive sleep apnea, should therefore be considered in this population.
KeywordsAsthma Obesity Lung function Inhaled corticosteroids Leukotrienes Gastro-esophageal reflux disease GERD Obstructive sleep apnea Treatment Weight loss Exercise Comorbidities
Anne E. Dixon has received grant support from the National Institutes of Health.
Conflict of Interest
Anne E. Dixon has served as a consultant for Boehringer Ingelheim.
Shyamala Pradeepan and Garth Garrison declare that they have no conflict of interest.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
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