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Thursday, December 5, 2013
Asthma and Weight
I`m quite overweight and pretty inactive, I just recently been told I have asthma. I get a lot of sympathy from my husband and he helps out a lot because I tire easily. I`m in my early 30`s. Has my weight anything to do with my asthma? I can`t keep up with our two small children and my husband has to help their too, but when he is at work I need some other help..what can I do?
Obesity (defined as having a body mass index (BMI) of over 30; BMI = weight in kilograms divided by the square of height in meters) is clearly associated with numerous medical conditions, including hypertension, atherosclerosis,Type II diabetes, obstructive sleep apnea and more. Many of these conditions can predispose an individual to developing dyspnea (a sense of shortness of breath, or difficulty breathing). These often lead to progressive inactivity, which in turn results in deconditioning (i.e., getting more and more `out of shape`). This leads to a viscious cycle of decreasing exercise and work capacity, and increasing shortness of breath. Recent studies have suggested that in addition to the above, there may well be a link between obesity and asthma. In a recent study of nearly 86,000 female nurses between 26 and 46 years old, those who gained more than 25 kg in weight since age 18 had the highest risk of developing asthma (Carmargo et al, Arch Int Med vol. 159, no. 21 (1999 Nov 22): 2582-8). Other smaller studies have suggested that weight reduction is associated with an improvement of asthma in obese asthmatics. While experts have raised questions about some of the methods employed by these studies, it is fair to say that there is at least preliminary evidence to support the notion that asthma may indeed be exacerbated by morbid obesity. Given the above, it is clear from your description that a balanced program of diet and exercise would be in your best interest. Talk with your doctor about starting a modest daily exercise program, which for people with small children could begin with long (30 minutes or more) walks with the stroller. Whether this will improve asthma symptoms is not clear, but it likely will result in improved exercise tolerance and the ability to do more `activities of daily living` without breathlessness. Given your age, there is still plenty of time to improve things, but the problem will likely only worsen without a genuine effort on your part. Good luck!
Stuart Green, MD
Assistant Professor of Medicine and Pathobiology
College of Medicine
University of Cincinnati