Effect of Surgically Induced Weight Loss on Asthma in the Morbidly Obese

Abstract

Forty morbidly obese asthmatic patients who underwent gastric restrictive surgery more than 2 years earlier were evaluated to determine the influence of weight loss on asthma outcome. Mean percentage excess weight loss in this group was 68% and body mass index (BMI) fell from a mean of 46 to 30. Following surgery, 90% showed improvement in asthma symptoms. Complete remission of asthma occurred in 48% and a further 12.5% became asthma free on reduced medications dosage. Of those taking daily medications for asthma before surgery, 42% were completely off medication following weight loss surgery, and another 18.5% experienced fewer asthma attacks on reduced medication dosage. Of the 22 patients with severe asthma (> 10 attacks per year) on routine daily medications for asthma preoperatively, 8(36%) required no medication after surgery, 7(32%) used medication only on an 'as-needed' basis, and 7(32%) controlled their asthma on reduced medication dosage. Five patients gained weight during the follow-up period. All developed an increased incidence of asthma attacks, which again abated after successfully losing weight following revisional surgery. Coexistent factors of smoking and clinically apparent esophageal reflux were evaluated, but no statistically significant correlation was shown with either smoking or reflux and improvement in asthma. Possible etiologies of the improvement in asthma with weight loss are discussed

Excessive body weight is associated with additional loss of quality of life in children with asthma

“…26 In adults, a reduction in excessive body weight by medical treatment and surgical procedures has resulted in a reduction of asthma symptoms, medication usage, and severity, and in improvement of lung function, indicating a possible causal relationship. [27][28][29] When considering our results, some possible limitations of this study should be discussed. First, the ISAAC questionnaire used in this study depended on the recall of asthma symptoms by parents.…”

“…14,15 Data on the effect of asthma in children with excessive body weight in the 62 (45) 7 (27) 73 (45) 9 (41) *n, Absolute number for the weight or disease group. %, Percent of total weight or disease group; however, because of missing values, data can be lower or higher than calculated.…”

Effect of obesity on asthma among adult Indian women

“…28 Moreover, several prospective studies of obese asthmatics have shown that weight reduction leads to improved pulmonary function, and reduced severity and frequency of asthma symptoms. [29][30][31][32][33] The evidence of a relationship between obesity and asthma is not conclusive, however. Several studies find a relationship between obesity and asthma only in females, not in males.…”

Influence of body mass index on the response to asthma controller agents

“…In fact, a nexus of these two epidemics exists [22], as shown by the recognition from a number of epidemiological studies (although not all studies [22]) that obesity is associated with an increased relative risk of asthma in both adults [21,[23][24][25][26] and children [27][28][29][30]. A more limited body of evidence suggests that obesity may also increase the severity of asthma, as weight loss by various means resulted in improved disease control in several small series [31][32][33][34][35]. However, the present authors are unaware of any studies that have explored the possibility that obesity might influence therapeutic responsiveness either to asthma medications or to the placebo itself.…”