How Obesity Affects Asthma
Obesity is a significant risk factor for asthma, worse asthma symptoms, and poor asthma control, according to the Centers for Disease Control and Prevention (CDC). Data suggest that nearly 39 percent of Americans with asthma also have obesity.
“Obesity and diabetes may contribute to airway inflammation, which in turn can cause worse asthma symptoms,” says Jimmy Johannes, MD, a pulmonologist and a critical care medicine specialist at MemorialCare Long Beach Medical Center in California, who wasn’t involved in the new research.
Excess fat tissue in the abdomen contains a “significant amount” of inflammatory cells that can produce chemicals called cytokines that may spark inflammation throughout the body, explains Richard Siegel, MD, the codirector of the diabetes and lipid center at Tufts Medical Center and an endocrinologist at Tufts Medicine, both in Boston. Dr. Siegel was not involved in the new study.
“As asthma is also a disease associated with inflammation, the increase in cytokines related to obesity may contribute to asthma in people who may be genetically susceptible,” he says.
GLP-1 Medications May Improve Asthma Symptoms in Several Ways
GLP-1 drugs can reduce weight and improve blood sugar control, both of which could improve asthma, Bloom says. The weight loss linked with GLP-1 medications may help to reduce bodily inflammation, including in the airways, Johannes says.
“Furthermore, there are GLP-1 receptors in the lungs, so there is a question whether GLP-1 medications can have a direct effect on the lungs independent of weight loss,” Johannes says.
But doctors emphasize that these are only theories at this point.
The Study Has Strengths and Limitations
The study has not yet been peer-reviewed or published, which is the gold standard in research. It’s also an observational study, making it difficult to prove cause and effect. Instead, the results only demonstrate a link between the medications and fewer breathing episodes.
“We still need mechanistic studies and clinical trials to understand exactly how [GLP-1s] work and how much of the benefit is due to weight loss versus other effects,” Bloom says.
GLP-1s Won’t Erase the Need for an Asthma Inhaler
Steroid inhalers remain the first-line treatment for asthma. But other treatments can influence symptoms.
“Asthma is influenced by both genetic and environmental factors,” Siegel says. He notes that avoiding allergens and environmental triggers, along with optimal nutrition and exercise, may help with symptoms of the condition. Inhalers and oral and injectable medications typically help with inflammation as well, Siegel says. GLP-1 medications may play a role, too, but more research is needed.
“People with asthma should not start GLP-1 receptor agonists specifically for their lung condition outside current prescribing guidance,” Bloom says.
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