Two common problems in pulmonary medicine are asthma and the effect obesity has on it. Obesity now affects approximately 42% of US adults. In addition, the presence of so-called “metabolic syndrome” affects approximately 60% of all obese individuals.
Obesity-related asthma results from various factors, including insulin resistance and a poorly regulated metabolism. Many patients with asthma have a more severe disease profile that does not fully respond to the usual treatments if they are obese. The rates of exacerbations in the obese asthmatic are higher.
Weight loss can lead to improved outcomes, particularly if the poorly regulated metabolic issues are improved. However, weight loss is difficult to achieve, and even harder to maintain. Therefore, any new, reasonable, and safe therapeutic options need to be considered. Surgically induced weight loss can be effective initially, but data indicates that most patients do not maintain the weight loss achieved. Dieting works, but at a slower pace, and requires a significant and prolonged commitment to a lifestyle change on the part of the patient.
Recently, investigations into the use of drugs associated with diabetic control have been shown to be helpful in obese patients, and have been studied in obese asthmatics to help control the rates of exacerbation. These new drug therapies block receptors for a compound called glucagon (GLP1-RA). They have been shown, in studies, to help reduce weight by themselves, or in combination with other medications and subsequently reduce the rate of asthma exacerbations in obese asthmatics.