Children with early-onset asthma who are overweight or obese may mistake exertional dyspnea and esophageal reflux for loss of asthma control, causing them to use more rescue medication. In a study published in the Journal of Allergy and Clinical Immunology, researchers assessed the differences between lean and overweight/obese pediatric patients (10–17 years of age) with persistent, early-onset asthma. Compared to lean asthmatic children, overweight/obese children reported shortness of breath more often and used their rescue medication more than three times as often. Overweight/obese children also had higher GERD scores; which appear to mediate overweight/obesity asthma symptoms. Because overweight/obese asthmatic patients may frequently misinterpret their symptoms, the authors suggest respiratory physicians discuss alternative causes of dyspnea and when rescue medication use is appropriate. Ultimately, these patients may require weight loss to improve their asthma-related symptoms and esophageal reflux.
Past studies of asthma in overweight/obese children have been inconsistent. The reason overweight/obese children commonly report worse asthma control remains unclear.