Risk of asthma exacerbation decreases after bariatric surgery

Published Online Febraury 7, 2015

Asthma and obesity are important public health problems in the US. However, little is known about the impact of weight reduction on patients with asthma. Previous clinical trials of non-surgical weight loss interventions have failed to show consistent efficacy on asthma control—though these interventions resulted in only modest weight reductions. Therefore, it is possible that the amount of weight reduction achieved by these non-surgical measures was too small to improve asthma control. In contrast, among the various approaches to weight loss, bariatric surgery—an operation in which the size of a person’s stomach is reduced—is the most effective option for morbidly obese patients.

In an article recently published in The Journal of Allergy and Clinical Immunology (JACI), Hasegawa and colleagues examined whether bariatric surgery would be associated with a rapid and sustained decrease in patients’ risk of experiencing an asthma exacerbation—and subsequent emergency room visits, or hospitalization. The investigators conducted a self-controlled case series study of 2,261 obese adults with asthma who underwent bariatric surgery, using the population-based emergency department and inpatient sample in three states (California, Florida, and Nebraska). Primary outcome was emergency department visit or hospitalization for asthma exacerbation from 2005 through 2011.

This study of 2,261 obese patients demonstrated that bariatric surgery was associated with decreased risks of emergency department visit or hospitalization for asthma exacerbation; this risk reduction was sustained for at least two years after bariatric surgery.

The authors’ data support the effectiveness of large and sustained weight loss on the reduction of asthma morbidities. Because the benefit of bariatric surgery may be offset by initial high cost and risks of surgical complications, these findings also emphasizes the importance of developing safe, effective, non-surgical approaches to achieve major weight loss, which would likely benefit millions of obese individuals with asthma.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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