Effect of Weight Loss on Asthma in Obese Adult Patients With Asthma: A Systematic Review and Meta-Analysis.

Abstract

Given its substantial impact on asthma, obesity is regarded as a treatable trait in asthma management. This systematic review and meta-analyses aim to assess weight loss intervention effects on asthma control in obese adults with asthma. We searched databases until February 2025 for English-language randomized controlled trials assessing weight loss influence on asthma control, quality of life, or lung function in obese adults. Six studies with 522 participants were included. Effect sizes were pooled as mean or standardized mean difference. Weight reduction over 12 to 24 weeks significantly improved Asthma Control Questionnaire score (-0.75; 95% confidence interval [95% CI] -0.91 to -0.59; I² = 0.0%) and quality of life (1.05; 95% CI 0.17-1.93; I² = 86.4%). Lung function also improved, with a mean forced expiratory volume in 1 second increase of 4.65% (95% CI 2.96-6.33; I² = 0.0%). However, benefits were not sustained at the 52-week follow-up, showing no significant changes in asthma control (-0.67, 95% CI -1.48 to 0.14; I² = 5.2%) or quality of life (0.05; 95% CI - 0.15 to 0.26; I² = 0.8%). Subgroup analysis revealed that participants achieving 10% or greater reduction experienced marked asthma control improvements (-1.37; 95% CI -1.55 to -1.20; I² = 0.0%). Weight reduction over 12 to 24 weeks significantly improves asthma control, quality of life, and lung function, with pronounced benefits in individuals losing 10% or greater baseline weight. Effects were not maintained at 52 weeks, indicating sustained weight management necessity for preserve long-term benefits. Nevertheless, available data remain limited because findings primarily address short-term outcomes and were based on limited number of patients.