Asthma Misdiagnosed in the Overweight

What came first, the asthma or the weight?

Are you carrying a few extra pounds? Those pounds could cause you to be diagnosed with asthma when something else is really the problem. In fact, researchers discovered that as many as 60 percent of overweight individuals with an asthma diagnosis didn't have the condition at all.

The author of the study, Dr. Chirag Mehta, is a pulmonary critical care doctor at Newark Beth Israel Medical Center in New Jersey. Dr. Mehta's study shows that the obese can have symptoms that are similar to asthma but are actually caused by the extra weight. For example, patients may have shortness of breath from lack of exercise, and wheezing could be caused by acid reflux disease. Dr. Mehta cautions physicians to look carefully at patients who have an increased Body Mass Index (BMI).

Asthma is a disease on the rise. About 1.5 million hospital emergency room treatments per year in the US are related to asthma. Rates of asthma are also escalating - in the time period between 1980 and 1994, asthma diagnoses skyrocketed by 75 percent. However, whether or not each diagnosis of asthma is accurate is something that can't really be proven.

Studies have linked asthma and obesity, but the question is whether the weight or the asthma comes first. Some asthma treatments actually cause patients to gain weight, such as steroid drugs. When patients increase their weight, their asthma symptoms usually worsen. When morbidly obese patients lose weight through bariatric surgery, often asthma symptoms are relieved. Again, it comes down to whether or not the original asthma diagnosis was correct.

This was the inspiration for Dr. Mehta's study. To determine if asthma really is prevalent in the overweight, Mehta took 20 people who had a diagnosis of asthma but had lung-function that indicated they might not have the disease. Of the group, 90 percent were overweight, and of those, 60 percent were clinically obese.

A test was administered to these people in an attempt to provoke an asthma reaction. Of the test subjects, less than 40 percent had an asthma reaction. So, of patients in the study with an asthma diagnosis, more than 60 percent had been misdiagnosed.

So, how does an overweight person get diagnosed with asthma? Apparently, the increased weight on the body contracts the space for the lungs and prevents them from expanding fully. In addition, some types of high blood pressure or untreated heart disease, which are associated with weight problems, can be the reason behind wheezing.

News Release, October 25, 2006

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