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A Total Diet Replacement Weight Management Program for Difficult-to-Treat Asthma Associated With Obesity: A
Varun Sharma1, Helen Clare Ricketts1, Louise McCombie2
1Institute of Infection, Immunity and InflammationSchool of Medicine, Dentistry and Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, Scotland; Clinical Research Facility, Glasgow Royal Infirmary, School of Health and Life Sciences, University of the West of Scotland, Glasgow, Scotland.
Chest
|January 17, 2023
Summary
The Counterweight-Plus Programme (CWP), a structured weight management program, significantly improved asthma control and quality of life in adults with obesity and difficult-to-treat asthma compared to usual care.
Area of Science:
- Pulmonology
- Obesity Medicine
- Clinical Trials
Background:
- Obesity is linked to severe, hard-to-manage asthma, increasing health risks.
- Weight loss shows potential for improving asthma, but optimal strategies remain unclear.
- The Counterweight-Plus Programme (CWP) offers a structured, dietitian-led total diet replacement (TDR) approach to weight management.
Purpose of the Study:
- To evaluate if the CWP improves asthma control and quality of life in obese adults with difficult-to-treat asthma.
- To compare the CWP against usual care (UC) in this patient population.
Main Methods:
- A 1:1 randomized controlled trial involving adults with difficult-to-treat asthma and a BMI ≥ 30 kg/m².
- The CWP group underwent a 12-week TDR phase followed by weight maintenance; the UC group received standard care.
- Primary outcome: change in Asthma Control Questionnaire 6 (ACQ6) score at 16 weeks. Secondary outcome: change in Asthma Quality of Life Questionnaire (AQLQ) score.
Main Results:
- Greater weight loss was observed in the CWP group (mean difference: -12.1 kg).
- Significant improvements in ACQ6 scores were seen in the CWP group compared to UC (mean difference: -0.69, P=0.048).
- A higher proportion achieved clinically important ACQ6 improvement with CWP (53% vs 19%), and AQLQ scores also improved significantly more (mean difference: 0.76, P=0.013).
Conclusions:
- Structured weight management via the CWP leads to clinically meaningful improvements in asthma control and quality of life for obese adults with difficult-to-treat asthma.
- The CWP is a generalizable and deliverable program for this challenging patient group.
- Longer-term outcomes are under ongoing investigation.
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