Managing obesity as a treatable trait of obstructive airway diseases

Obesity is a non-communicable chronic disease that is growing in prevalence in all regions of the world. In adult populations obesity rates have doubled since the 1990s. Defined as an excess in fat deposits that deleteriously effect health, obesity is complex and leads to multimorbidity, and death from disease. In people with obstructive airway diseases, obesity is even more common and negatively impacts outcomes for people living with these coexisting diseases. Treatable Traits is a personalised medicine approach to managing obstructive airway diseases, focusing on clinically relevant traits that are identified in individuals followed by the application of individualised interventions. In airway diseases traits are grouped within three domains: pulmonary, extra-pulmonary and behavioural/risk-factors. Obesity is a key extra-pulmonary trait which we purpose to be a super trait due to its impact on individuals living with the disease and the major improvements gained from successful treatment. In this review we explore the clinical relevance of obesity as a treatable trait of obstructive airway diseases, the optimal approach to measuring and treating obesity, the mechanisms, and the person-centred recommendations for shared decision making. All these areas enable the management of obesity as a treatable trait.