When it comes to asthma and appetite, doctors and dietitians worry most about patients who eat too much, shun exercise for fear of becoming breathless, and end up being overweight.
But in a small minority of patients, poorly controlled asthma can leave them too breathless and fatigued to eat properly. Furthermore, a few asthma medications can cause upset stomachs or thrush infections in the mouth, leading to poor appetite.
Asthma is the leading cause of chronic illness in children. It affects more than one of every 10 children in the U.S., and, for unknown reasons, it is steadily increasing. It can begin at any age, but most children have their first symptoms by age 5.
“As a group, asthmatics are overweight,” says Karen McCoy, MD, chief of the division of pulmonary medicine at Nationwide Children’s Hospital in Columbus, Ohio.
Parents of children with asthma often excuse them from physical activity if they complain of shortness of breath, she says. Although most asthma drugs, including inhaled steroids, typically don’t affect appetite, oral steroids can make some children eat more than double their usual amount, she says.
Carrie Gleeksman, MS, RD, works with many adult asthma patients who are on long-term oral steroids such as prednisone at National Jewish Health, a respiratory hospital and research center based in Denver, She has seen long-term use of these asthma drugs have dramatic effects on patients.
“Prednisone has a number of side effects that impact their nutritional status,” Gleeksman says. “The biggest one is significant weight gain, partly due to an increase in appetite from the prednisone, partly due to the way the medication works and slows down the metabolism and leads to fluid retention.”
“Weight loss in that population is no different than weight loss in any other population: balanced diet, increased activity, decreased calories -- basically, the same thing that everybody knows,” Gleeksman says.
Asthma May Also Cause Poor Appetite
Although it’s much less common, some asthma patients have poor appetite.
Loss of appetite “is usually a signal that the asthma is not well controlled, not adequately treated,” McCoy says. If patients are not breathing well, their lungs can become hyper-inflated, she says. “They get full faster since their diaphragms under the lungs are pushing down on the stomach and it may not feel comfortable to their breathing to over-fill themselves.”