Most people know about the usual weight gain suspects — eating too much unhealthy food or spending too much time on the couch, for instance. But people with asthma need to watch out for an additional factor — their medication. Weight gain is an unfortunate side effect of oral steroids, taken in pill or inhaler form to treat asthma.
There is a proven link between weight gain and oral steroids, says Christine Gerbstadt, MD, RD, registered dietitian and spokesperson for the American Dietetic Association. The reason? “Steroids simply increase your appetite,” says Dr. Gerbstadt, adding that steroids raise blood glucose levels and cause other metabolic changes that not only put the patient at risk of gaining weight, but perhaps even developing diabetes.
Weight gain is a less common medication side effect when steroids are taken through asthma inhalers as opposed to oral medications because the doses administered through asthma inhalers are far lower and go straight to the lungs, explains Gerbstadt.
In contrast, other asthma medications such as beta-agonist bronchodilators, which relieve the symptoms of asthma by relaxing the muscle of the bronchial tubes, are not associated with weight gain, but they have their own medication side effects. “Beta-agonists can cause jitteriness, dilate pupils, and increase heart rate,” says Gerbstadt.
There is also an unhealthy cycle connected to asthma and weight. People with asthma may be reluctant to exercise for fear of triggering their asthma symptoms. Lack of exercise can contribute to weight gain. And being overweight can, in turn, make exercise more difficult because excess weight can compress your lungs and make breathing during exercise more difficult. Weight loss, therefore, can help improve your asthma and help improve your workouts.
• Eat less. To prevent weight gain, people with asthma should first and foremost eat less, says Gerbstadt. Cutting back is important, she says, but understands that it’s easier said than done. “Most people are not used to going hungry.”
• Eat lots of veggies. Crunchy, water-filled vegetables such as celery or carrots are an excellent choice.
• Include whole grains in your diet. “People worry about carbs, but if all you ate were brown rice and whole-grain bread, you could eat a lot without worry about weight gain,” says Gerbstadt.
• Find good flavorings. If you need to use dips or other flavorings to jazz up veggies, try salsa or low-fat marinara sauce. Other good options include hummus and yogurt.
• Drink plenty of water. “A lot of people mistake thirst for hunger,” says Gerbstadt. “Drink room temperature water, which is more filling than ice water.” Other good options for hydration are herbal or green tea or warm broth, which can help make you feel full, says Gerbstadt.
• Cut down on fat. Air-popped popcorn or baked potatoes with yogurt instead of chips are great snack choices, says Gerbstadt. Use herbs and spices to flavor food instead of cream or butter.
• Relearn portion sizes. Find out what foods and in what amounts you should be eating and stick to those recommendations.
• Don’t forget to move. “Walk. Do jumping jacks when you’re watching TV and commercials are on — it all adds up,” says Gerbstadt.
Gerbstadt’s advice is followed within her own family — her son, now 6 years old, has. “His asthma started off when he had a cold, and then would go away,” Gerbstadt explains. To better manage his asthma, he eats a healthy diet, a habit that was fostered at a young age. “He likes to eat grilled fish with veggies,” says Gerbstadt.
The youngster follows a three-pronged approach to staying healthy with asthma — he participates in sports, follows a nutritious diet, and manages his asthma, and weight gain has not been an issue for him, she says.
No matter what your age, choosing foods wisely and getting regular exercise are important lifestyle habits for preventing weight gain and living well with asthma.
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