TOPLINE:

Metabolic and bariatric surgery (MBS) was associated with remission of asthma and enhanced pulmonary function in patients with obesity and asthma. Nearly half of patients discontinued medication for asthma, and more than half achieved clinical remission of asthma following MBS.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis of 33 observational studies to evaluate the effectiveness of MBS on asthma in patients with obesity.
• Data of 3731 adults with obesity (BMI ≥ 30) and asthma who underwent MBS were analysed, with studies including various surgical procedures such as Roux-en-Y gastric bypass, laparoscopic sleeve gastrectomy, laparoscopic adjustable gastric banding, and biliopancreatic diversion with a duodenal switch.
• Participants had a mean age of 34.3-63.4 years, with 49%-100% being women, the baseline preoperative BMI ranging from 39.2 to 61.0, and the postoperative BMI ranging from 28.4 to 41.1.
• Remission of asthma, defined as the absence of asthma symptoms, discontinuation of medication for asthma, or both (determined by clinician assessment or patient self-reporting), and improvement in lung function were assessed.
• Pulmonary function was assessed using forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), and the FEV₁/FVC ratio, with the mean follow-up duration between the index surgery and asthma assessment ranging from 6 months to 8 years.

TAKEAWAY:

• A pooled analysis revealed that 47% of patients discontinued medication for asthma following MBS (P < .05), with significant statistical heterogeneity among studies (I², 76.9%), and 58% of patients achieved clinical remission of asthma (P < .05; I², 78.9%).
• MBS was associated with an 8.5% increase in FEV₁ in a pooled mean difference analysis (P < .05; I², 93%).
• A 9.4% increase in FVC was observed after MBS (P < .05; I², 42.9%), whereas no significant change was observed in the FEV₁/FVC ratio.

IN PRACTICE:

"These associations should not be interpreted as causal due to the heterogeneity across the studies," the authors of the study wrote.

SOURCE:

The study was led by Angel Alois Osorio Manyari, Service of Surgery, Hospital Don Benito-Villanueva, Don Benito, Spain. It was published online on May 19, 2026, in Obesity Surgery.

LIMITATIONS:

The study included only observational studies due to the absence of randomised controlled trials. Out of the 33 studies included, 12 were rated as having fair quality due to issues in their methodologies, and 28 of them included fewer than 50 patients, with a predominance of female participants across all studies. None of the studies conducted subgroup analyses based on phenotype/endotype classifications, the severity of asthma, or obesity complications such as gastroesophageal reflux or smoking status.

DISCLOSURES:

No specific grants from funding agencies in the public, commercial, or non-profit sectors were received for this investigation. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.