Weight Management in Children who have Asthma and Comorbid Overweight/ Obesity

Abstract

Children living with asthma have an increased risk of overweight/obesity, and consequently, a greater prevalence and severity of asthma symptoms. Nevertheless, research on comorbid asthma and obesity, and how to optimise weight management support in this population, remains limited. This thesis uses a mixed-methods approach, including a systematic review, qualitative interview studies and questionnaire research, to explore the asthma-obesity relationship and to develop an asthma-specific weight management intervention. The systematic review highlights the potential to improve asthma outcomes through weight management; however, limitations in existing research mean it is not possible to identify optimal health behaviour theories or behaviour change techniques to do so. Findings from the qualitative research indicates that families and healthcare professionals recognise the multifaceted nature of comorbid asthma and obesity and that families’ perceptions of asthma control could influence their engagement with weight management behaviours. Questionnaire findings corroborate reports of an interdependent relationship between asthma and overweight/obesity. Parents of children living with asthma reported significantly greater use of unhealthy feeding practices, such as using food to regulate emotions and restricting food for weight control, monitoring of child activity levels, pressure to exercise and control over child activity than parents of children without asthma. Asthma control was found to moderate a positive relationship between specific concerns about asthma medication and parental control of active behaviours, and parental asthma-related anxiety with the use of food to regulate emotions in the inadequately controlled asthma sample. Findings from this formative research were synthesised, and used to develop a theory-informed asthma-specific weight management intervention. This thesis demonstrates the necessity of bespoke weight management support for paediatric asthma and concludes with recommendations for future research and practice.