Sally Edwards was in for a shock when the nurse at her asthma clinic asked her to step on to the scales.
My doctor had retired and I changed to a new surgery where they had an asthma clinic, says Sally, 45, a hairdresser from Aldington in Kent.
They saw on my notes that I suffered from asthma, but this was the first time anyone in the medical profession had weighed me.
She took a sharp breath and made a face, so I knew it wasnt good news, says Sally.
Like many women, she usually avoided the scales, and was appalled to discover her weight had shot up to more than 11st. At only 5ft 2in tall this made her officially obese.
The problem was that I didnt feel fat because the weight had crept on so gradually during and after my pregnancies, says Sally. Then when the children left things on their plates, Id pick at the leftovers.
Sally was also struggling increasingly to manage her asthma, making simple tasks such as walking up the stairs and looking after her children, Maizie, now 12, and Merrin, nine, more difficult.
The asthma clinic nurse advised her to lose weight and said it would reduce her asthma symptoms. It was a real wake-up call, says Sally. I knew that I had to do something about it or my asthma would just get worse because I would become more immobile and reluctant to exercise.
There is a clear link between obesity and asthma attacks, as Deborah Waddell, clinical lead nurse at the charity Asthma UK, explains: Obese people find their asthma much harder to control.
It seems they dont respond as well to treatment as people who are a healthy weight. Indeed, a recent study by Royal Brompton Hospital in London, involving more than 600 patients at severe asthma clinics across the UK, found that patients with a BMI of more than 30 were more likely to need the steroid prednisolone - used to reduce inflammation in the airways - and to resort to their inhalers more often.
But as Dr Andrew Menzies-Gow, a consultant in respiratory medicine at Royal Brompton, says: Unfortunately, one of the side-effects of prednisolone is increased appetite and weight gain, so patients are more inclined to find activity difficult.
Its a vicious circle, but if an asthma sufferer can break that cycle and lose weight, the benefits will be obvious.
Sallys asthma started when she was 19, triggered by a severe bout of flu. Upper respiratory infections are often caused by cold and flu viruses and are a common trigger of asthma.
Sally lost a stone-and-a-half and it made a huge difference, bringing the asthma under control I had the flu jab when I was 19, but I was one of the unlucky people who contracted the flu badly, she says.
Her asthma started to affect her daily life. Getting up the stairs was very scary because the wheezing was so loud. And it stayed at the same level in my 30s and into my 40s. I couldnt run after the children at the park.
Since being diagnosed with asthma, Sally has used a brown preventer inhaler each morning to build up a constant level of protection and a stronger, fast-acting Ventolin version when symptoms worsen. This would tend to happen in winter, and also if she was stressed or had been in contact with pet hair, particularly rabbits.
As well as losing weight, Sally embarked on an exercise regimen - which can be a brave step for an asthma sufferer, as many worry that increased activity will spark an attack.
But, in fact, exercise is good for asthmatics because it improves their lung capacity. Done carefully, it shouldnt be risky. And, for Sally, the regimen has been a life-changer.
After seeking advice from the Asthma UK website, she took up jogging.
As well as running four miles three times a week, she started going to a weekly spinning class, while cycling short distances instead of using the car soon became part of her routine.
I lost a stone-and-a-half in eight months and it made a huge difference, says Sally.
It really brought the asthma under control and made the attacks less frequent and less severe - I have just one a month instead of three a week.
She can now also run up the stairs. When I was 11st, my body was struggling to cope with the weight, especially climbing stairs, but the fitter you are, the stronger your lungs become.
Sallys experience is backed up by Asthma UK.
If you can exercise, this will expand the airways, and improve your lung function, says Deborah Waddell. Following a low-fat, low-sugar diet and getting rid of weight, especially around the middle, will make a big difference. Its all about changing your behaviour and lifestyle.
Andrew Menzies-Gow suggests that people with asthma should look closely at their whole lifestyle, stop smoking, avoid pets which aggravate the condition, and take up exercise gradually, especially walking, swimming and cycling.
When it comes to exercise, he recommends taking a friend with you when you first start, stopping your work-out to rest if wheezing starts and choosing gentle, age-appropriate exercises to begin.
Weight loss and exercise are not a magic bullet for asthma, but they can help enormously, adds Dr Menzies-Gow.
As for Sally Edwards, shes delighted that her asthma is now under control.
But that day at the asthma clinic is so vivid and humiliating that she still steers clear of the scales.
I still dont weigh myself very often, but now I have a pair of size 12 jeans and I try them on once a week.
I know that if they dont fit then I have to try just that bit harder to keep the weight off, she says.
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