Many people living with aspergillosis, bronchiectasis or ABPA notice their body shape changing as they get older — especially after 60.
A very common pattern is:

• Thinner hips and legs

• More weight around the waist or tummy

This can feel confusing, but there are clear reasons why it happens.

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1. Chronic lung conditions make it harder to keep leg and hip muscle

When you live with a long-term lung condition, you often have:

• Breathlessness

• Fatigue

• Repeated chest infections

• Less ability to walk long distances or climb stairs

Because the legs work harder than any other muscles, they are the first to lose strength and size when activity drops.
This is why many people notice:

• Slimmer thighs

• Smaller hips

• Feeling weaker when getting out of a chair

This is partly due to age, but it happens faster in people with chronic lung disease.

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2. Steroids can move weight from the limbs to the waist

Many aspergillosis patients have had:

• Several courses of prednisolone over the years

• High-dose inhaled steroids

• Hydrocortisone replacement for adrenal problems

Even short or occasional courses can cause fat redistribution, where:

• Fat and muscle reduce in the arms, hips and legs

• More fat settles around the stomach area

• The centre of the body becomes rounder even if the overall weight hasn’t changed much

This effect can continue long after stopping steroids.

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3. Ageing naturally shifts fat towards the waist

After about age 60, the body changes how it stores fat:

• Less around the hips and thighs

• More around the waist

• More “internal” fat around organs (visceral fat)

This happens to everyone, but can be more noticeable in people with aspergillosis because illness already reduces leg muscle.

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4. You can lose muscle even if weight on the scales stays the same

Many patients say,
“I feel thinner and thicker at the same time.”

That’s because:

• Muscle in the legs may be lost

• Fat around the waist may increase

• The total body weight doesn’t always change much

This is a normal pattern in long-term lung disease.

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5. Illness, flare-ups, infections and poor appetite add to this

During flare-ups or infections, it’s common to:

• Eat less

• Feel exhausted

• Lose muscle faster

• Keep or gain tummy fat

The body burns muscle first when unwell, not fat — especially not tummy fat.

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Is this dangerous?

Not usually on its own — but it does mean:

• Legs may feel weaker

• Balance and stamina can reduce

• It may be harder to stay active

Strength and gentle exercise (within your limits) can help rebuild some leg muscle.

If weight changes are sudden or unexplained, they should always be discussed with your GP or specialist.

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In summary

This body-shape change is very common in people with aspergillosis over 60.
It’s caused by a combination of:

• Reduced activity due to breathlessness

• Loss of leg and hip muscle

• Steroid effects on fat distribution

• Natural age-related changes

• Appetite changes during illness

It doesn’t mean you’re doing anything wrong — it’s simply a pattern seen in many people with long-term lung disease.