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A kid with asthma has a greater risk of being obese than one without, according to a recent study in the American Journal of Respiratory and Critical Care Medicine.

In a study of nearly 2,200 elementary school students in California, childhood asthma was linked to a 51 percent increased risk of obesity over the next 10 years, researchers found. The silver lining: those who used quick-relief inhalers were less likely to become obese, compared with those who didn’t properly treat flare-ups.

What may be to blame for the obesity and asthma link? For starters, kids play outside less when they’re more likely to have asthma flare-ups.

Sleep disturbances—a risk factor for obesity—are common with asthma. Weight gain also happens to be a side effect of many asthma meds.