The Role Obesity Plays in COPD

How Does Obesity Affect People Living with COPD?

obese woman
How are obesity an COPD related?. Photo: Chris Jackson / Getty Images

How does obesity affect people with COPD? Does losing weight really make a difference, and if so, how much? What is the best way to lose weight if you are coping with COPD?

Obesity and COPD

What do obesity and chronic obstructive pulmonary disease (COPD) have in common? First of all, they are both far too common. COPD is currently considered the third leading cause of death in the United States, behind only heart disease and cancer.

Not only is this too common, but it appears that mortality rates from COPD are increasing.

Obesity is harder to decipher as it's not often looked at directly as a cause of mortality. Yet obesity is a leading cause of heart disease (the leading cause of death in the United States) and is rapidly approaching (and perhaps passing smoking) as the leading cause of cancer; the second most common cause of death in the U.S.

Both COPD and obesity are increasing, but how are they tied together? What role does obesity play in COPD and how can COPD increase the risk of obesity? After all, the stereotypical person with COPD is underweight.

How Obesity Affects COPD

Despite any picture you have in your mind of the overly thin person puffing on oxygen, obesity plays an important and very significant role in chronic obstructive pulmonary disease (COPD.)

Although obesity, by itself, is not a risk factor for COPD, as it is for so many other conditions, there is clinical evidence that suggests an influential relationship between the two.

Obesity lends itself to a worsening of COPD symptoms, and a decrease in both exercise tolerance and quality of life. Weight loss, however, can provide significant, symptomatic improvement.

People with COPD who are overweight or obese are also at risk of obstructive sleep apnea.

How COPD Affects Obesity

Having COPD, likewise, can play a role in obesity.

If you have COPD, you know how much it can affect your exercise tolerance, and being sedentary is an important risk factor for obesity. For the same reason, trying to lose weight with COPD can be difficult.

Definition of Obesity

Obesity can be defined in relation to body mass index (BMI), which describes a relationship between weight and height. The following guidelines will help you determine if you are overweight or obese, according to a standard BMI chart.

  • Underweight: >18.5
  • Normal: 18.5 to 24.9
  • Overweight: 25 to 29.9
  • Obese: 30.0 or 39.9
  • Morbid obesity: 40 and higher

The BMI chart isn't perfect as it doesn't take into account body type and build, but it is a good place to start. You may wish to talk to your doctor, who can consider some of these other variables and give you an estimate of your ideal weight.

Obesity Statistics

With a BMI of 25 or greater defining overweight and a BMI over 30 signifying obesity, more than one billion people across the globe are either overweight or obese. Obesity is a significant risk factor for heart disease, diabetes, rheumatoid arthritis and cancer and is responsible for roughly 10 percent of health care costs. Yet how does it cause problems for people with COPD in particular?

The Effects of Obesity on Your Lungs

Being overweight or obese affects lung function in many ways. An overabundance of fat tissue, which occurs from obesity, impairs the breathing process in both adults and children. Obesity also leads to a reduction in several pulmonary function tests including:

  • Forced expiratory volume in one second (FEV1)
  • Forced vital capacity (FVC)
  • Total lung capacity (TLC)

Since carrying around excess weight increases the work of breathing, there is a direct association between obesity and shortness of breath, or dyspnea, which is also recognized as the hallmark symptom of COPD.

Obesity is also strongly associated with a decrease in exercise tolerance. Along with health problems associated with inactivity, being unable to exercise can severely impact quality of life.

Health Benefits of Weight Loss for People with COPD

Knowing that being overweight can worsen your symptoms, what benefits have been shown for those with COPD who have successfully lost weight? Some of these include:

  • An increased energy level
  • A reduction of cholesterol levels
  • A reduction in blood pressure
  • A reduction in pain
  • Improved mobility
  • Improved sleep
  • Prevention of angina, or chest pain caused by decreased oxygen to the heart
  • A decreased risk of sudden death from heart disease or stroke
  • A decreased risk of developing type 2 diabetes
  • Improved blood sugar levels

Success Strategies for COPD Patients Who Are Obese

Weight reduction, if you are overweight or obese, is the optimal health strategy for people who suffer with COPD. This can be done through a combination of diet, an increase in physical activity and (sometimes) medication. There are limited study results and recommendations about weight loss strategies for people with chronic respiratory illnesses, such as COPD. What we have learned is that setting up and maintaining an exercise program is critical to success. You will probably learn quickly that exercise helps people with COPD in many ways that go beyond weight control.

Incorporating pulmonary rehabilitation into your COPD treatment and weight loss plan hasn't been studied in detail but is likely to be helpful in many ways. A pulmonary therapist can work with you to find ways to improve your exercise tolerance.

Finding someone to exercise with is also a proven method of sticking with a program. It is more difficult to "give up" or begin skipping your exercise routine when you are accountable to another person.

The best types of exercise in the long run are going to be those that you enjoy the most. Think of activities you do which are active but which you do not usually view as "exercise." For some people it is walking. To add a little fun, you may want to start "geocashing." For others, it is gardening, and in fact gardening can be an excellent type of physical activity for weight loss and overall health. Take some time to learn about the best exercises for people with COPD.

With regard to diet, portion control is usually key. Rather than begin a "diet" think of lasting changes which you can make to your eating habits. As with exercise, if you can find a way to make eating healthy enjoyable, you're more likely to be successful. Trying new recipes out of a Mediterranean foods cookbook can be a great start.

Bottom Line on Obesity and COPD

It's fairly clear that obesity has a negative affect on those with COPD, and COPD can predispose a person to obesity due to exercise limitations. Weight loss can help, and should be focused on with a combination of both good dietary habits and physical activity.

Sources:

Kasper, Dennis L.., Anthony S. Fauci, and Stephen L.. Hauser. Harrison's Principles of Internal Medicine. New York: Mc Graw Hill education, 2015. Print.

O’Donnell, D., Ciavaglia, C., and J. Neder. When Obesity and Chronic Obstructive Pulmonary Disease Collide. Physiological and Clinical Consequences. Annals of the American Thoracic Society. 2014. 11(4):635-44.

Park, J., Lee, J., Heo, E., Kim, D., and H. Chung. The Effect of Obesity on Patients with Mild Chronic Obstructive Pulmonary Disease: Results from KNHANES 2010 to 2012. International Journal of Chronic Obstructive Pulmonary Disease. 2017. 12:757-763.

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