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EDITORIAL
Year : 2022  |  Volume : 2  |  Issue : 3  |  Page : 81-82

Impact of obesity on respiratory health


From The Editorial Desk

Date of Submission03-Aug-2022
Date of Acceptance05-Aug-2022
Date of Web Publication17-Aug-2022

Correspondence Address:
Dr. Safreena Mohamed
Department of Pulmonary Medicine, Government Medical College, Kozhikode, Kerala

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jalh.jalh_25_22

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How to cite this article:
Mohamed S. Impact of obesity on respiratory health. J Adv Lung Health 2022;2:81-2

How to cite this URL:
Mohamed S. Impact of obesity on respiratory health. J Adv Lung Health [serial online] 2022 [cited 2022 Sep 25];2:81-2. Available from: http://www.jalh.com/text.asp?2022/2/3/81/353870



The global prevalence of obesity is on the rise and has reached epidemic proportions in recent years. The World Obesity Atlas 2022 predicts that over a billion people worldwide will be living with obesity (body mass index [BMI] ≥30 kg/m2) by 2030. The rise in obesity has naturally created larger populations with respiratory problems linked to obesity.

The mechanical, as well as inflammatory, effects of obesity can alter lung function. In addition to BMI, the pattern of obesity also needs to be assessed. Central or android obesity, characterized by the distribution of excessive adipose tissue in the visceral organs, thorax, and abdomen, negatively impacts lung mechanics more than peripheral or gynoid obesity. Obesity can cause increased airway resistance and reduced respiratory system compliance and respiratory muscle strength. In morbidly obese (BMI ≥40 kg/m2) individuals, tidal volumes are often reduced with increased respiratory rates. The impaired respiratory mechanics may cause a reduction in functional residual capacity (FRC) and expiratory reserve volume.[1],[2] As visceral fat is metabolically more active than subcutaneous fat, central obesity causes more inflammation as well. The anti-inflammatory adipokine adiponectin is markedly reduced while the proinflammatory adipokine leptin is increased in obese patients.[3]

It has already been well established that obesity can lead to obstructive sleep apnea and obesity–hypoventilation syndrome. Deposition of fat in the parapharyngeal region causes the airways to collapse easily, especially during sleep when there is a reduction in neuromuscular tone. Reduced FRC also lowers the tracheal traction on the pharynx, accentuating the pharyngeal collapsibility.[4]

Obesity may increase the prevalence and severity of asthma, and weight loss results in better asthma control in obese individuals. The mechanical changes altering lung function may cause symptoms that simulate asthma.[5] An interesting observation noted in chronic obstructive pulmonary disease (COPD) patients is the possible existence of an Obesity Paradox. Although obesity is associated with reduced exercise capacity, poor quality of life, more dyspnea, and an increased risk of exacerbations, obese COPD patients have demonstrated reduced in-hospital mortality.[6],[7]

Obesity is a well-recognized risk factor for the development of both community-acquired and health care-associated pneumonia. However, there are conflicting results regarding obesity and pneumonia outcomes. Obese patients with sepsis are at a higher risk for the development of acute respiratory distress syndrome and prolonged mechanical ventilation. The higher morbidity and mortality associated with COVID-19 infections in the obese population has indeed reinforced the need to treat obesity effectively. Obesity is associated with a hypercoagulable state and is an independent risk factor for deep vein thrombosis and pulmonary embolism.[8]

Obesity is a complex, multifactorial disease and not just a state of excess fat deposition. Measurement of BMI alone is not a reliable predictor of metabolic health. Obesity is a potentially reversible and treatable risk factor for a wide spectrum of diseases. Weight loss can improve treatment outcomes in a large number of obesity-related respiratory disorders. Comprehensive policy approaches and social support programs to prevent and treat obesity are non-existent in most countries and must be developed to combat the obesity epidemic.



 
  References Top

1.
Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med 2018;12:755-67.  Back to cited text no. 1
    
2.
Littleton SW. Impact of obesity on respiratory function. Respirology 2012;17:43-9.  Back to cited text no. 2
    
3.
Palma G, Sorice GP, Genchi VA, Giordano F, Caccioppoli C, D'Oria R, et al. Adipose tissue inflammation and pulmonary dysfunction in obesity. Int J Mol Sci 2022;23:7349.  Back to cited text no. 3
    
4.
Nousseir HM. Obesity: The major preventable risk factor of obstructive sleep apnea. J Curr Med Res Pract 2019;4:1-5.  Back to cited text no. 4
  [Full text]  
5.
McClean KM, Kee F, Young IS, Elborn JS. Obesity and the lung: 1. Epidemiology. Thorax 2008;63:649-54.  Back to cited text no. 5
    
6.
Lambert AA, Putcha N, Drummond MB, Boriek AM, Hanania NA, Kim V, et al. Obesity is associated with increased morbidity in moderate to severe COPD. Chest 2017;151:68-77.  Back to cited text no. 6
    
7.
Yamauchi Y, Hasegawa W, Yasunaga H, Sunohara M, Jo T, Takami K, et al. Paradoxical association between body mass index and in-hospital mortality in elderly patients with chronic obstructive pulmonary disease in Japan. Int J Chron Obstruct Pulmon Dis 2014;9:1337-46.  Back to cited text no. 7
    
8.
Murugan AT, Sharma G. Obesity and respiratory diseases. Chron Respir Dis 2008;5:233-42.  Back to cited text no. 8
    




 

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