|Year : 2022 | Volume
| Issue : 3 | Page : 81-82
Impact of obesity on respiratory health
From The Editorial Desk
|Date of Submission||03-Aug-2022|
|Date of Acceptance||05-Aug-2022|
|Date of Web Publication||17-Aug-2022|
Dr. Safreena Mohamed
Department of Pulmonary Medicine, Government Medical College, Kozhikode, Kerala
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mohamed S. Impact of obesity on respiratory health. J Adv Lung Health 2022;2:81-2
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., 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.
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.
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. 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.,
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.
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.
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