Respiratory impairment and obesity are very common especially when one is not active and does not live a healthy lifestyle

Respiratory impairment and obesity: The inclination of obesity with other diseases

Obesity is a worldwide public health problem, and it is even a bigger concern in the US with more than half of adults in the United States are believed to be overweight or obese. Like I have indicated earlier obesity is inclined with numerous medical diseases, including diabetes mellitus, hypertension, respiratory impairment, cardiovascular disease, stroke, dyslipidemia, osteoarthritis, cancer, obstructive sleep apnea, and gallbladder disease. It is also associated with several abnormalities of respiratory function. Obesity is characterized by altered respiratory system mechanics, resulting in decreased lung volumes. This is related to decreased chest wall compliance from an elastic load on the chest and abdomen as well as decreased lung compliance resulting from the closure of dependent airways.

Because of these abnormalities, a greater negative pleural pressure is needed to initiate airflow. Obese patients may also have reduced respiratory muscle strength. Respiratory system resistance is increased as a result of smaller airway caliber associated with decreased lung volumes. The resistance in the larger airways is typically normal. Some people with obesity may be hypoxemic, resulting from ventilation–perfusion mismatching, especially in the poorly expanded lung bases.

Obesity is a major cause of dyspnea, exercise intolerance, functional limitation, disability, and impaired quality of life. The following physiological conditions impair exercise tolerance:

• Pulmonary function and gas exchange derangements
• Increased metabolic rate relative to lean body mass
• High metabolic (oxygen) cost to perform modest exercise
• Exaggerated cardiorespiratory response to exercise
• Circulatory impairment (claudication, microvascular disease, or both)
• Cardiac impairment as a result of myocardial ischemia; pulmonary or systemic hypertension
• Reduced respiratory muscle strength
• Anxiety
• Mechanical inefficiency
• Musculoskeletal disturbances

Regular exercise is a crucial component of weight loss intervention programs. Exercise training, more so when put together with calorie restriction, can lead to decreased body weight and fat, increased fat-free mass, improved strength and endurance, and improved aerobic fitness. However, traditional weight loss programs are generally not configured to meet the needs of morbidly obese people or obese patients with gas exchange impairments or respiratory failure. Comprehensive pulmonary rehabilitation is better suited to meet these complex needs, utilizing its components of exercise training (including recommendations for long-term adherence), collaborative self-management education, nutrition counseling, and psychological support for anxiety and depression while closely monitoring the patient’s respiratory status. Pulmonary rehabilitation can lead to lower body weight and improved functional status and health status in obese patients.

Respiratory diseases and being obese: Pulmonary rehabilitation

Goals of pulmonary rehabilitation for obese people with respiratory impairment include the following:

• Increased exercise tolerance
• Weight loss
• Increased self-efficacy
• Decreased disability and return to ADLs, hobbies, and work
• Acclimatization to or optimization of use of CPAP or BiPAP
• Optimal utilization of assistive equipment (related to mobility, self-care, and hygiene), home care services, and outpatient resources

Additional special considerations apply to the rehabilitation of people with morbid obesity and people with severe obesity with concomitant lower-extremity musculoskeletal disturbances. In general, such rehabilitation requires special equipment that can accommodate people of extreme weight. Morbidly obese people may not be able to use standard exercise equipment such as cycle ergometers and treadmills. Staff members must be familiar with the weight limits of the equipment in their programs. Walking, low-impact aerobics and water-based activities are suitable forms of aerobic exercise for these patients. Experts’ at AWAREmed health and wellness resource center are highly trained to help get your health back if only you can schedule an appointment with doctor Dalal Akoury today.

Respiratory diseases and being obese: The inclination of obesity with other diseases

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