Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Nov 1;44(6):417-424.
doi: 10.1097/HCR.0000000000000913. Epub 2024 Oct 31.

The Obesity Paradox in Pulmonary Rehabilitation: Relevance and Implications to Clinical Practice

Abebaw M Yohannes  1 , Mark T Dransfield, Peter E Morris
Affiliations
Review

The Obesity Paradox in Pulmonary Rehabilitation: Relevance and Implications to Clinical Practice

Abebaw M Yohannes et al. J Cardiopulm Rehabil Prev. .

Abstract

Pulmonary rehabilitation (PR) increases exercise capacity, reduces dyspnea, and improves quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD). Patients requiring PR can present with multiple comorbidities. One of the most common comorbidities is obesity. The prevalence of obesity in patients with COPD is increasing at an alarming rate. To date the efficacy of PR to ameliorate obesity in patients with COPD is unclear. Obesity in patients with COPD is associated with increased morbidity and mortality compared to patients without obesity. However, the benefits of obesity paradox in lower mortality rate health-related QoL and health care utilization remain unclear. This review discusses the challenges of prescribing PR to patients with obesity and COPD. In addition, the definition of and the potential challenges and benefits of the obesity paradox in patients with COPD will be discussed. Treatment strategies that include combining PR with lifestyle management, individually tailored nutritional advice, pharmacotherapy, and surgery need to be tested in prospective, randomized controlled trials. The challenges of providing complex care, prioritizing patient needs, and future directions will also be discussed for patients with obesity and COPD.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. GBD 2019 Risk Factor Collaborators. Global Burden of 87 Risk Factors in 204 Countries and Territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet. 2020;396(10258):1223-1249. doi:10.1016/S0140-6736(20)30752-2. - DOI
    1. Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. 2022;10(5):447-458. doi:10.1016/S2213-2600(21)00511-7. - DOI
    1. World Health Organization (WHO). The top ten causes of death. WHO website. Published December 9, 2020. Accessed March 28th, 2024. https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
    1. World Health Organization. Obesity and overweight. Accessed 22 March, 2024. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
    1. Global BMI Mortality Collaboration. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388(10046):776-786. doi:10.1016/S0140-6736(16)30175-1. - DOI

MeSH terms