Doctors used to think that having obesity might help protect people with chronic obstructive pulmonary disease (COPD), a lung disease that gets worse with time. But now researchers are finding that this may not be true for everyone.

COPD involves two conditions: emphysema (which makes it difficult for your lungs to expel air) and chronic bronchitis (inflamed airways with thick mucus). People with COPD often experience chest tightness and dyspnea (shortness of breath). In severe cases, COPD may make it hard to carry out simple tasks like household chores and can significantly affect quality of life.

About 65 percent of people with COPD have a body mass index (BMI) that falls into the overweight or obese range. (BMI uses your height and weight to estimate body fat, but it’s just one tool your doctor might use to assess your health.) People living with both COPD and obesity have some unique challenges to consider.

Effects of Obesity on Breathing

Obesity can make breathing problems worse. People living with both COPD and obesity may need more healthcare appointments and extra medications to manage their symptoms. However, even with more medicine, breathing sometimes doesn’t improve.

Not all breathing problems are caused by COPD alone. It’s possible that extra weight itself makes it harder to breathe. If that’s the case, weight loss — not additional COPD medication — may be a more helpful treatment.

Members of MyObesityTeam have described how losing weight improved their breathing problems. “Since I’ve lost weight, breathing has become so much easier,” shared one member.

Obesity Hypoventilation Syndrome

Excess body fat puts pressure on the chest, making it harder to breathe deeply. This condition, called obesity hypoventilation syndrome (OHS), can cause a buildup of carbon dioxide in the blood and reduce blood oxygen levels. OHS also overlaps with another respiratory condition called sleep apnea, a condition in which breathing repeatedly pauses during sleep. Because of OHS, people with obesity may get short of breath easily and feel tired all the time.

Obesity also raises the risk of being hospitalized or dying from COPD. A study published in the International Journal of Chronic Obstructive Pulmonary Disease found that women with larger waists had lower forced vital capacity — a measure of how much air a person can breathe in and out. This test is used to check lung function in people with COPD. Losing body fat around the chest and belly can help improve breathing by giving the lungs more room to work.

Obesity-Related Inflammation, Fluid, and Lung Function

People with obesity have more inflammation throughout their bodies. This systemic inflammation means the body is under constant, low-grade stress. In fact, some markers of inflammation can be 3.3 times higher in people with obesity versus those with lower BMIs.

One type of COPD, chronic bronchitis, causes repeated irritation of the airways, leading to more inflammation and thick mucus. People with COPD may cough constantly, even when they’re not sick. Coughing is often the first symptom of mild COPD.

Triggers such as cold weather, air pollution, or a virus like the flu can lead to COPD flare-ups (spikes in respiratory symptoms). Your doctor may prescribe steroid inhalers or pills to calm down lung inflammation and open up the airways. Mucus that turns yellow or green often indicates an infection that may require antibiotics.

Both obesity and COPD can also cause problems with fluid overload. In people with severe obesity, fluid can build up due to heart failure, leading to swelling and water weight gain. This extra fluid can make it harder to breathe and may also be a sign of other health problems, such as kidney issues. It’s important to alert your doctor if you notice new or worsening symptoms.

Targeting Obesity To Improve Lung Problems

Losing weight can make breathing easier and help lower the risk of other chronic diseases, such as heart disease. Even small changes can help. Today, people with obesity who want to lose weight have more options than ever before. For some, medications or bariatric surgery (a procedure to shrink the stomach) may offer the best long-term results. Still, healthy lifestyle changes play a key role in managing both obesity and COPD.

Physical Activity

MyObesityTeam members have shared how being more active — even when taking it slow — helped improve their breathing. “I’ve been trying to exercise more, which is hard as I have breathing problems, but every little bit helps,” one member said.

“I was on oxygen for a great many years. I took steroids for my breathing, and that caused a lot of weight gain. I was never supposed to get better. I never gave up. I fought hard, and walking from one room to another made me feel like I’d pass out. I exercised hard, refusing to give up,” another member shared. “Fast-forward to today. I’m off daytime oxygen. I can finally lie on my side or flat if I want. It’s the first time in decades. Don’t ever lose hope. Every little thing you do to try to be healthy helps you, even if you can’t see it. 🤗”

Before starting a new exercise routine, it’s important to talk with your doctor, especially if your COPD isn’t well controlled. They can help you find safe ways to be active and monitor your breathing.

If outdoor air quality is poor because of air pollution, extreme temperatures, or seasonal allergens, it may be a good idea to exercise indoors. Using air filters at home can also help reduce the risk of COPD flare-ups.

Healthy Eating

Your healthcare provider may suggest starting with nutrition changes before focusing on exercise. If weight loss through diet makes breathing easier, it may be safer to increase your physical activity later.

For people with obesity and COPD, a nutritious diet can lower inflammation and improve overall health. An anti-inflammatory eating plan, like the Mediterranean diet, may help reduce flare-ups and make it easier to breathe.

Try to limit or avoid foods that may increase inflammation, such as:

• Sugary foods and drinks (like candy, regular sodas, and syrup)
• Deep-fried foods
• Processed meats (such as ham, bacon, sausage, and deli meat)
• Red meat (like burgers and steaks)
• Trans fats (indicated by the word “hydrogenated” on food labels)

Fill your plate with more anti-inflammatory foods, like:

• Fresh fruits and vegetables
• Beans and lentils
• Fatty fish (such as salmon, sardines, and tuna)
• Olive oil for cooking
• Whole grains

People with COPD sometimes have trouble eating large meals or getting enough nutrients. In those cases, smaller meals or nutrition supplements may help. A registered dietitian nutritionist can offer personalized guidance to support your health goals and make eating easier.

Talk With Others Who Understand

MyObesityTeam is the social network for people with obesity and their loved ones. On MyObesityTeam, more than 57,000 members come together to ask questions, give advice, and share their stories with others who understand life with obesity.

Do you have COPD or other respiratory diseases? How do breathing conditions affect your life with obesity? Share your experience in the comments below or on your Activities page.