British researchers have found that obese patients with chronic obstructive pulmonary disease (COPD) stand to gain as much from pulmonary rehabilitation as their slimmer counterparts, even though as a group they have a lower exercise capacity. The findings were presented at the American Thoracic Society (ATS) 2010 International Conference in New Orleans.
For the study, patients with clinical and spirometric COPD who were classified according to their level of obesity, from normal weight (BMI 21-25 kg/m2) to extreme obesity (BMI >40 kg/m2), underwent pulmonary rehabilitation. Researchers then assessed improvements in the patients’ exercise performance and endurance, as well as their health status (chronic respiratory questionnaire) and baseline characteristics.
“We found that obese people with COPD are more disabled in terms of exercise capacity, despite having less severe airflow obstruction (the measure used to quantify severity of COPD). However, they do just as well with rehab—including those with extreme obesity,” said Neil Greening, MBBS, MRCP, from University Hospitals of Leicester, leader of the study. “There is no difference between obesity subgroups in the proportion of patients achieving clinically significant improvement in the incremental shuttle walk test.”
The researchers recommend that extremely obese patients with COPD be considered for enrollment in a pulmonary rehabilitation program, irrespective of body mass. Although there are no weight limits for pulmonary rehabilitation programs, there is likely some discrimination by medical staff who may emphasize weight loss over exercise, adds Greening.