Obesity and Shortness of Breath: What’s the Connection?

Medically reviewed by Michael Menna, DOMedically reviewed by Michael Menna, DO

Obesity is a medical condition that occurs when there are excess fat cells in the body. It raises your risk of various adverse health effects and conditions, such as cardiovascular disease, diabetes, and hypertension (high blood pressure). Clinical obesity can also impact lung function.

Difficulty breathing, gasping, and breathlessness (dyspnea) can be symptoms of obesity. If breathing difficulties become severe and chronic, a healthcare provider may diagnose shortness of breath as obesity hypoventilation syndrome (OHS). Because breathing problems like this can significantly impact your health and quality of life, understanding how obesity affects lung function and what you can do about it are essential.

This article discusses how obesity causes shortness of breath, the symptoms of OHS, and how healthcare providers diagnose this issue. You’ll also learn how to manage obesity-related shortness of breath.

How Can Obesity Cause Breathing Problems?

There are several ways that obesity and breathing problems are linked, though more research is necessary. Below are examples of the relationship between breathing problems and obesity:

• Pressure on the lungs: Excess fat tissue in the abdomen or chest adds pressure to the lungs, making them work harder to expand and contract. They may not fill completely and can work slower, affecting breathing capacity.

• Pressure on the airways: Excess fat deposits in the neck (pharyngeal fat) can put pressure on the airways when you lie down, which can cause snoring and obstructive sleep apnea (OSA).

• Inflammation: Obesity is associated with increased inflammation—the body’s immune response. Bodily inflammation increases susceptibility to a range of conditions, which can impact breathing.

• Hormones: Excess fat cells in the neck affect the hormones that help regulate breathing. Researchers believe this causes OHS.

• Shared risk factors: Poor lung function, asthma, and other issues are associated with obesity risk factors, such as smoking, lack of exercise, and a sedentary lifestyle.
  

Obesity puts you at higher risk for a range of cardiovascular and other diseases and conditions, including high cholesterol, cancer, and liver disease, among others. You are also more likely to experience breathing problems, including:

• Asthma

• Attacks of gasping breath

• Dyspnea

• Obstructive sleep apnea (SOA)—which causes snoring and disrupts sleep

• Obesity hypoventilation syndrome (OHS)

These issues—which often overlap—can cause carbon dioxide to build up in the blood, making getting enough oxygen more challenging.

Can Obesity Cause Shortness of Breath and Wheezing?

Alongside shortness of breath, you may experience wheezing or hear sounds when you breathe, especially during physical activity.

Physical exertion increases lung activity as your body demands more oxygen. When air travels in and out of your lungs faster, it increases pressure on the walls of the airways; this causes louder exhales and inhales. Excess weight can exacerbate this issue as the lungs work harder to keep up.

Excess neck or abdominal fat can narrow the airways, resulting in louder breathing. Airway obstructions have a similar effect.

Symptoms of Obesity Hypoventilation Syndrome (OHS)

Obesity hypoventilation syndrome (OHS) is a chronic condition that causes dyspnea, wheezing, and breathlessness both during waking and sleeping hours. Many factors contribute to this condition, including:

• Excess carbon dioxide (hypercapnia)

• Insufficient blood oxygen (hypoxia)

• Reduced inhale (respiratory drive)

• The effects of disrupted or inadequate sleep

• Weight-related impaired lung function

The  symptoms of OHS include:

• Daytime sleepiness or sluggishness

• Depression

• Dizziness

• Dyspnea and breathlessness
  

• Fatigue, tiredness after minimal effort

• Headaches

• Snoring, choking, gasping, or difficulty breathing at night, interrupting sleep
  

How OHS Is Diagnosed

To diagnose OHS, healthcare providers rule out other potential causes of breathlessness and breathing problems, such as COPD or other lung issues. First, they’ll assess your medical and family history, medications, and other factors. They will perform a physical evaluation and may order additional tests. Diagnostic methods may include:

• Auscultation (listening to your lungs with a stethoscope)

• Measuring your weight and height

• Calculating your body mass index (BMI)

• Measuring around your neck and waist (circumference)

• Spirometry (assesses lung capacity and how quickly you exhale)

• Plethysmography (a measure of lung volume when inhaling and after exhaling)

• Lung diffusion tests (determine how much oxygen gets into your blood when breathing)

• Exercise tests (track breathing and cardiac function while active—walking on a treadmill or performing another exercise)

BMI and Obesity

Though BMI is still widely used, it's a flawed and outdated measure. It does not account for important factors such as body composition, ethnicity, sex, race, and age. Despite its bias, healthcare providers often rely on BMI because it’s an inexpensive and efficient way to assess potential health status and outcomes.

Obesity and Shortness of Breath Treatment Options

Treatment goals for obesity-related shortness of breath are to increase oxygen levels, strengthen the lungs, and manage weight. Treatments for obesity and OHS may include:

• Continuous positive airway pressure (CPAP): A CPAP machine pumps air into your lungs through a ventilator mask you wear while you sleep. It keeps the airways open, treating OHS and nighttime hypoxia.

• Oxygen therapy: Also known as hyperbaric oxygen therapy, this treatment option involves breathing in supplemental oxygen from a tank.

• Tracheostomy: In rare, severe cases, this surgical procedure delivers additional air through a hole in the neck.

• Lifestyle changes: Your provider may recommend dietary changes and increased physical activity for weight management. Ensuring you’re getting enough sleep is also essential.  

• Medications: If lifestyle changes alone are not working, your healthcare provider may recommend medications for weight loss.

• Weight loss surgery: Weight loss surgery reduces the stomach’s capacity, thus reducing calorie intake and spurring weight loss.

Can Losing Weight Help With Shortness of Breath?

The evidence is clear: losing excess weight should help with obesity-related breathlessness. In one study, men with obesity who undertook a three-month weight loss program saw significant improvement; losing about 10% of body weight led to more substantial reductions in dyspnea measurements and symptoms during exercise.

Researchers also found this effect in women after moderate weight loss over 12 weeks. They, too, reported less breathlessness with exercise, improved oxygen levels, and other signs of healthier lung function.

Losing weight helps improve shortness of breath because it reduces pressure on the lungs or airways, improves breathing regularity, and reduces how much oxygen you need. In addition, researchers noted that weight loss can also affect brain activity, regulating the sensation of breathlessness.

Summary

For some, obesity can cause shortness of breath. Excess weight places extra pressure on the lungs or airways, making breathing more difficult. Excess weight can also raise the risk of other conditions that affect lung function, such as asthma.

In severe cases, shortness of breath can develop into obesity hypoventilation syndrome (OHS), a chronic breathing problem related to excess weight. This condition disrupts sleep and causes other symptoms, like dizziness, headaches, snoring, and choking at night. Treatments for OHS include therapies to improve breathing and methods to lose weight. 

Read the original article on Verywell Health.