The Management of Obesity and Related Disorders

By Peter G. Kopelman | Go to book overview

6

Obesity and respiratory complications

Tracey D Robinson and Ronald R Grunstein

Introduction

Obesity can impact significantly on lung function, with excess central fat deposition producing a restrictive pulmonary abnormality and increased work of breathing. As a result, respiratory complaints are common in subjects with obesity and conditions such as asthma are often overdiagnosed in obese patients. Obesity is also strongly linked to breathing disorders during sleep, such as sleep apnoea and nocturnal hypoventilation. Sleep-disordered breathing has a number of clinical consequences, including impaired daytime gas exchange and excess cardiovascular morbidity. The combination of obesity-induced reduced pulmonary function and sleep-disordered breathing can lead to progressive respiratory failure during sleep, finally resulting in awake hypercapnic respiratory failure (obesity-hypoventilation syndrome, OHS). OHS can occur without any intrinsic lung disease. Weight reduction can improve lung function, reduce respiratory symptoms and reduce the severity of sleep apnoea. However, long-term maintenance of weight loss is difficult to achieve. Treatment of sleep-breathing disorders has been advanced greatly by the use of positive airway pressure devices

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The Management of Obesity and Related Disorders
Table of contents

Table of contents

  • Title Page iii
  • Contents v
  • Preface x
  • 1 - Defining Overweight and Obesity 1
  • References 7
  • I - The Complications of Obesity 9
  • 2 - Obesity and Diabetes 11
  • References 36
  • 3 - Obesity and Hyperlipidemia 45
  • 4 - Obesity and Cardiovascular Disease and Hypertension 65
  • 5 - Obesity and Abnormalities of Haemostasis 85
  • 6 - Obesity and Respiratory Complications 103
  • References 123
  • II - Management Approaches 127
  • 7 - Dietary Management of Obesity 129
  • References 156
  • Appendix 1 159
  • 8 - Behavior Therapy 165
  • 9 - The Physical Activity Approach to the Treatment of Overweight and Obesity 179
  • 10 - Pharmacological Approaches 203
  • References 219
  • 11 - Surgery 221
  • 12 - An Integrated Approach to the Management of Overweight and Obesity 235
  • Index 247
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