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Weight and ventilation

International Journal of Obesity volume 24, page 261 (2000)Cite this article

The recent article by Carey and co‐workers on the effects of adiposity and weight change on forced expiratory volume (FEV) decline in a longitudinal study of adults (Int J Obes 1999; 23: 979–985) documents the decrease in FEV1 after weight gain in British citizens at 7 y follow‐up. They also noted that these effects were correlated with waist:hip ratio (W:H) in men but not in women.

Respiratory impairment associated with central obesity is secondary to an increased intra‐abdominal pressure which pushes the diaphragm up, raises intra‐thoracic pressure and compresses the lungs.1,2 This leads to a decrease in all lung volumes, but most markedly a decrease in residual lung volume so that at end‐expiration there may be large numbers of perfused but unventilated alveoli, leading to a large left‐to‐right shunt.3 Surgically induced weight loss is associated with a marked increase in all lung volumes but, again, most dramatically in residual lung volume.3,4 Unfortunately, it is very difficult to measurelung volumes in a population‐based study. Thus, although the data on FEV1 are interesting, it over-looks the major ventilatory defect associated with severe obesity.

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References

  1. Hackney JD, Crane MG, Collier CC, Rokaw S, Griggs DE . Syndrome of extreme obesity and hypoventilation: studies of etiology Ann Intern Med 1959 51: 541–552.

    Article  CAS  Google Scholar 

  2. Sugerman HJ, Windsor ACJ, Bessos MK, Wolfe L . Abdominal pressure, sagittal abdominal diameter and obesity co‐morbidity J Intern Med 1997 241: 71–79.

    Article  CAS  Google Scholar 

  3. Sugerman HJ, Fairman RP, Lindeman AK, athers JAL . Gastric surgery for respiratory insufficiency of obesity Chest 1986 90: 81–86.

    Article  CAS  Google Scholar 

  4. Sugerman HJ, Fairman RP, Sood RK, Engle K, Wolfe L, Kellum JM . Long‐term effects of gastric surgery for treating respiratory insufficiency of obesity Am J Clin Nutr 1992 55: 597S–601S.

    Article  CAS  Google Scholar 

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  1. Professor of Surgery, Medical College of Virginia, Richmond, 23298‐0519, VA, USA

    Harvey J Sugerman

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  1. Harvey J Sugerman
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Sugerman, H. Weight and ventilation. Int J Obes 24, 261 (2000). https://doi.org/10.1038/sj.ijo.0801131

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