There’s a reason people who are overweight or obese easily get out of breath going up a flight of stairs or doing other physical activities.
“An important aspect of obesity is how it affects lung volume,” explains Jorge Moreno, MD, a Yale Medicine obesity medicine specialist. “If someone is obese, they can’t always get a full breath or full volume into their lungs, which can create breathing problems.”
Specifically, extra abdominal fat inhibits the ability of the diaphragm (a wall of muscle between the chest and abdomen) to properly draw in air and expand the lungs. People who are obese usually have smaller lung volume because of this, which leads to breathlessness, Dr. Moreno says.
There are also hormonal factors at play, for both men and women. As fat builds up under the skin, the fat cells secrete hormones. These hormones can cause inflammation throughout the body, including in the lungs, Dr. Moreno explains.
Severe lung inflammation was an early problem among many COVID-19 patients. It was no surprise to physicians, such as Dr. Moreno, that obesity emerged as a leading risk factor for severe illness from COVID-19.
“There are two stages to COVID. The first involves cold-like symptoms, which are typical and, in many cases, they resolve,” Dr. Moreno says. “The other is the inflammatory stage, in which the lungs can become inflamed and damaged, potentially leading to problems with the heart and other organs. This is what led to severe disease and death.”
Obesity is what Dr. Moreno calls “a pro-inflammatory state.” If you add the effects of the virus on top of it, the theory is that inflammation is increased even more, he adds.
Even for people who managed not to get sick with COVID, the pandemic presented challenges. For instance, working from home, being glued to a computer much of the day, and putting in more hours, can make it difficult to find time to eat well and exercise.
“One piece of advice is to try and plan meals better. We can be flexible if we are at home, but that might mean grazing on whatever is in the fridge,” suggests Dr. Moreno. “Instead, try to be mindful of what you are eating. This goes for alcohol, too.”
Dr. Baldassarri recommends daily exercise and a diet consisting mainly of whole foods, vegetables, fruits, high fiber, and plant-based protein. “Try to engage in moderate-to-vigorous exercise at least 20 minutes every day,” he says. “If you can do more than that, it’s even better. But any amount of exercise, even a few minutes per day, is better than none. A healthy diet and exercise are great for lung-specific and overall health”