September 17, 2018

Severe weight loss and malnutrition, medically referred to as cachexia, have long been a concern pulmonary physicians have had for their COPD patients.  Unfortunately, the incidence of obesity and the metabolic syndrome is now more common in patients with moderate to severe COPD.  The metabolic syndrome is characterized by insulin resistant diabetes, high blood pressure, a pot belly and an increased risk of blood clotting.  The significance of obesity in the COPD population is not totally clear. Obesity and the metabolic syndrome contribute substantially to an increased risk of heart disease, which is a major cause of morbidity and mortality in the COPD population.

Weight loss is difficult to achieve in the COPD population.  A recent investigation has found that weight loss surgery decreases the risk of being hospitalized for a COPD exacerbation.  Previous studies have shown the relationship between obesity and an increased risk.

All of these observations beg the question, “Does bariatric surgery reduce COPD exacerbation rates in obese patients?” Medical science can begin to provide an answer. A study of 481 obese patients with COPD, who subsequently underwent bariatric surgery, found that bariatric surgery was associated with a substantial reduction in the risk and occurrence of a COPD exacerbation.

Does this mean, if you are obese (BMI>30), you should immediately request bariatric surgery?  Obviously, no!  This study did not look at other non-surgical means to control a patient’s obesity, but a frank discussion with your doctor will be helpful in your decision making.

Lung Disease Center of Central Pennsylvania
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The Buzz by Dr. Z

George M. Zlupko, MD, FCCP

Timothy A. Lucas, MD, FCCP

Alan J. Kanouff, DO, FCCP

Dr. Michael C. Zlupko, MD

800 Chestnut Ave
Altoona, PA 16601




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