What to Know About Obesity and Shortness of Breath


Obesity hypoventilation syndrome (OHS), also called Pickwickian syndrome, is a breathing disorder that affects some children and adults who suffer from obesity. The disorder can make it difficult to breathe, which can cause low oxygen levels and high carbon dioxide levels in the blood. Left untreated, OHS can be life-threatening, as it can lead to serious issues with the heart and blood vessels, as well as disability and death. Fortunately, OHS symptoms can be reduced or eliminated entirely with treatment. 

What Causes Obesity Hyperventilation Syndrome?

OHS is linked to being overweight or obese, but it’s unclear why the disorder affects some people and not others. There are three main components of OHS:

  • Obesity
  • Daytime hypoventilation (breathing too slowly or shallowly to adequately supply the body with oxygen)
  • Sleep-disordered breathing (such as obstructive sleep apnea)

Extra fat on the neck, chest, or abdomen can affect the ability to draw in deep breaths; additionally, it’s believed that the fat accumulation in these areas can produce hormones that affect the brain’s breathing regulation. Insufficient oxygen in the blood and excess carbon dioxide can also result in delayed nervous system response.

What Are the Symptoms of OHS?

Many of the symptoms of OHS overlap with those of sleep apnea. These include:

  • Breathlessness
  • Morning headaches
  • Feeling sluggish or sleepy during the day
  • Dizziness
  • Fatigue
  • Poor sleep quality
  • Depression and irritability
  • Loud, chronic snoring
  • Snoring that’s interrupted by choking or gasping
  • Memory or concentration issues
  • Fast, shallow breathing
  • Bluish or reddish-colored skin
  • Signs of right-sided heart failure, such as swollen feet or legs, shortness of breath, feeling tired after little effort

OHS can also cause high blood pressure (hypertension) or high blood pressure in the lungs (pulmonary hypertension). 

How is OHS Diagnosed and Treated?

To diagnose obesity hypoventilation syndrome, your healthcare provider will take a complete history of your symptoms, determine your mass body index (BMI), and assess your oxygen and carbon dioxide levels with a blood test or a pulse oximeter; having a high carbon dioxide level in your blood while awake helps distinguish OHS from obstructive sleep apnea. Additional tests, such as a chest x-ray, pulmonary function tests, or a sleep study may also be recommended to rule out other causes and determine the severity of your sleep apnea. 

If you’re diagnosed with OHS, your healthcare provider may recommend lifestyle changes to promote weight loss, such as increasing physical activity and eating a healthy balanced diet. In some cases, a continuous positive airway pressure (CPAP) machine or other breathing devices may be recommended at night to improve your breathing and oxygen levels while you sleep. 

To prevent complications, it’s essential to follow your healthcare provider’s instructions and to notify them of any new symptoms you experience, such as chest pain, swelling, wheezing, or lightheadedness. Let them know if you plan to travel by plane or undergo surgery, as these can increase the risk of serious complications. 

Get Support for Your Symptoms

If you’re currently at risk for OHS or you’ve noticed symptoms that suggest you have the disorder, it’s important to understand that there are many steps you can take right now to prevent or reverse it. Losing weight, eating a healthy diet, increasing your activity levels, and addressing issues like sleep apnea is very effective in avoiding this serious health condition, as well as other obesity-related conditions like heart diseasehigh blood pressure, and some cancers. 

However, it can feel difficult to know where to start or how to stay on track with your new lifestyle. If you’ve been struggling to lose or maintain a healthy weight, contact Dr. Jennifer Hubert. Her customized medical weight loss plans have helped many patients reclaim their health. Dr. Hubert takes a holistic approach to weight loss, with behavior modification, nutrition counseling, medical monitoring, and other tools to help you meet your weight loss and health goals. Schedule your consultation today at (707) 575-8446.