REDUCE BREATHLESSNESS THROUGH WEIGHT LOSS IN PATIENTS WITH CHRONIC LUNG DISEASE

Abstract

SESSION TITLE: Monday Electronic Posters 5 SESSION TYPE: Original Inv Poster Discussion PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM PURPOSE: There are a variety of mechanisms by which obesity affects the respiratory system, creating increased breathlessness. This symptom is especially troublesome for those who concomitantly suffer from chronic lung disease. For chronic lung patients who are considered optimized from a medical standpoint, weight reduction may be a novel way to reduce shortness of breath, but there are no weight loss programs proven to produce results in this population. The aim of our study was to test the feasibility and acceptability of a comprehensive, multi-component lifestyle intervention for patients with lung disease, MRC breathlessness class 2 or greater and clinically significant obesity with BMI>34. METHODS: The components of the intervention included telephonic health coaching, the Weight Watchers lifestyle online program, activity monitoring from a Garmin wristband activity monitor, a Bluetooth scale and mindfulness-based exercises. The participants were expected to wear the Garmin wristband activity monitor, log the food they ate in the Weight Watchers app and do the mindfulness exercises daily. Each week they were asked to weigh themselves with the Bluetooth scale and participate in a health coaching phone call that reviewed the data from the app (steps, weight, food logging) . Outcomes of the study included the chronic respiratory questionnaire (CRQ), positive and negative affects schedule (PANAS), mindful eating questionnaire (MEQ), body composition, and 6-minute-walk test. RESULTS: Mean starting weight was 265.3 lb with a mean BMI of 43.2. Of the 17 outpatients who were invited to participate in the study, 14 agreed to enroll and 13 finished the program. Eleven of the 14 carried a diagnosis of COPD and the other 3 had asthma. Improvements were seen in weight with average loss of 9lbs (p=0.0003), BMI (p=0.0001), 6-minute-walk distance (p=0.0008), and body fat (p=0.0072), mindful eating questionnaire external domain (p=0.0481) and summary (p=0.0153) and on the CRQ in the domains of fatigue (p=0.0358), and total score (p=0.0185). Every extra day of logging food was associated with a decrease of 0.4 lb, a loss of 0.16% of the baseline weight, and a BMI decrease of 0.05. CONCLUSIONS: A comprehensive, multi component lifestyle intervention is feasible in patients with severe obesity and chronic lung disease and has demonstrated clinically significant results in a small sample size. A potential next step would be a randomized control trial with a larger sample size to better determine the magnitude of effect possible with this intervention and the generalizability of results. CLINICAL IMPLICATIONS: Weight loss is a valid means of reducing breathlessness in patients with chronic lung disease and significant obesity. This particular intervention may improve quality of life and decrease breathlessness in this specific patient group and could be a next step for in treatment for medically optimized patients. DISCLOSURES: No relevant relationships by Roberto Benzo, source=Web Response No relevant relationships by Kara Dupuy-McCauley, source=Web Response