Introduction

Key points

Some people with severe chronic obstructive pulmonary disease (COPD)—especially those with emphysema—may be underweight and malnourished.

• People with COPD often lose weight. When you lose weight, you lose muscle mass, including the muscles that help you breathe. This may make breathing more difficult.
• About 1 out of 4 people with COPD weighs too little for good health, and those who are very underweight, especially those with emphysema, are at higher risk of death than are people with COPD who have a normal weight.¹
• To avoid losing weight and muscle mass, you generally need to eat more foods containing fat and protein. Because eating too much fat and targeting certain nutrients (such as protein) may have health risks, always consult with your doctor or a registered dietitian before eating more of these foods to gain weight.

 What causes weight and muscle loss in COPD?
 Why is weight loss a concern in COPD?
 How do I avoid weight loss in COPD?
 Where to go from here

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What causes weight and muscle loss in COPD?

Although the reasons for weight and muscle loss in COPD are not completely understood, experts believe that it happens because of a combination of factors. These include:

• Using more energy overall (perhaps due to the increased energy required to breathe).
• Using more energy during physical activity.
• Eating less because of shortness of breath. Shortness of breath may make it difficult to shop for, prepare, and eat foods.
• Using oral corticosteroids, which increase the breakdown of muscle tissue in the body.
• Less interest in food. People who have COPD may be depressed (causing a lack of interest in eating) or may be taking medicines that reduce appetite.
• The possibility that COPD may reduce oxygen levels in the blood. This can prevent your body from using food properly.

Poor eating habits and nutrition also contribute to weight loss. For older adults, the cost of food and being isolated from others also play a role in poor eating habits.

Test Your Knowledge

1. Weight loss in COPD may be caused by:
1. Increased use of energy by the body.
   

   The answer is correct

   Weight loss in COPD may be caused by many different factors, including increased use of energy, depression, and shortness of breath. All answers are correct.

   
2. Depression. People who have COPD may be depressed, which often causes a lack of interest in eating.
   

   The answer is correct

   Weight loss in COPD may be caused by many different factors, including increased use of energy, depression, and shortness of breath. All answers are correct.

   
3. Shortness of breath, which may make it difficult to prepare and eat foods.
   

   The answer is correct

   Weight loss in COPD may be caused by many different factors, including increased use of energy, depression, and shortness of breath. All answers are correct.

   

Continue to Why is weight loss a concern in COPD?
Return to COPD: Avoiding weight loss

Why is weight loss a concern in COPD?

Weight loss is a concern in COPD because as you lose weight, you lose muscle mass. Muscle loss may result in feeling weaker and makes it more difficult to breathe (the muscles that help you breathe also weaken). Weakness can also lead to a greater chance of infections, such as pneumonia.

About 1 out of 4 people with COPD weighs too little for good health, and those who are very underweight, especially those with emphysema, are at higher risk of death than are people with COPD who have a normal weight.¹

Test Your Knowledge

1. Weight loss in COPD can make breathing more difficult.
1. True
   

   The answer is correct

   When you lose weight, you lose muscle, including the muscles that help you breathe. This can result in more difficulty breathing.

   
2. False
   

   The answer is incorrect

   When you lose weight, you lose muscle, including the muscles that help you breathe. This can result in more difficulty breathing.

   

Continue to How do I avoid weight loss in COPD?
Return to COPD: Avoiding weight loss

How do I avoid weight loss in COPD?

If you are beginning to lose weight and muscle mass, you probably need to eat more protein and get more calories. This generally means eating more foods containing fat and protein. Because eating too much fat and targeting certain nutrients (such as protein) may have health risks, always consult with your doctor or a registered dietitian before eating more of these foods to gain weight.

High-calorie, nutritious snacks

Foods that can help you add nutritious calories to your diet include:

• Ice cream.
• Pudding.
• Cheese.
• Granola bars.
• Custard.
• Nachos with cheese.
• Eggs.
• Crackers with peanut butter.
• Bagels with peanut butter or cream cheese.
• Cereal with half and half.
• Popcorn with margarine and parmesan cheese.
• High-calorie nutritional supplements, such as nutrition shakes.

Adding calories to a meal or snack

Adding the following foods to meals or snacks can help you add calories and protein to your diet.

• Add an egg or egg yolk to meat loaf, macaroni and cheese, or similar foods. Be sure to cook the food after adding the egg.
• Add powdered milk to creamed soups, scrambled eggs, pudding, potatoes, yogurt, and casseroles.
• Add cheese to sandwiches, crackers, casseroles, soups, toast, and pasta.
• Add an extra tablespoon of vegetable oil or olive oil, mayonnaise, butter, margarine, or sour cream to sandwiches, bread, casseroles, soups, cooked cereals, pasta, potatoes, rice, or vegetables.
• Grind up some nuts and sprinkle the dust on puddings, gravy, mashed potatoes, casseroles, salads, and yogurt.

Adding protein to your diet

Milk, milk products, and meats are high in protein. Try to eat more of these foods, or:

• Add skim milk powder to milk, cold cereals, scrambled eggs, soups, and ground meat.
• Add cheese or peanut butter to snacks.
• Choose desserts that use eggs, such as sponge cake, egg custard, and rice pudding.
• Use nutritional supplements high in protein, such as nutrition shakes.

Test Your Knowledge

1. You should consult with your doctor or registered dietitian before changing your diet to maintain or gain weight.
1. True
   

   The answer is correct

   To gain weight when you have COPD, you may have to eat more foods with higher amounts of fat and protein. Eating too much fat and focusing on certain nutrients may have health risks, so it is important that you work with your doctor or a registered dietitian to find the best way to gain weight safely.

   
2. False
   

   The answer is incorrect

   To gain weight when you have COPD, you may have to eat more foods with higher amounts of fat and protein. Eating too much fat and focusing on certain nutrients may have health risks, so it is important that you work with your doctor or a registered dietitian to find the best way to gain weight safely.

   

Continue to Where to go from here
Return to COPD: Avoiding weight loss

Where to go from here

If you have COPD and are worried about losing weight, see your doctor or a registered dietitian. He or she can help you plan a healthy, high-calorie and high-protein diet.

If you are eating more calories but are continuing to lose weight, see your doctor.

People with COPD often have little interest in food or difficulty eating because of shortness of breath. For tips on eating regularly and eating healthy foods, see:

COPD: Keeping your diet healthy.

Return to COPD: Avoiding weight loss