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Obesity and Pulmonary Disease
OSA
➤ For individuals with OSA and overweight or obesity, recommend
comprehensive lifestyle interventions to promote weight loss.
➤ For individuals with OSA and symptoms of excessive daytime
sleepiness, insomnia, fatigue, apnea, or snoring, refer to sleep
medicine for initiation and titration of positive airway pressure.
➤ For individuals with moderate to severe OSA (apnea-hypopnea
index ≥15):
• Initiation and titration of positive airway pressure therapy and/or
referral to sleep medicine specialist.
• Consider treatment with tirzepatide.
Asthma
➤ For individuals with asthma and overweight or obesity,
recommend >5% weight loss.
➤ Assess the level of physical activity and determine whether the
individual is meeting the goal of 150 minutes of moderate to
vigorous physical activity per week.
➤ If the physical activity goal is not met, identify barriers to regular
physical activity and encourage behavior change to promote
increased physical activity.
➤ No specific physical activity is preferred, except for water-based
activities, particularly for younger individuals.
➤ Initiate treatment according to guidelines, limiting use of short-
acting β-agonists with inhaled corticosteroids as preferred short
and long-term treatment, along with long-acting β-agonists,
leukotriene receptor antagonists, or long-acting muscarinic
antagonists, based on asthma symptoms and pulmonary function.
