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The Role of Cardiorespiratory Fitness and Respiratory Muscle Training in Weight Loss

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Dr. Noman Elahi

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Dr. Noman is a medical researcher and expert writer dedicated to bridging the gap between science and public understanding by translating complex medical studies into explicit, engaging, and informative content.
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Nina Bausek, PhD

Chief Scientist

With 10 years of experience in respiratory health research, Dr. Nina provides expert review and validation to ensure accuracy, clarity, and scientific integrity in medical content.
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Key Takeaways
  • Obesity reduces cardiorespiratory fitness (CRF), leading to decreased lung capacity and increased oxygen demands during physical activities, resulting in fatigue and exertional dyspnea (breathlessness).
  • Improved CRF is associated with positive changes in body composition and non-surgical weight loss in obese individuals due to increased oxygen uptake and expenditure.
  • Respiratory muscle training (RMT) strengthens the respiratory muscles, contributing to increased CRF and better performance in weight loss exercise programs when used as part of comprehensive weight loss strategies.

Obesity is a prevalent health concern with far-reaching implications for both individuals and society at large. In the United States, nearly half of all adults aged 20 or above are classified as obese, and this epidemic shows no signs of abating.

In this blog post, we’ll delve into the staggering statistics surrounding obesity and its profound impact on health and the economy.

Additionally, we’ll explore the intriguing connection between cardiorespiratory fitness (CRF) and obesity, shedding light on how respiratory muscle training (RMT) could be a game-changer in the fight against excess weight.

The alarming statistics of obesity

Let’s begin with a sobering fact: about 43% of adults in the United States are currently grappling with obesity, while an additional 31% fall into the overweight category. Within this cohort, 9% face the harsh reality of severe obesity. Unsurprisingly, these figures have grave implications for health, well-being, and healthcare expenditure [1]

Alarming rise of obesity in US (desktop view)

Alarming rise of obesity in US (mobile view)

The geographical distribution of obesity in the U.S. reveals some striking disparities. West Virginia leads the pack with a staggering 40% of its population classified as obese, while Massachusetts boasts the lowest obesity prevalence, with just 28% [2].

What is the economic toll of obesity?

Obesity doesn’t just affect individuals—it also places an enormous economic burden on society. The annual medical costs associated with obesity amount to a staggering $172.74 billion [3].

Beyond direct medical expenses, the indirect costs due to decreased economic productivity are equally concerning. In 2016, obesity and its associated chronic diseases incurred $480.7 billion in direct healthcare costs and a jaw-dropping $1.24 trillion in indirect costs. This total of $1.72 trillion represents a staggering 9.3% of the United States’ gross domestic product [4].

What is the relationship between CRF and obesity?

Cardiorespiratory fitness (CRF) emerges as a crucial indicator of obesity. Obesity can lead to reduced lung and chest wall compliance, resulting in decreased functional residual capacity and expiratory preserved volume [5] [6].

This means that individuals with obesity typically breathe with reduced lung volume compared to their healthier counterparts. Consequently, they often exhibit lower CRF and energy expenditure, which can manifest as early fatigue, exertional dyspnea, and increased oxygen cost during exercise [7] [8] [9]

Exploring treatment options for losing weight

Addressing obesity necessitates a multi-faceted approach, including both pharmacological and non-pharmacological interventions [10].

Anti-obesity drugs, while effective in curbing appetite, can raise concerns about potential cardiovascular or psychiatric side effects with long-term use [11].

Non-pharmacological strategies include bariatric surgery, dietary modifications, cognitive behavioral interventions, and exercise [12]

RMT and weight loss - A girl happily seeing her weighing scale (desktop view)

RMT and weight loss - A girl happily seeing her weighing scale (mobile view)

What is the role of respiratory muscle training in weight loss?

Respiratory muscle training offers a novel approach to assist individuals suffering from obesity on their weight reduction journey or in improving daily mobility [13]. A recent clinical study showed that RMT helps weight reduction in individuals with obesity who trained with THE BREATHER for 2 weeks.

RMT strengthens respiratory muscles, reducing breathlessness—a common obstacle for individuals struggling with obesity during exercise. This reduced breathlessness can enhance exercise tolerance, a crucial component of successful weight loss [14].

Furthermore, RMT can benefit those with limited mobility, making daily activities more manageable and improving overall mobility and exercise tolerance [15].

Crucially, RMT can contribute to improved CRF, facilitating better performance during weight loss exercises. It’s important to note that RMT isn’t a standalone strategy for significant weight loss but rather an adjunct therapy that complements comprehensive weight loss programs involving nutritional control and exercise [16].

Conclusions

The obesity epidemic presents a substantial challenge to both individual health and the broader economy. Cardiorespiratory fitness plays a pivotal role in understanding and addressing this issue, with respiratory muscle training offering a promising avenue for improvement.

By addressing breathlessness and enhancing CRF, RMT can make a meaningful contribution to the fight against obesity.

References

[1]. Upadhyay J, Farr O, Perakakis N, Ghaly W, Mantzoros C. Obesity as a Disease. Medical Clinics. 2018 Jan 1;102(1):13–33.

[2]. Fryar CD, Carroll MD, Ogden CL. Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2–19 years: United States, 1963–1965 through 2015–2016. [cited 2025 Feb 6]; Available from: https://stacks.cdc.gov/view/cdc/58669.

[3]. Ward ZJ, Bleich SN, Long MW, Gortmaker SL. Association of body mass index with health care expenditures in the United States by age and sex. PLOS ONE. 2021 Mar 24;16(3):e0247307.

[4]. Waters H, Graf M. America’s obesity crisis. The Health and Economic Costs of Excess Weight [Internet]. 2018; Available from: https://milkeninstitute.org/sites/default/files/reports-pdf/Mi-Americas-Obesity-Crisis-WEB_2.pdf

[5]. Lin CK, Lin CC. Work of breathing and respiratory drive in obesity. Respirology. 2012;17(3):402–11.

[6]. Sood A. Altered Resting and Exercise Respiratory Physiology in Obesity. Clinics in Chest Medicine. 2009 Sep 1;30(3):445–54.

[7]. Bhammar DM, Stickford JL, Bernhardt V, Babb TG. Verification of Maximal Oxygen Uptake in Obese and Nonobese Children. Med Sci Sports Exerc. 2017 Apr;49(4):702–10.

[8]. Salvadego D, Lazzer S, Busti C, Galli R, Agosti F, Lafortuna C, et al. Gas exchange kinetics in obese adolescents. Inferences on exercise tolerance and prescription. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 2010 Nov;299(5):R1298–305.

[9]. Mendelson M, Michallet AS, Estève F, Perrin C, Levy P, Wuyam B, et al. Ventilatory responses to exercise training in obese adolescents. Respiratory Physiology & Neurobiology. 2012 Oct 15;184(1):73–9.

[10]. Reid TJ, Korner J. Medical and Surgical Treatment of Obesity. Medical Clinics. 2022 Sep 1;106(5):837–52.

[11]. Dietrich MO, Horvath TL. Limitations in anti-obesity drug development: the critical role of hunger-promoting neurons. Nat Rev Drug Discov. 2012 Sep;11(9):675–91.

[12]. Higuera-Hernández MF, Reyes-Cuapio E, Gutiérrez-Mendoza M, Rocha NB, Veras AB, Budde H, et al. Fighting obesity: Non-pharmacological interventions. Clinical Nutrition ESPEN. 2018 Jun 1;25:50–5.

[13]. Boswell-Ruys CL, Lewis CRH, Wijeysuriya NS, McBain RA, Lee BB, McKenzie DK, et al. Impact of respiratory muscle training on respiratory muscle strength, respiratory function and quality of life in individuals with tetraplegia: a randomised clinical trial. Thorax. 2020 Mar;75(3):279–88.

[14]. Salvadego D, Tringali G, De Micheli R, Sartorio A. Respiratory Muscle Interval Training Improves Exercise Capacity in Obese Adolescents during a 3-Week In-Hospital Multidisciplinary Body Weight Reduction Program. International Journal of Environmental Research and Public Health. 2023 Jan;20(1):487.

[15]. Kaeotawee P, Udomittipong K, Nimmannit A, Tovichien P, Palamit A, Charoensitisup P, et al. Effect of Threshold Inspiratory Muscle Training on Functional Fitness and Respiratory Muscle Strength Compared to Incentive Spirometry in Children and Adolescents With Obesity: A Randomized Controlled Trial. Front Pediatr. 2022;10:942076.

[16]. Mancini DM, Henson D, La Manca J, Donchez L, Levine S. Benefit of selective respiratory muscle training on exercise capacity in patients with chronic congestive heart failure. Circulation. 1995 Jan 15;91(2):320–9.

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