pdfjoiner

35
30
25
Prevalance (%)
20
15
10
5
0
Figure 1 Adult trends in obesity (BMI ≥ 30 kg.m 2 ) in the UK male (○)
and female (●) population, showing three-yearly averages. Redrawn
from Health Survey England 2013 data (see http://www.hscic.gov.uk/
catalogue/PUB16077) accessed 10/03/2015).
People who exhibit central, or visceral, obesity are often male and
can be described as ‘apple shaped’, while those with a predominantly
peripheral fat distribution are more likely to be female and are described
as ‘pear shaped’.
Respiratory system
Obesity results in reduced functional residual capacity (FRC), significant
atelectasis and shunting in dependent lung regions [12], but resting metabolic
rate, work of breathing and minute oxygen demand are increased.
This combination means that, following the cessation of breathing, arterial
oxygen levels decrease rapidly.
Wheeze in the obese may be due to airway closure rather than
asthma: 50% of patients diagnosed with asthma ‘recover’ with weight
loss [13]. Formal assessment of the effectiveness of bronchodilator therapy
may be useful in differentiating the two conditions [14].
Sleep-disordered breathing
© 2015 The Authors. Anaesthesia published by John Wiley & Sons Ltd
on behalf of Association of Anaesthetists of Great Britain and Ireland
5