An 8-week, feasible, novel lifestyle program was pilot tested (ClinicalTrials.gov Identifier: NCT03836547) to evaluate its effectiveness in improving dyspnea, eating awareness, and overall quality of life in patients with chronic obstructive pulmonary disease (COPD) and obesity. Results of the study were published in CHEST.
All patients were recruited from the pulmonary outpatient practice of the Mayo Clinic in Rochester, Minnesota. Patient inclusion criteria were as follows: age >17 years; body mass index (BMI) >34 kg/m2, dyspnea greater than Medical Research Council class II, and a diagnosis of chronic lung disease.
The 8-week intervention involved weekly telephone health coaching, use of the Weight Watchers® online program, use of a Garmin VivoFit 3® wristband, a DVD with mindfulness-based movement and breathing, and a Bluetooth smart scale for at-home weigh-ins. The participants agreed to record all the food they ate at least twice daily in the Weight Watchers app, to wear the Garmin VivoFit 3 wristband to capture their daily steps, and to weigh themselves at least once per week.
Of the 19 patients who were invited to participate in the study, 14 individuals were recruited. Overall, 86% of the participants were women and 80% were married. The mean patient age was 67 years, the mean body weight was 263.4 pounds, and the mean BMI was 43.2 kg/m2. A majority of the patients (86%) had a diagnosis of COPD; however, 1 patient had asthma and 1 patient had sarcoidosis. The participants’ average 6-minute walk distance was 318 yards.
During the 8-week study period, the participants weighed themselves an average of 8.9 times, watched the mindful movement videos an average of 14.2 times, and logged food on 40 of a possible 56 days. Of the 14 participants, 13 (92.9%) completed the study, with 1 person discontinuing for personal reasons.
Results of the study showed that the average weight loss during the 8-week intervention was 9.3 pounds (P =.0001), corresponding to a weekly average weight loss of 1.2 lb, a loss of 3.5% of participants’ baseline body weight (P =.0001), a mean decrease in BMI of 1.5 kg/m2 (P <.0001), and a mean percentage of body fat loss of 1.8% (P =.0072). In addition, the 6-minute walk distance increased by an average of 117.3 feet (P =.0013). The summary of the Mindful Eating Questionnaire increased by 0.2 (P =.0208).
All the domains on the Chronic Respiratory Questionnaire improved, as did summaries on the Physical (dyspnea and fatigue) and Emotional (emotion and mastery) aspects.
The investigators concluded that once the lifestyle intervention analyzed has been validated, it may help provide relevant, timely, valuable information that can be used to design and power a trial with a larger, more diverse patient population.
Dupuy-McCauley K, Novotny P, Benzo R. Treating severe obesity to reduce dyspnea in patients with chronic lung disease: a pilot mixed methods study [published online March 4, 2020]. CHEST. doi:10.1016/j.chest.2020.02.032