Chronic obstructive pulmonary disease outpatients bear risks of both unplanned weight loss and obesity

Background & aims: Malnutrition is commonly seen in chronic obstructive pulmonary disease (COPD) and has been associated with negative outcomes. The objective of this study was to examine unintended weight loss (UWL) within three months, as a primary indicator for disease related malnutrition among COPD outpatients, to evaluate the prevalence of UWL, and to identify possible characteristics for UWL. Methods: A cross-sectional study including a patient questionnaire and medical record data extraction was made with all patients visiting a Danish COPD outpatient clinic. Results: Among the 200 included patients (68.7 +/- 11.2 years of age), UWL was seen in 21.5%, with a median weight loss of 3.5 (2-16) kg. Underweight (BMI<18.5 kg/m2) was recognized in 13.5%, while 34.5% were obese (BMI>30 kg/m2). Reduced food intake (RFI) within the past week was experienced among 22.0% of the patients. The most common nutrition impact symptoms (NIS) were shortness of breath, reduced appetite and nausea. NIS, RFI and BMI<18.5 kg/m2 were associated to UWL, while comorbidities, hospitalization within three months and resent exacerbations showed no association to UWL. Conclusions: A high prevalence of UWL was found in COPD outpatients, and NIS and RFI as characteristics associated with UWL. Shortness of breath, reduced appetite and nausea were the most common NIS. This study found 13.5% of patients underweight, 23.5 overweight and 34.5% obese. Underweight as well as obesity may have negative consequences for the patient and the community. (c) 2022 The Author(s). Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism. This is an open access article under the CC BY license (http://creativecommons.org/licenses/ by/4.0/).