Living with obesity can bring health challenges — some expected, others more surprising. One symptom that might catch you off guard is feeling short of breath. While obesity can contribute to shortness of breath — especially when linked with conditions like sleep apnea or reduced lung function — it’s not the only possible cause. That’s why understanding what’s behind your symptoms is an important first step toward feeling better.

Your doctor can help you figure out what’s going on, but going into that conversation prepared can make a big difference. Knowing what questions to ask and what signs to pay attention to can help you leave your appointment with clearer answers. Here’s what to know about the possible connection between obesity and shortness of breath — and how to start the conversation with your doctor.

Can Being Overweight Cause Difficulty Breathing?

Obesity may contribute to shortness of breath in several ways. It can make it harder to breathe and reduce how much air you’re able to exhale. It also changes the muscles you have to use to breathe and changes how your lungs work. Obesity is also a risk factor for obesity hypoventilation syndrome, obstructive sleep apnea, and asthma, all of which can contribute to shortness of breath.

Obesity Hypoventilation Syndrome

Obesity hypoventilation syndrome (OHS), or Pickwickian syndrome, occurs in some people with higher body weights. If this happens to you, it means that your body isn’t exhaling enough carbon dioxide. Instead, it builds up in your bloodstream until there’s too much carbon dioxide there. If you have OHS, you might feel breathless or extremely sleepy, have headaches, or experience dizziness.

No one knows exactly why some people living with obesity experience this. It may be due to fat pushing on thr lungs, which can make it hard to breathe deeply and cause breathing problems. It may also be due to hormones that fat can produce or an issue with the part of your brain that controls your breathing. You may also have weaker muscles that help you breathe because they have to work harder when a person has a higher weight.

About 90 percent of people diagnosed with OHS also live with obstructive sleep apnea (OSA), which we’ll discuss below. If you feel like you’re struggling to breathe and you don’t know why, talk to your doctor today so you can get some tests. The most important tests are called polysomnography and arterial blood gas testing. This information can help your doctor decide if you have OHS and how to treat it.

Obstructive Sleep Apnea

Obesity is one risk factor for obstructive sleep apnea. According to the Obesity Medicine Association, in people with moderate to severe OSA, up to 63 percent of men and 22 percent of women are diagnosed with obesity. In OSA, breathing slows significantly or stops while you’re asleep, usually because your airway has collapsed.

In people living with obesity, sleep apnea may occur because the weight of some fat deposits puts extra pressure on their upper airway. However, since other causes of OSA don’t involve a diagnosis of obesity, the relationship may be more complicated. Researchers need to do more work to understand this better.

If you’re very sleepy during the day, snore or sound like you’re choking while sleeping, or regularly experience headaches you can’t explain, talk to your doctor about getting tested for OSA.

Asthma

Asthma develops when the passages in your lungs become inflamed. This causes them to narrow, which can make it harder to breathe. Obesity is also a risk factor for asthma. In fact, the greater your body mass index (BMI), the higher your chances of also having asthma.

If you find yourself wheezing, coughing a lot, or feeling like your chest is tight, talk to your healthcare provider about asthma. No one knows exactly why obesity might cause asthma in some people. It may happen when fat produces chemicals that cause inflammation throughout the body, including in the lungs.

Other Causes of Breathlessness With Obesity

Sometimes, you might struggle with shortness of breath even if you’re not diagnosed with any of the conditions listed above. Given the ways that having a higher body weight can affect your lungs, there may be times when you feel like it’s hard to breathe. You should talk to your healthcare team about what would be best for your body when it comes to managing this symptom.

Manage Shortness of Breath Related to Obesity

A few small changes to your daily habits can make a big difference. Working with your doctor to find the right approach for you is a great place to start.

Can Losing Weight Help With Shortness of Breath?

Lowering your body weight may help with shortness of breath. You can talk to your doctor about how to approach this, especially if you’ve tried before and found it difficult to see any change. Most doctors will recommend making changes to your lifestyle. These changes may include changing what you eat, how much, or how often you eat. It may also involve monitoring how much alcohol you drink. Your doctor may refer you to a licensed dietitian, who can help you figure out what these look like in your daily life.

What About Increased Physical Activity?

Exercising more may help if your doctor has prescribed weight loss for your shortness of breath. In addition, exercising may help improve symptoms of conditions like asthma. If you’re dealing regularly with shortness of breath, you’ll want to make sure you exercise in a way that is safe for your body. Your doctor can help you find a physical therapist who has experience working with people who have your condition. This person should be able to tailor an exercise program to your needs.

Do You Need to Ask About Medical Interventions?

Some people will need medical help to treat shortness of breath. They may need medical help losing weight, like weight loss surgery or weight loss medications. Or, they may need treatment based on what’s causing their trouble breathing. People living with OHS and OSA may need machines (called continuous positive airway pressure, or CPAP, machines) to help them breathe. CPAP machines make sure you get enough oxygen. Those with asthma may need medications that help keep their airways open and inflammation down.

Your doctor can help you figure out what interventions might be best for you. They can also help you decide which treatment is best for your body and its needs. You should always talk to a medical professional before you try any new therapy or treatment.

Talk to Your Doctor

Anytime you experience shortness of breath, you should talk to your doctor right away. They’ll be able to screen you for obesity and evaluate you to determine whether that symptom is tied to a higher body weight. If it is, they should be able to recommend both lifestyle changes you can make, as well as treatments for the specific cause of your shortness of breath.

If you’ve already been diagnosed with one of the conditions here that causes shortness of breath, you should still talk to your doctor when it happens. They can check if your current treatment is still working or help you find a better option.

Never ignore shortness of breath. If it doesn’t get better, you could end up needing urgent medical attention. Take care of yourself by reaching out for medical advice as soon as you realize something is wrong.

Talk With Others Who Understand

MyObesityTeam is the social network for people with obesity and their loved ones. On MyObesityTeam, more than 56,000 members come together to ask questions, give advice, and share their stories with others who understand life with obesity.

Are you living with shortness of breath related to obesity? What have you done to improve your breathing? Share your experience in the comments below, start a conversation by posting on your Activities page, or connect with like-minded members in Groups.