Energy balance
Obese adults with obesity hypoventilation syndrome (OHS) should undergo weight-loss interventions targeting a sustained loss of 25-30% of body weight to achieve resolution of the syndrome, with bariatric surgery being the most effective method for achieving this threshold.
If you have Obesity Hypoventilation Syndrome, standard weight loss may not be enough. You need to aim for losing 25-30% of your body weight to potentially cure the condition. Because this is a large amount, you should discuss bariatric surgery with your doctor if you are a candidate, as it is the most likely way to achieve this specific threshold and resolve the breathing failure.
For patients with OHS, we suggest using weight-loss interventions that produce sustained weight loss of 25–30% of actual body weight. This level of weight loss is most likely required to achieve resolution of hypoventilation... those who have no contraindications may benefit from being evaluated for bariatric surgery.
Why this rating
The guideline explicitly states the evidence quality is 'very low' due to paucity of studies.
Source
Evaluation and Management of Obesity Hypoventilation Syndrome. An Official American Thoracic Society Clinical Practice Guideline
Babak Mokhlesi et al. · American Journal of Respiratory and Critical Care Medicine · 2019
DOI 10.1164/rccm.201905-1071st
More from this paper
- Continuous Positive Airway Pressure (CPAP) is the recommended first-line treatment for stable ambulatory patients with OHS who also have severe Obstructive Sleep Apnea (OSA).Weak
- Serum bicarbonate levels below 27 mmol/L can effectively rule out Obesity Hypoventilation Syndrome (OHS) in obese patients with sleep-disordered breathing who have a low to moderate pretest probability (<20%) of having the condition.Weak
Related findings · Energy balance
- Achieving a total body weight loss of 10-15% (or >10-15 kg) through Total Diet Replacement (TDR) induces remission of Type 2 Diabetes in individuals with short-duration disease.Strong
- Bariatric surgery is superior to medical management alone for inducing significant long-term weight loss, remission of type 2 diabetes, and reduction in mortality for patients with BMI ≥ 40 or ≥ 35 with comorbidities.Strong
- Achieving type 2 diabetes remission requires significant weight loss (≥15 kg) via major caloric restriction, independent of macronutrient composition.Strong
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