COPD Health Center

Key points

Some people with severe chronic obstructive pulmonary disease (COPD)-especially those with emphysema-may be underweight and malnourished.

• People with COPD often lose weight. When you lose weight, you lose muscle mass, including the muscles that help you breathe. This may make breathing more difficult.
• Some people with COPD weigh too little for good health. People who are very underweight, especially those with emphysema, are at higher risk of death than are people with COPD who have a normal weight.¹
• To avoid losing weight and muscle mass, you generally need to eat more foods containing fat and protein. Because eating too much fat and targeting certain nutrients (such as protein) may have health risks, always consult with your doctor or a registered dietitian before eating more of these foods to gain weight.

Although the reasons for weight and muscle loss in COPD are not completely understood, experts believe that it happens because of a combination of things. These include:

• Using more energy overall (perhaps due to the increased energy required to breathe).
• Using more energy during physical activity.
• Eating less because of shortness of breath. Shortness of breath may make it difficult to shop for, prepare, and eat foods.
• Using oral corticosteroids, which increase the breakdown of muscle tissue in the body.
• Exercising some muscles less, which can cause them to weaken.
• Increased inflammation caused by COPD.
• Hormonal imbalances.
• Having less interest in food. People who have COPD may be depressed (causing a lack of interest in eating) or may be taking medicines that reduce appetite.
• The possibility that COPD may reduce oxygen levels in the blood. This can prevent your body from using food properly.

Poor eating habits and nutrition also can contribute to weight loss. For older adults, the cost of food and being isolated from others may play a role in poor eating habits.

Weight loss is a concern in COPD because as you lose weight, you lose muscle mass. Muscle loss may result in your feeling weaker. And muscle loss makes it harder to breathe (the muscles that help you breathe also weaken). Weakness can also lead to a greater chance of infections, such as pneumonia.

Some people with COPD weigh too little for good health. People who are very underweight, especially those with emphysema, are at higher risk of death than are people with COPD who have a normal weight.¹

If you are beginning to lose weight and muscle mass, you probably need to eat more protein and get more calories. This generally means eating more foods containing fat and protein. Because eating too much fat and targeting certain nutrients (such as protein) may have health risks, always consult with your doctor or a registered dietitian before eating more of these foods to gain weight.

High-calorie, nutritious snacks

Foods that can help you add nutritious calories to your diet include:

• Ice cream.
• Pudding.
• Cheese.
• Granola bars.
• Custard.
• Nachos with cheese.
• Eggs.
• Crackers with peanut butter.
• Bagels with peanut butter or cream cheese.
• Cereal with half and half.
• Popcorn with margarine and parmesan cheese.
• High-calorie nutritional supplements, such as nutrition shakes.

Adding calories to a meal or snack

Adding the following foods to meals or snacks can help you add calories and protein to your diet.

• Add an egg or egg yolk to meat loaf, macaroni and cheese, or similar foods. Be sure to cook the food after adding the egg.
• Add powdered milk to creamed soups, scrambled eggs, pudding, potatoes, yogurt, and casseroles.
• Add cheese to sandwiches, crackers, casseroles, soups, toast, and pasta.
• Add an extra tablespoon of vegetable oil or olive oil, mayonnaise, butter, margarine, or sour cream to sandwiches, bread, casseroles, soups, cooked cereals, pasta, potatoes, rice, or vegetables.
• Grind up some nuts and sprinkle the dust on puddings, gravy, mashed potatoes, casseroles, salads, and yogurt.

Adding protein to your diet

Milk, milk products, and meats are high in protein. Try to eat more of these foods, or:

• Add skim milk powder to milk, cold cereals, scrambled eggs, soups, and ground meat.
• Add cheese or peanut butter to snacks.
• Choose desserts that use eggs, such as sponge cake, egg custard, and rice pudding.
• Use nutritional supplements high in protein, such as nutrition shakes.

If you have COPD and are worried about losing weight, see your doctor or a registered dietitian. He or she can help you plan a healthy, high-calorie and high-protein diet.

If you are eating more calories but are continuing to lose weight, see your doctor.

People with COPD often have little interest in food or difficulty eating because of shortness of breath. For tips on eating regularly and eating healthy foods, see:

COPD: Keeping Your Diet Healthy.