Overweight and shortness of breath when exercising: which is the best activity and how?

First a nurse, he then became a physio and quickly specialised in respiratory rehabilitation. Hugues Gauchez is fascinated by how the body works: he is learning constantly. In his opinion: "It's essential for treating patients". He shares his expertise about learning to breath again.

It is a problem when you are breathless after the slightest effort. Hugues Gauchez adds: "It is pathological when it becomes distressing, when you need to catch your breath all the time, when walking, climbing stairs or speaking, for example. "

Tests exist to assess the degree of discomfort. Hugues even talks about the degree of respiratory disability or impairment.Most of the time they are conducted by a doctor or physio specialised in respiratory rehabilitation: "There is a 6-minute walking test which calculates how far the person is able to walk without feeling uncomfortable. There is also the chair test which has 2 parts. First the patient must do as many flex exercises as possible in a minute. Then as many flex exercises as possible in 3 minutes: if they are under 50 flex exercises they are out of shape, around 70 they are sedentary, 90 to 95 is an athlete's score."

According to Hugues Gauchez, excess weight is not the only reason for pathological shortness of breath. Smoking, stress, diet and age also contribute to shortness of breath. That said, excess weight is one of the main reasons: "When you are overweight, it is more difficult to move your body - both for weight and occupied space.For example, when the belly circumference is over 90 cm, it is a metabolic disease. The ribs are stretched apart and the diaphragm is flattened.”

Less mobility in the diaphragm - the breathing muscle - increases breathing frequency and reduces the amount of air absorbed. Are you still following? That's the beginning of a vicious circle: more and more air is taken in to increase oxygen levels but it is never enough. What's more, not enough carbon dioxide is evacuated. What happens next? Hyperventilation - even faintness. 

When you have “pathological” breathlessness, you tend to avoid physical activity to avoid the discomfort. That's perfectly normal. Hugues Gauchez reminds us that it's important to exercise regularly to build muscle! We need muscles to carry our body, to stay independent and to be able to move around on our own. The more we move, the more mobile we are.It's important to go "step by step" as Hugues says. Progress with patience, regularity and above all with medical supervision, is more reassuring.

It means you feel breathless when you make any effort, as soon as you move. What does it feel like? You are doing exercises that put strain on your heart and suddenly you feel tightness that prevents you from catching your breath. Hugues Gauchez describes how this feels in the body: "At the medical level we speak of "dyspnoea" which means dysfunctional breathing. This is respiratory discomfort with an unpleasant sensation of breathlessness, which also has a sensory and emotional element. Patients suffering from shortness of breath when exercising feel fear of not being able to breath properly. This is called ventilatory stress. Breathing is usually unconscious. In this case, the person is conscious of their breathing. It becomes oppressive - like drowning.”

According to physio Hugues, the body mass index or "BMI" (divide weight by height squared), is often questioned but remains the best overweight indicator, and most importantly, to what degree.The difference between being overweight and obese is measured by the BMI. You're overweight when the BMI is over 25. You are is obese when the BMI is over 30. Over 30, it is severe obesity, then morbid obesity. Regardless of the degree, movement with appropriate supervision is always recommended.

There are also impedance scales that assess the percentage of fat and muscle in your body.

Our specialist recommends you consult your GP. They will look for possible metabolic disease and links between breathlessness and other disorders due to age or lifestyle (diabetes, smoking, etc.). After this consultation, you will be sent to a cardiologist or lung specialist for effort tests.

There are 2 ways to improve your breathing: respiratory rehabilitation and muscular fitness.

According to Hugues: “The goal is to restore optimum mobility to the respiratory pump so the patient can take in the amount of air they need for each respiratory cycle.”

For respiratory rehabilitation, physios use cardio activities like walking, exercise bikes or cross trainers and rowing machines. They also give exercises to strengthen muscles that encourage more upright posture to optimise breathing.

Precautions for exercising with shortness of breath : ” Choose gentle activities. Do not exceed the maximum heart rate: subtract 220 - age. Always consult your doctor and have an effort test before taking up exercise. Cardiologists recommend that intense exercise should not exceed 50 seconds.”

Moving increases quality of life. According to Hugues, walking is the most complete activity: “ Every level of the spine and all the muscles and organs are active. The respiratory and cardiac pumps function. Head carriage is improved and posture is upright. It even creates an abdominal massage that optimises bowel movement.”

Breathing exercises also help to improve breathing: “They restore osteoarticular mobility. Activities such as yoga, Pilates, sophrology and relaxation improve mobility, particularly for the thoracic cage. And that's essential for improving breathing.”