Does obesity cause shortness of breath and tiredness?

Obesity is often associated primarily with appearance and body weight. Yet its consequences can have a much greater impact on everyday life. Climbing stairs, going for a long walk, cleaning the flat, going shopping, getting up from a chair or finding a comfortable position whilst sleeping may, over time, require more effort than before. Fatigue, shortness of breath, joint pain, reduced mobility and, at times, a reluctance to be active may set in.

1. What is the problem?
2. Every step requires more effort
3. You get out of breath more quickly
4. Joints may feel more strain
5. Everyday tasks can take more energy
6. Fatigue can have more than one cause
7. Obesity can make it difficult to sleep well
8. Mental health also plays a role
9. You don’t have to change everything at once
10. When should you consult a doctor?
11. Summary
12. FAQ – Frequently Asked Questions

What is the problem?

This does not mean that a person with obesity is simply "weaker" or less fit through their own fault. The body has to function under greater strain, and obesity can also be associated with metabolic changes, sleep problems, musculoskeletal issues and other health problems. As a result, a vicious circle can develop: the harder it is to move, the less you move, and the less you move, the harder it is to regain fitness.

Every step requires more effort

The simplest movements involved in moving the body become more demanding when the body has to carry greater mass. This applies to walking, climbing stairs and getting up from a chair. When walking, the muscles of the legs and trunk, amongst others, are engaged, whilst the joints bear the load associated with every step. With greater body weight, the musculoskeletal system has to cope with a greater mechanical load. This does not mean that every person with obesity will experience knee or back pain, but the risk of musculoskeletal problems may be higher. Consequently, an activity that was previously automatic may begin to require greater effort. Climbing a few flights of stairs is no longer a minor challenge, and a longer walk may cause fatigue that was not previously experienced.

You get out of breath more quickly

Physical exertion requires muscle work, and working muscles need an adequate supply of oxygen and energy. With a higher body weight, performing the same movement may require greater energy expenditure. As a result, your heart rate and breathing may increase more rapidly during physical activity. Someone who has led a sedentary lifestyle for a long time may also have low fitness levels. In such cases, even a relatively gentle walk can cause noticeable breathlessness. This often discourages further activity, as the belief arises: ‘If I get so tired, I’m not cut out for exercise.’ However, low fitness is something that can be gradually improved. There is no need to start with intense training. For an inactive person, even a few minutes of gentle walking can be a good starting point.

Joints may feel more strain

The knees, hips, ankles and spine are involved in almost every movement. With a higher body weight, they are subjected to greater mechanical stress, particularly when walking, going down stairs or standing up.

If pain occurs, the natural reaction is to limit movement. People begin to avoid stairs, walks, shopping trips involving prolonged walking, or sporting activities. In the short term, this may bring relief, but long-term restriction of movement leads to a further decline in fitness. Less activity also means fewer opportunities to strengthen muscles. Weaker muscles, in turn, can make it harder to carry out everyday tasks. This creates a vicious circle that is difficult to break without gradually increasing activity levels and adapting them to the body’s capabilities.

Everyday tasks can take more energy

Obesity affects more than just training or sport. Its effects can be felt whilst carrying out everyday tasks. Cleaning, cooking, shopping, playing with a child or standing for long periods can cause greater fatigue. Reduced mobility can also be a problem. A larger waist circumference can make it harder to bend down, put on shoes or perform certain exercises. Certain positions simply become less comfortable. It is the cumulative effect of these minor difficulties that can lead a person with obesity to start limiting their daily activity. Not because they don’t want to move, but because movement requires more effort than it used to.

Fatigue can have more than one cause

Not everyone who is obese will feel constantly tired. However, if you experience a chronic lack of energy, you should not automatically assume that body weight alone is the cause. The quality of your sleep, amongst other factors, may play a role. Obesity increases the risk of obstructive sleep apnoea, which can lead to poorer sleep quality, daytime sleepiness and a feeling of tiredness. Other health conditions, medication, insufficient physical activity, an unbalanced diet or chronic stress may also be contributing factors. If the fatigue is severe, persists for a long time or is accompanied by other worrying symptoms, it is worth speaking to a doctor rather than trying to solve the problem solely through more exercise.

Obesity can make it difficult to sleep well

Sleep and body weight can be linked in many ways. As well as the aforementioned sleep apnoea, reduced comfort whilst resting may also play a role. It becomes harder to find a comfortable position, and snoring, frequent awakenings or excessive daytime sleepiness may occur. When sleep does not provide adequate recovery, it is harder to find the energy for a walk or a workout the next day. There is also a greater inclination towards rest and a sedentary lifestyle. This is another element of the vicious circle. Less exercise can mean poorer fitness, and poorer fitness makes exercise more tiring.

Mental health also plays a role

Physical limitations are only part of the problem. Many women who are obese experience shame, criticism regarding their appearance, or fear of being judged by others. For this reason, they may avoid the swimming pool, the gym, group classes or even walks in places where they feel they are being watched.

Added to this are previous failed attempts at weight loss. Yet another diet started with high hopes and ending with a return to old habits can undermine a sense of self-efficacy. However, it is important to separate body weight from a person’s worth. Obesity does not mean laziness, a lack of character or a lack of self-care. Such beliefs do not help in changing behaviour, and the added shame may actually make it harder to seek professional support.

You don’t have to change everything at once

If day-to-day life has become more difficult, it’s easy to fall into the trap of thinking that an immediate revolution is needed. However, a new diet, daily exercise, walking thousands of steps and completely giving up your favourite foods may prove too much of a burden. It is far more sensible to choose one or two specific areas. This could be a regular, short walk or getting up from your desk more often. Over time, you can add further elements. The aim does not have to be an immediate change in body shape. The first sign of success might be that climbing the stairs is no longer so tiring, a walk lasts a few minutes longer, or daily chores no longer leave you as exhausted as they used to.

When should you consult a doctor?

Certain symptoms require assessment by a specialist. Particularly important ones include, amongst others, chest pain during exertion, fainting, significant or unusual shortness of breath, worsening palpitations or severe joint pain. In cases of severe obesity, it is also advisable to have your health assessed, especially if you haven’t had basic medical checks for a long time or if you have any chronic conditions. A doctor can help assess risk factors and choose a safe way to increase your activity levels. The point is not to be afraid of exercise. On the contrary – it is about starting in a way that is tailored to your current state of health and fitness.

Summary

Obesity can make everyday life more difficult, as greater body weight puts extra strain on the musculoskeletal system, and carrying out many activities requires more energy. In addition, problems such as sleep disturbances, pain, low fitness levels or reduced activity may arise. Psychological factors also play a role – feelings of shame and fear of judgement can lead a person to start avoiding physical activity.

However, this does not mean the situation is irreversible. Fitness can be built up gradually, starting at a level that matches your current abilities. You do not need to start running straight away, undertake strenuous training or reach a specific number of steps. Sometimes, the first important step is simply a few minutes of exercise a day.

The sooner you manage to break the vicious circle of inactivity, the easier it will be to regain your fitness. It’s worth looking not only at the number of kilograms, but also at how the body functions: how long you can walk for, how easily you get up from a chair, what your everyday stamina is like, and how much energy you have left for life beyond your daily duties. It is precisely these changes that can be the first sign that your body is starting to cope better.

FAQ – Frequently Asked Questions

Why does fatigue set in more quickly in people with obesity?

Moving a greater body mass requires more energy, which is why the cardiovascular system and muscles may have to work harder when walking, climbing stairs or getting up from a chair. If this is compounded by low fitness levels resulting from a lack of activity, fatigue may set in even more quickly.

Does obesity always cause pain in the knees and spine?

No. Not everyone who is obese experiences pain. However, greater body weight increases the mechanical strain on the joints and may be one of the factors that increase the risk of musculoskeletal problems.

Why is it harder to climb stairs when you are obese?

Climbing stairs requires the simultaneous use of large muscle groups and lifting one’s body weight against the force of gravity. The greater the mass to be moved, the higher the energy cost of such an activity may be.

Does shortness of breath in obesity indicate heart disease?

Not always. It may result from low fitness, the higher energy cost of movement, or a sedentary lifestyle. However, if the shortness of breath is severe, unusual, occurs with very little exertion, or is accompanied by chest pain, fainting or palpitations, medical advice is required.

Can obesity affect sleep?

Yes. Obesity increases, amongst other things, the risk of obstructive sleep apnoea. Poorer sleep quality can, in turn, increase daytime tiredness and make it harder to engage in physical activity.

Why can a lack of exercise further reduce fitness?

A prolonged reduction in activity can lead to a decline in fitness, muscle strength and exercise tolerance. As a result, everyday activities begin to require even greater effort, which encourages people to avoid exercise even more.

Should someone who is obese start exercising intensively straight away?

There is no need to do so. For someone who has previously been inactive, a better starting point might be short walks, simple strengthening exercises, water-based activities or a gradual increase in daily physical activity. The intensity should be appropriate to their current fitness level and state of health.

Is it possible to improve fitness without significant weight loss?

Yes. Increasing physical activity can improve fitness, strength, balance and the ability to carry out everyday activities, even when body weight does not change rapidly. That is why it is worth assessing progress by more than just the number on the scales.

Is obesity solely the result of a lack of exercise and bad habits?

No. Obesity is a complex condition that can be influenced by biological, genetic, hormonal, environmental, psychological and social factors. Reducing it solely to a ‘lack of willpower’ is inconsistent with our current understanding of the issue.

Sources:

• https://www.yalemedicine.org/news/biology-of-obesity
• https://pmc.ncbi.nlm.nih.gov/articles/PMC10729542/