Overweight and obesity as a risk factor for pulmonary problems has been well-established. Many studies have suggested that obesity may offer a clinical advantage as it relates to post cardiac intervention morbidity, length of stay, and mortality. There are few studies about the obesity paradox with regard to pulmonary debility. This study was designed to determine whether this obesity paradox is also reflected in the recovery of patients with debility secondary to a pulmonary event who were undergoing care in a rehabilitation hospital.

Retrospective cohort study included all patients admitted to the pulmonary unit of a rehabilitation hospital from January 2000–April 2006.

For the 381 patients admitted during the observation period, BMI was compared with FIM score changes per day (FIM efficiency). After adjusting for age, and sex, the FIM efficiency only slightly differed by BMI subgroups (P=0.12). The difference among FIM efficiency was not, however, large enough to be considered significant.

This study is not inconsistent with the findings of other medical subspecialties suggestive of a non-significant U shaped curve when comparing medical outcomes with BMI. In conclusion, we cannot expect inferior performance from patients with BMI in the obese category.