Obesity has risen at epidemic rates over the last 20 years. This increase crosses all ages, genders, racial/ ethnic groups, and income and educational levels. A variety of genetic, environmental, physiological, psychological, and sociocultural factors influence the development of obesity. Increased morbidity and mortality are associated with obesity.

Most health-related problems and the increased risk of death in obesity are due to cardiopulmonary compromise. This paper addresses the physiologic effects of obesity on the cardiopulmonary system and the impact obesity has on the critically ill patient. Suggestions for alterations in cardiovascular and pulmonary assessment techniques are discussed.

Nursing practice interventions are presented for maximizing cardiopulmonary function and preventing complications.

The advocacy role of the nurse is addressed as a critical component in working to develop a culture of understanding and acceptance for the obese patient.
Introduction

Obesity has risen at epidemic rates during the last 20 years. Today it is among the top public health problems and a major cause of morbidity and mortality in the United States. The health care implications of the obesity epidemic, in terms of pathophysiological complications and shortened longevity, are significant and often related to cardiopulmonary health.