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And gradation of COPD severity according to the Global initiative for chronic Obstructive Lung Disease (GOLD) guidelines,1 classification of overweight and obesity is based on body mass index (BMI) as defined by the World Health Organization (WHO).2According to the Burden of Obstructive Lung Disease (BOLD) Initiative,3 the estimated international prevalence of stage II or higher COPD is currently 10.1% in individuals aged 40 years and older.COPD was the fifth leading cause of mortality around the world in 2001 and will be the third most frequent cause of deathby the year 2020.4 The prevalence of obesity, defined as BMI 30 kg/m2,2 has multiplied during the last decades and varies from 10 20% in most European countries to >32% in the USA.2 According to the most recent global WHO projections, 400 million adults were obese in 2005 and it is estimated that thisnumber will exceed 700 million by the year 2015.5 Obesity plays a major role in the development of the metabolic syndrome and has been identified as an important risk factorfor chronic diseases such as type 2 diabetes mellitus and cardiovascular disease.

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