Patients with chronic obstructive pulmonary disease (COPD) often complain of dyspnea and may experience oxygen desaturation with activities of daily living . Eating is an activity common to all individuals. Although modest degrees of desaturation have been shown to occur with eating, the mechanism by which this occurs remains speculative. Meal-related dyspnea has not been evaluated comprehensively in a prospective fashion. In this study we examined oxygen desaturation and dyspnea during eating in patients with COPD. Our aim was to determine the extent to which the phenomena occurred during eating and whether desaturation and/or dyspnea is related to upper extremity use in this specific activity. To elucidate the latter, we measured oxygen saturation and dyspnea in patients with severe COPD eating normally and while being fed.