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(HealthNewsDigest.com) – Over 40% of adults and close to 18% of children under the age of 19 struggle with weighing too much every day. They face discrimination, isolation, loss of higher paying jobs and the inability to enjoy activities such as sports, flying comfortably, sitting in a movie seat or fitting in a restaurant booth. Everyday life can be tough and often disheartening. Many people feel that those who weigh too much simply eat too much. If only it were that simple. Obesity is a multifaceted condition that the medical and nutrition community has a poor track record addressing. Between 1999 and 2018 the obesity rate in the US jumped from slightly over 30% of the population to over 42%. And then, along came COVID-19 to make everything even worse.
Experts estimate that the pandemic will create another bump in America’s obesity epidemic due to less availability of healthy food, less exercise, and more mental health issues that often drive excessive snacking, overeating and bingeing. Not only are our heaviest citizens getting heavier but they are dying in larger numbers from COVID-19.
COVID-19 infection runs the gamut from being asymptomatic (with no symptoms) to a mild respiratory condition to a severe acute respiratory infection that can result in death. Most people have only mild illness, 15% develop serious enough complications to require hospitalization and oxygen support, while 5% need to be admitted to the ICU (intensive care unit). That 5% may suffer acute respiratory distress syndrome (ARDS), sepsis and septic shock, organ failure, cardiac injury, and possibly death.
From COVID-19 risk to recovery, the odds are stacked against those with obesity. A new study led by the University of North Carolina at Chapel Hill examined published studies on people infected with the virus. The researchers found that those with obesity (a BMI over 30) were at 113% greater risk for hospitalization, were 74% more likely to be admitted to intensive care, and had a 48% greater risk of death from the virus.
Obesity drives many chronic conditions – heart disease, stroke, high blood pressure, type 2 diabetes, and some cancers. Being significantly overweight already puts a person at risk for premature death. The Centers for Disease Control and Prevention (CDC) considers those with a BMI of 40 or greater to be at risk for flu complications. Sadly, America has a high burden of those with class III obesity, those with BMIs at or over 40. Over 9% of Americans are morbidly obese. These patients, by virtue of their body size present patient care challenges in the hospital – larger beds are needed, intubation is difficult, and imaging diagnosis is hard because imaging machines have weight limits. Overweight patients can be very difficult to position and may not do well in a prone position which takes weight off the diaphragm and helps with breathing issues. Susceptibility to ARDS, the primary cause of COVID-19 deaths, is much higher in people who are obese.
The prevalence of people who are overweight, globally, is at an all time high and increasing. In most countries more than one-fifth, over 20% of the population weighs too much. Asians are traditionally thinner. For this reason, some of the original information coming from China about COVID-19 did not translate into handling the American adults who were getting sick. For example, only 20% of the NYC population is overweight, yet close to 42% of the patients hospitalized with COVID-19 in the city were people who were obese. In the majority of the studies that the researchers examined, obesity significantly increased the odds of death among COVID-19 patients.
Past experience with seasonal flu should have raised cautions about the severity of COVID-19 and overweight patients. In 2009, the H1N1 virus, identified obesity as an independent risk factor for severe virus symptoms and higher death rates. In 2012, there were more cases of the respiratory syndrome MERS-CoV in people who were obese. Obesity causes an imbalance in immune cell subsets creating inflammation and insulin resistance which makes it difficult to fight infections. Patients with COVID-19 and a BMI over 30 have higher viral loads that persist longer. In research presented at the European and International Congress on Obesity by Dror Dicker, MD from Israel, individuals with BMIs less than 30 took approximately 14 days to recover from the virus. Those with BMIs greater than 30 took about 17 days and those with BMIs less than 25 did not get well till 19 or 20 after they got sick. Dr. Dicker data showed that the chances of more severe disease increased with a higher BMI and almost all ICU patients with severe obesity will need to use a ventilator.
Though this news may appear grim it does provide us with a cautionary tale for the future. There will be other viruses or serious seasonal flu strains to deal with. Understanding that weight is a contributing factor may encourage more health care practitioners to have a conversation about eating and exercise at routine medical checkups and provide recommendations to others resources, like registered dietitians, exercise programs, or mental health counselors to help patients take charge of their health.
© NRH Nutrition Consultants, Inc.
Jo-Ann Heslin, MA, RD, CDN is a registered dietitian and the author of 30 books.
Available as eBooks from iTunes and Kindle/Amazon:
Diabetes Counter – the most up-to-date information on managing diabetes
Calorie Counter – a weight loss guide that won’t let you down
Protein Counter – put the latest protein recommendations to work for you
Healthy Wholefoods Counter – planet-friendly eating made easy
Complete Food Counter – food counts and nutrition information at your fingertips
Fat and Cholesterol Counter – newest approach to heart-healthy eating
Available in print from Gallery Books:
Most Complete Food Counter, 3rd Ed.
For more information on Jo-Ann and her books, go to: www.TheNutritionExperts.com or on twitter: @JoAnnHeslinRD.