The Startling Link Between Being Overweight and COVID-19

Western Cape South Africa. Specialist physician Dr. Gary Hudson says we’re facing a pandemic on top of an obesity epidemic. Startling research has now emerged showing that being obese or even slightly overweight can worsen the effect of  COVID-19³.

People living with pre-existing conditions such as atherosclerosis, type 2 diabetes, and hypertension, conditions are also common in people with obesity⁴. Initial data pointed towards the older population being particularly vulnerable, as well as those with these comorbidities. That said, an increasing number of reports have now also linked obesity to more severe COVID-19 illness as well as death⁵.

The statistics

What has been termed “the elephant in the room” when it comes to this pandemic is the fact that being overweight and obese are already major global healthcare problems. This is now making a really serious global health situation that much worse¹.  In fact, data from the first 2 204 patients admitted to 286 National Health Service Intensive Care Units with COVID- 19 in the United Kingdom reveal that 72.7% of them were overweight or obese¹.

A perfect storm

Hudson says that COVID-19 is spreading amongst a global obese population that numbers 2.4 billion people, which means that more than 30% of the world’s population is at risk of severe disease and even death^7,8. “This is creating the perfect storm^6,7.,” he says.

He cites an example that in France, the highest death rate due to COVID-19 was in North-Eastern France. Ironically, this is a region with statistically the largest overweight and obese population.

In fact, BMI was found to be the most important independent risk factor. As a result, a special guideline was introduced for anyone with a BMI of over 27.9 to be tested and isolated^7,8.

Similar patterns were found in Italy. “Once again the map of severe disease and obesity completely overlap” he says. Conversely, Singapore and South Korea had comparatively low death rates but also have populations with a general low BMI^7,8.

Metabolic syndrome

Research has found that patients with type 2 diabetes and metabolic syndrome might have to up to 10 times greater risk of death when they contract COVID-19¹. Metabolic syndrome is a cluster of conditions that occur together, increasing your risk of heart disease, stroke, and type 2 diabetes. These conditions include:

• increased blood pressure
• high blood sugar
• excess body fat around the waist
• abnormal cholesterol or triglyceride levels⁵.

Your BMI and COVID-19

A high percentage of the population who will contract coronavirus are also expected to have a BMI over 25³.

BMI is calculated by using a person’s height and weight. BMI = kg/m².

Although this is not the most accurate measurement, it is the widely accepted global definition of obesity as per the World Health Organisation, which defines a BMI of over 25 as overweight and over 30 or more as obese^7,8.

Abdominal fat

“It is a very important clinical measurement,” says Dr. Hudson, who says that even a BMI of over 25, which is literally just above the normal weight range, seems to correlate with a higher incidence of serious disease, particularly when combined with a comorbidity such as hypertension^7,8.

Dr. Hudson says that it is important to stress that the presence of abdominal fat is associated with a high risk of severe complications due to COVID-19. This is relevant for people with a mild increase in weight, and not only for the extremely obese^7,8.

Furthermore, in a French study, the risk for invasive mechanical ventilation in patients with COVID-19 infection admitted to Intensive Treatment Units was more than seven-fold higher for obese patients with a BMI over 35⁵.

Lockdown Weight up

To add fuel to a growing fire, for many people staying at home, consumption of more sugar and refined flour, along with less mobility and physical activity, has put even many people at an increased risk of metabolic disease³. An additional health challenge during the coronavirus crisis seems to be the consumption of a varied, nutrient-rich diet and keeping calorie intake under control².

Economics of being overweight

Lockdown restrictions have forced more people to stay home. As a result, people are now more reliant on processed food, as they have a longer shelf life and canned food which is generally higher in salt. We might well see an increase in weight if this persists for a longer period of time³.  The cause for even more concern is that the resultant economic downturn caused by this pandemic might well worsen obesity, especially amongst the most vulnerable⁵.

Where to from here?

The bottom line is that lifestyle can have a major impact on a person’s immune system. The basic weapons against many diseases, including COVID-19, is diet and exercise. These are weapons available to most of us but not nearly enough of us take advantage of them².

Therapeutic interventions such as proven weight loss medication and low-calorie diets might well be some tools that could potentially reduce the risk of developing severe COVID-19 illness as well as other lifestyle-related diseases⁵.

More than ever before, eating real food and exercising might help save lives. This pandemic has highlighted that we need to do more in order to tackle and prevent obesity in our societies. It’s important for the prevention of chronic disease and to decrease adverse reactions to these types of viral pandemics⁵.

About Dr. Gary Hudson

Dr. Gary Hudson is a Specialist Physician practicing in Betty’s Bay in the Western Cape.  He has expertise in immune-related diseases and therapies, including arthritis and inflammation, infectious diseases, and metabolic disorders. Dr. Hudson has a special interest in weight management.  Dr. Hudson says we are facing a pandemic on top of an obesity epidemic. He, therefore, reiterates that there is a definite link between the more obese areas of the world and those battling COVID-19 complications^7,8.

References

1. European Scientist – COVID-19 and The Elephant in the Room (April 2020) at https://www.europeanscientist.com/en/article-of-the-week/covid-19-and-the-elephant-in-the-room/ (website accessed on 17 June 2020)
2. The New York Times – To Fight Covid-19, Don’t Neglect Immunity and Inflammation (May 2020) at https://www.nytimes.com/2020/05/25/well/live/to-fight-covid-19-dont-neglect-immunity-and-inflammation.html (website accessed on 17 June 2020)
3. World Obesity – Coronavirus (COVID-19) & Obesity (2020) at https://www.worldobesity.org/news/statement-coronavirus-covid-19-obesity (website accessed on 17 June 2020)
4. Chiappetta, S et al. COVID- International Journal of Obesity. COVID-19 and the role of chronic inflammation in patients with obesity. May 2020.
5. Sattar et al. Obesity – A Risk Factor for Severe COVID-19 Infection: Multiple Potential Mechanisms (Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Center) 11 May 2020
6. Mayo Clinic – Metabolic Syndrome (2019) at https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916 (website accessed on 17 June 2020)
7. Pandemic on Epidemic – Dr Gary Hudson June 2020
8. Webinar by Dr Gary Hudson 4 June 2020

The content in this editorial is for general information only. There is no intent to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.