The Dangerous Link Between Coronavirus and Obesity
‘Our world is facing two pandemics right now,’ says Dr. Rami Bailony
There’s still a lot we don’t know about Covid-19, as the news headlines demonstrate on a daily basis. That’s to be expected with a virus that has so quickly and completely consumed the globe, dramatically outpacing testing and mitigation efforts. However, the continued unknowns about this virus shouldn’t obfuscate what we do know to be true about this deadly disease. As the weeks wear on, our failure to act on known medical truths is becoming increasingly unforgivable.
Our world is facing two pandemics right now. The acute one, Covid-19, is swift and relentless — and it’s disproportionately preying upon people affected by an even larger, more-enduring pandemic: obesity.
Obesity is a leading risk factor in mortality and morbidity from Covid-19. And yet we’re not acknowledging this truth in our plans for protecting our most vulnerable populations. This speaks to a much larger deficiency within our society and our health care system today: the stubborn refusal to recognize and treat obesity as the chronic, deadly disease that it is.
As we look to the future and begin planning for what the “new normal” looks like, both in society and health care, it’s incumbent upon us to address the current deficits in our treatment of people with obesity. By closing this vast chasm, we can dramatically reduce the number of people who die in future pandemics.
The growing evidence linking obesity to Covid-19 deaths
Based on the patterns we saw with H1N1 and obesity a decade ago, many physicians (myself among them) worried that obesity would prove to be a prevalent risk factor for mortality among Covid-19 patients. In recent weeks, that fear has been confirmed as a harsh reality — perhaps even harsher than we imagined it would be.
In study after study, obesity has been found to be a leading risk factor for mortality and morbidity from Covid-19 across the globe. In a study out of NYU, severe obesity (BMI >40) was a greater risk factor for hospitalization among Covid-19 patients than heart failure, smoking status, diabetes, or chronic kidney disease. In China, in a small case series of critically ill Covid-19 patients, 88.24% of patients who died had obesity versus an obesity rate of 18.95% in survivors. In France, patients with a BMI greater than 35 were seven times more likely to require mechanical ventilation than patients with a BMI below 25.
The data on the repercussions of obesity in the setting of this global pandemic cannot be ignored. Nearly half of the U.S. population is expected to have obesity by 2030. This statistic was alarming when it was released prior to the global spread of Covid-19. In the context of the pandemic, given what we now know about the increased mortality risk among people with obesity, this statistic is downright terrifying.
Our world is facing two pandemics right now. The acute one, Covid-19, is swift and relentless — and it’s disproportionately preying upon people affected by an even larger, more-enduring pandemic: obesity.
Where systemic change is needed
Clinical studies have supported the notion that obesity is a chronic disease for decades now. And yet society, insurance providers, and the health care system at large continue to treat it as a lifestyle choice.
The World Health Organization was quick to warn that people with chronic disease were at increased risk from Covid-19, but it somehow left obesity off its list of preexisting conditions likely to make patients more vulnerable. Likewise, when Covid-19 hit the United States, health care systems and medical professionals rushed to protect and isolate “high risk” individuals, but people struggling with obesity were not included in these protective measures.
The failure to protect people with obesity in our Covid-19 response plans mirrors our failure to protect these individuals within our health care system at large. While major medical institutions have teams devoted to tackling diabetes, heart failure, chronic kidney disease, and other life-threatening conditions, the clinical staff that addresses obesity tends to be on the periphery, rarely granted funding or taken seriously. Insurance providers, including Medicare, continue to deny coverage for obesity treatment, and obesity counseling continues to be one of lowest-reimbursed codes in medicine.
Obesity represents an enduring global pandemic, but there’s no vaccine on the horizon. Fighting obesity means waging a multifaceted war on a number of fronts — not just diet and lifestyle, but also with regard to environmental, psychological, medical, genetic, and microbiomic factors. It’s not going to be easy. Fighting a pandemic never is. But that doesn’t make the fight any less worthy or necessary.
Covid-19 has clearly revealed that obesity — independent of its associated diseases — kills. It’s time for our society and our health care system to devote the same amount of resources toward medical obesity treatment as it does toward diabetes and heart disease. To continue ignoring the mounting evidence of obesity’s deadly toll — before, during, and after the Covid-19 outbreak — will be to continue ignoring the most costly pandemic in human history.
