Understanding the Two Pandemics: COVID-19 and Obesity

The facts are clear: obesity may triple your risk of being hospitalized for COVID-19, according to the Centers for Disease Control and Prevention, and the risk of severe COVID-19 illness including risk of needing mechanical ventilation and mortality increase with a higher body mass index (BMI). Nearly one million adults have been hospitalized in the United States between the spring and fall of 2020 and models from the CDC estimates that more than 30 percent of those hospitalizations were attributed to obesity.

The obesity epidemic continues where more than 35% of the population in 12 states had obesity compared to nine states the previous year. In New York City, more than 50 percent of adults are either overweight or obese and nearly half of all elementary school children are overweight, according to the New York City Department of Health.

Why is obesity so dangerous with COVID-19?

People who present with obesity may have higher levels of inflammation which can impact the ability to fight off viral infections, and can also increase the risk of developing diabetes, heart disease and certain cancers. They may already have comorbidities such as risk of diabetes, heart disease, stroke, high-blood pressure, asthma, arthritis and cancer, which further may impair the body’s immune response. There can also be a decreased lung capacity, making it harder to breathe in general. Combine that with a virus that can cause shortness of breath, and it’s a recipe for disaster.

Even before the COVID-19 pandemic, obesity was the second-leading cause of preventable death, after smoking, responsible for approximately 300,000 death per year. Now, because of the pandemic, lockdowns, quarantines, remote schooling, added stress, reduced physical activity and job losses, which in turn, created food insecurity, it became easy to gain weight during the pandemic. But this can and will have long-term public health consequences. On average, people gained nearly 30 pounds this year, according to a Lancet Commission on Obesity study.

What can we do?

Obesity is now considered a chronic disease, and must be placed in appropriate social and cultural contexts, and should not be considered a weakness of willpower. Care should be holistic, and must address both the individual as well as psychological, social, environmental and economic factors that impact healthy lifestyle .

Healthy eating with a variety of foods including whole grains, fruits and vegetables is crucial, while excess dietary restriction and fad-diets can lead to cycles of weight loss and regain. Exercise is also recommended daily as it boosts our immune systems, reduces inflammation, increases pulmonary and cardiovascular health, and improve our mental health as well, all of which helps to lessen COVID-19 symptoms and lowers incidences of hospitalizations, and even death.

If you are concerned about excess weight gain and are at risk of diabetes, high blood pressure, high cholesterol or heart disease, it’s important to talk to your primary physician and consider evaluation by an obesity medicine specialist/endocrinologist.

Reshmi Srinath, M.D. is an Assistant Professor of Medicine (Endocrine, Diabetes and Bone Disease) and Director of Weight and Metabolism Management Program for the Mount Sinai Health System