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COVID-19 and Obesity

How to prepare for the Coronavirus with obesity

With the entire world in a state of worry around COVID-19 (or Coronavirus), it’s not surprising that people with pre-existing conditions — like obesity — might feel more anxious than normal. If that’s you, it is totally natural and understandable. The virus swiftly took over the globe, leaving researchers scrambling to understand how it works, who is most at risk, and how to control its spread. It’s only right that you have the information you need to stay healthy and safe.

Many people struggle with weight management. Being diagnosed as overweight or with clinical or genetic obesity is not a shameful thing, nor does it mean help isn’t available. Obesity can be genetic, or caused by illness or medication, but it is also often linked to a lack of education in healthy eating, financial limitations, or psychological trauma and psychiatric issues. So, it’s a widespread issue that deserves attention and compassion.

What we know about COVID-19 and Obesity

During this time — as COVID-19 spreads across the globe — you may be wondering how being overweight or obese might affect you if you were to contract the virus. 

According to the World Obesity Federation, “obesity-related conditions seem to worsen the effect of COVID-19; indeed, the Centers for Disease Control and Prevention (CDC) reported that people with heart disease and diabetes are at higher risk of COVID-19 complications.”

You may be wondering why this is the case. On the physiological level, there’s a reason why excess fat can be risky, according to Dr. Karl Nadolsky, the chairman of the American Association of Clinical Endocrinologists’ (AACE) Obesity and Nutrition Diseases State Network and an assistant professor of medicine at the University of Michigan: “There is a concern even for metabolically healthy patients with obesity, just from the excess adiposity based upon angiotensin-converting enzyme 2 (ACE2).”

Obesity can increase severity of COVID-19 symptoms

To break this down, that ACE2 enzyme binds well to viruses, like severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Nadolsky says that this suggests an increased risk of illness severity due to the amount of actual fat in the body.

Unfortunately, the risk of serious illness increases even more if you have comorbidities, or illnesses or conditions that occur together. These might include diabetes, sleep apnea, coronary artery disease, or heart failure, says Dr. Nadolsky.

“Based on data from China,” he says, “fatality was higher for those with preexisting adiposity-based chronic disease.”

If you are currently managing any of those conditions, you may experience a severe form of the illness if you were to contract the virus. If you are older, the risk is further increased.

Obese patients are not being denied ventilators, contrary to rumors

Understanding that the risks are increased if you’re clinically overweight or obese, it may be frightening to scour social media every day — especially when it is full of misinformation and rumors.

One of the more frightening rumors taking over the Internet right now involves ventilator rationing in the United States.

Of course, after watching Italy struggle to meet its patients’ needs with appropriate resources, it’s only natural to worry that the same issue would affect Americans. Even more problematic is that rumors and poorly reported articles suggest that obese and overweight patients are among those who do not have access to life-saving ventilators.

And while it is true that hospitals are dealing with a massive surge in patients as well as a drain on their resources — leading to widespread discussions of triage ethics — there is no evidence that hospitals are not currently offering ventilation to patients who need them, including obese or overweight patients.

In fact, the Swedish Hospital and the University of Washington Medical Center – two of the largest facilities in the county – say they are following CDC guidelines and are not rationing ventilators for any patients.

In New York City, the current Coronavirus hot spot, medical professionals are discussing worst-case scenarios, in addition to ways to split a ventilator so that it can accommodate two patients.

Medical professionals are also discussing triage ethics, including an idea around putting patients into color-coded categories — blue for fatally ill patients, red for high priority, yellow for sicker patients, and green for patients who can wait for a ventilator. 

All of this comes as a proposed “worst-case scenario” in a COVID-19 patient treatment memo from the Henry Ford Health System that was leaked to social media. It implied that some high-risk patients would not be offered ventilators. It also suggested some people would get treatment focused on comfort, rather than survival. A Henry Ford spokeswoman, Brenda Craig, said that they did not run out of ventilators and that the memo was not put into action.

You should know, however, that some overweight and obese people might not be treated with ventilators. Cheryl Allen, ARNP, an internal medicine nurse practitioner, says that people who are seriously overweight or obese may have excess tissue that makes ventilator use dangerous.

The World Obesity Foundation says it can also be more challenging to “obtain diagnostic imaging (as there are weight limits on imaging machines),” and that some obese patients may be more difficult to transport or position in a time of crisis. Sadly, there’s a general lack of focus on obese patients in the healthcare system, as shown by a study published in Clinical Obesity.

While the pandemic is certainly frightening and complex, try not to worry about what might happen, as that can get in the way of living, Nadolsky says. Focus on what you can do right now to mitigate your risk. Working on getting healthier is a great way to feel in control in these very uncertain times. Focus on you, your own protection, and your health going forward.

How to stay safe from coronavirus if you are obese

The best thing to do? Take self-isolation and CDC precautions very seriously, Nadolsky says. You’ll want to clean your hands well and often (for at least 20 seconds), especially after being in public. Avoid touching your eyes, nose, mouth, or anything else with unwashed hands, and don’t go within six feet of others or attend gatherings of any type. If you have family members or housemates going in and out of the house, you may want to isolate yourself from them, as they may carry the virus even if they do not have symptoms.

This may seem difficult to pull off, but the spread is rapid and highly contagious. The CDC believes that respiratory droplets produced by coughs or sneezes easily pass from person to person.

Nadolsky says that younger patients with obesity who are otherwise metabolically healthy and practice good physical fitness may be on the much lower-risk end. If this is you, you’ll still need to practice social distancing along with the other precautions.


At this time, it may also be worth it to explore or revisit lifestyle changes to help you stay healthy in general and during the COVID-19 pandemic, he says. You might start a daily workout routine or begin eating healthier while in quarantine, for example — changes that will benefit you well after quarantine is over.

There are many free, low-impact YouTube workout videos made for people in quarantine or in small apartments, for example. It might also be wise to start stocking up on plant-based foods, like fruits, veggies, and grains, in addition to lean proteins — or to look into a healthy meal delivery service if you don’t want to leave your home for groceries.

Nadolsky also stresses continuing all of your current medications — including ACE inhibitors — which may carry some increased risk.

Recalibrate your diet

If you’re already passionate about diet and exercise, now is a good time to deepen your relationship with healthy foods and movement. Easy adjustments? “Since you can’t go to the gym, make sure you spend more time up and walking than sitting. Go do 15 minutes on your stairs. If you watch TV, do some pushups while you do it,” Nadolsky offers. “Think about muscles as little factories you need to keep churning and burning.”



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