We’re here to guide you through the coronavirus pandemic. Sign up to the Life newsletter for daily tips, advice, how-tos and escapism.
Losing weight could help protect people if there’s a second wave of coronavirus, it’s been reported – but is this actually the case?
Dr Jenny Harries, the deputy chief medical officer for England, appeared on ITV’s This Morning on Wednesday to discuss the risk of a second wave. “Myself and colleagues are very, very concerned about looking for a potential second peak as we move into the autumn,” she said.
While her key message was to continue washing hands, keep social interactions down, and be careful when visiting public spaces, she also said there are other learnings in terms of who is at risk, singling out obesity.
“Obesity is actually problematic and that’s one of the things that we could do something about,” she said. While she didn’t expand on what we could do about it, publications took it as a red light to tell people to lose weight.
What is obesity?
Obesity impacts one in four adults and one in five children, and is characterised by abnormal or excessive fat in the body that presents a risk to people’s health. Those impacted tend to have a higher than average body mass index (BMI) – 25 to 29.9 is classed as ‘overweight’, 30 to 39.9 is classed as ‘obese’, and 40 or above as ‘severely obese’.
But BMI can’t measure obesity alone, as some muscular people have a high BMI without having much body fat. Generally, men with a waist size of 94cm or more and women with a waist size of 80cm or more are considered more likely to develop obesity-related health problems, states the NHS.
There are hundreds of factors that can contribute to weight gain, some of which are out of a person’s control – for example, underlying health conditions.
What do we know about obesity and Covid-19?
Obesity has been linked to an increased likelihood of being admitted to an intensive care unit (ICU) with serious complications related to Covid-19. We also know that while young people tend to swerve the more severe effects of Covid-19, young obese people do not.
Individuals with a BMI greater than 35 – particularly those with heart disease – are at high risk for severe Covid‐19, one study found. Obese patients should be the focus of streamlined prevention and treatment strategies, researchers said.
The reason why obesity is a particular risk factor isn’t fully understood and more research is needed. But cardiologist David Kass, who works at Johns Hopkins Hospital in Baltimore and co-led a study that linked higher BMI to more severe cases of Covid-19, has a few theories.
One of them is to do with physics. Carrying more weight impacts the diaphragm, which, in turn, makes it harder to breathe, he explained.
Another factor he believes plays a part is inflammation, caused by fat itself. Fat cells release signals, which the immune system responds to, and this produces a “low level of background inflammation,” he said. We already know Covid-19 can cause the immune system to go into overdrive and attack itself – known as a cytokine storm – so this may be even worse for someone who is obese.
Obesity is a complex chronic disease caused by genetic, environmental, social, cultural, and individual factors.Dr Karen Coulman
Dr Karen Coulman, a dietitian and research fellow at the University of Bristol, agrees that the risk of complications “may be due to increased inflammation and changes to the normal immune response in the bodies of people carrying excess weight”.
Lastly, Kass is interested in the role of something called the ‘ACE2 protein’ in fat cells. This protein enables the virus to intercept the cells – the virus binds to it in order to gain entry into a cell and infect it.
“It turns out, fat cells express ACE2 at fairly high levels,” explains Kass, “and there’s some past data on this idea related to other respiratory viruses that they can attack fat, last in fat, and shed more slowly from fat.”
What can you do about it?
Obesity isn’t simply an individual lifestyle choice which can be reversed overnight, says Dr Coulman. “It’s a complex chronic disease caused by genetic, environmental, social, cultural, and individual factors.”
The NHS suggests the best way to treat obesity is to eat a healthy, reduced-calorie diet and exercise regularly – it’s recommended you do 150 to 300 minutes (2.5 to 5 hours) a week.
A study of 18,400 adults in China, aged 30-70 years old, found jogging was best for helping people maintain a healthy weight if they had a genetic link to obesity, followed by mountain climbing, walking, power-walking, dancing, and a longer practice of yoga.
The importance of good nutrition also can’t be underestimated in the fight against Covid-19. Professor Daniel Altmann, from the Department of Medicine at Imperial College London, previously told HuffPost UK good nutrition tends to correlate with a healthy, functioning immune system, while poor nutrition correlates with the opposite.
Immunologist Dr Jenna Macciochi also urged people to adopt a healthier lifestyle if they want to help their immune system in the coming months. “It’s all about the small, long term habits,” she said. “Be a regular exerciser, eat a diverse plant-rich diet with lots of fibre and phytonutrients, and get adequate protein and healthy fats. Don’t over or under consume calories, make sure to get enough sleep, and don’t overuse antibiotics.”
Dr Coulman wants to see government-supported public health initiatives to address the obesity crisis in the UK. They are “urgently needed” to prevent people becoming obese, she says, and there’s also a need for effective clinical treatments for those already living with obesity.
There’s no “one magic solution” to achieve weight loss, she adds, and people living with obesity are encouraged to seek advice from their health providers about support available to them.
