Revisiting the Link Between Obesity and COVID-19
Just about a year ago, the country shut down. Kids were pulled from school and businesses closed. We hunkered down in our houses, fearful of what was to come. We have lived with this pandemic for a year, and during that time, we have learned a lot. We have been bombarded with messages about washing our hands and wearing masks and staying 6 feet away from other people. All great advice. And all things we should keep doing.
These primary prevention measures aren’t perfect (no one ever said they would be) but they are better than nothing! Think of them like a bulletproof vest. If I had to walk into a gunfight and I had the choice of wearing a bulletproof vest or not wearing one, I would choose the vest. It might not prevent me from getting shot (other body parts would still be exposed) – but it would dramatically increase my odds of dying during the gunfight. However, despite a vigorous campaign, some people are choosing not to wear masks or wash hands or social distance. I think it’s safe to assume that they are not doing this out of ignorance – but out of personal choice.
It’s time to stop pouring more money into trying to change people’s personal choices and start pouring money into education about how to improve our odds of survival if we happen to get COVID-19. Very early in this pandemic, we learned that people with obesity are at increased risk for severe disease. In fact, a recent statistical analysis and report showed that the majority of COVID-19 hospitalizations in the US are attributable to four preexisting conditions. The authors estimate that among the 906,849 total COVID-19 hospitalizations that had occurred among US adults as of November 2020, 30% were attributable to obesity; 26% to hypertension; 21% to diabetes; and 12% to heart failure.
This disease has been around for a whole year with millions dead and tens of millions hospitalized worldwide, and we haven’t addressed one of the major ways of preventing such severe outcomes. We are preventing people from seeing their loved ones, but we are not telling them to lose weight and do some moderate exercise. It’s time to shift public health messages to reducing diabetes and obesity as a means to reducing severe COVID disease.
The disease of obesity is treatable. It’s not easy, but it can be treated. Not by shaming people or bribing them (or by selling them MLM products on social media) but by using medical science. There is a whole field of medicine devoted to treating obesity and conditions associated with it. There are medications designed to help people as they treat their obesity. Yet so often, these services and medications are not covered by health insurance. For some reason, people that purchase health insurance for other people often deliberately exclude scientific treatment of obesity from coverage. Which sends a really crummy message to the people covered by health insurance – and does very little to help them work upstream of the problem. Regardless of the cause (personal responsibility or not), we cover medications to treat things like lung cancer, erectile dysfunction, liver failure, skin cancer and a whole host of other diseases that have modifiable components. By excluding the treatment of obesity from this list, we essentially tell people that it is all up to them to find (and pay for) a cure. We have to stop letting this happen.
COVID-19 isn’t going away. We need to start working on protecting our most vulnerable – not just with vaccines, but with treatments designed to help with the underlying problems that make them vulnerable. If obesity, diabetes, high blood pressure, and heart failure are the conditions that make us most at risk – let’s start addressing these things. Now. Not individually, but collectively.
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And as always, you know where to find me if you need me!
Courtney Younglove, M.D.