Is obesity a key factor in Covid-19 deaths?

What we know about Covid-19 increases daily. But what we don’t remains largely out of sight in the submerged part of this very menacing iceberg that keeps policy-makers awake at night. What we do know we must use wisely applying it where we can to save lives. In January as they were getting to grips with the infection China identified many of the risk factors for poorer outcomes and these have since been confirmed in other countries. Being older is the biggest risk followed by having heart disease, lung disease and diabetes. These risks are mostly unalterable; none of us, for example, are getting any younger.

Statistics that identify relationships are vital, especially where this information allows us to alter something that reduces risk particularly where it could allow us to open up the economy. We are so focused on finding magic bullets – vaccines, accurate testing and contact-tracing and effective medicines. While all we have now is staying at home, social distancing and washing our hands raw. Cocooning or shielding those over 70 has been proposed as a serious policy option. Might it be that simply losing weight could reduce the more serious consequences of the disease?

A week or so back figures published by the Irish government showed that of total deaths then (767), 86% were in patients over the age of 70 years. Of course governments have been keen to show that younger people also die from Covid-19 and to a degree are playing down the age link hoping everyone sticks with public health messages. Yet if you are younger and find yourself in ICU because of Covid-19 then you are more than likely obese. As at least one national leader found out.

Obesity is emerging as a strong link between age and chronic disease and adds further clarity to who is most at risk of ending up in ICU if they get infected. It may also explain why people from the black communities and the socially deprived fare less well when it comes to who dies of Covid-19.

The correlation between a higher body mass index (BMI) and severe symptoms is now well established. In the UK last week two-thirds of those Covid-19 in ICU were overweight or obese and an Italian study showed that 99% of Covid-19 deaths had pre-existing conditions associated with obesity: hypertension, heart disease, diabetes and cancer. A New York study showed that after age, obesity was the second strongest predictor of a need for critical care.

Half the UK population weighs too much with a BMI greater than 25 and with one quarter having a BMI over 30. A BMI over 30 classifies an individual obese. In the US over 40% of the population is obese and it is the US and the UK that are experiencing the largest death rates from Covid-19 infection.

Obesity first became a public health problem in the 1980s as we wallowed through our obesogenic environment designed and promoted by a less caring form of capitalism: too much poor quality food to eat and too often and not enough physical activity. Black people are more likely to be obese and get type 2 diabetes for genetic reasons. The less well-off are more likely to eat cheaper, poor quality foods with higher levels of simple sugars, the types of highly processed foods you busy in the aisles of any supermarket.

There is now sufficient data to at least theorise that obesity may be the central reason for poorer outcomes from Covid-19. Obesity increases naturally as we age, black and poorer populations are more likely to be obese and obesity is the cause of metabolic syndrome a collection of hypertension, type 2 diabetes, heart disease and lung disease. Sleep apnoea is mainly caused by obesity. Is a key reason why this virus is so aggressive in about 10% of those infected because they are too fat?

How do we improve the health of the nation?

A Matched Set” by Tobyotter is licensed under CC BY