Do you have a body mass index over 25? If so, you’re not alone. A full 69% of Americans are overweight (BMI of 25 to 29.9) or obese (BMI 35-39.9)—including President Donald Trump, who has just contracted COVID-19. Of those people, 6.9% are severely obese (meaning a BMI over 40). Although Trump is said to be doing “well at this time,” as your BMI rises, so does your risk of severe COVID infection and death. Obesity increases the risk of high blood pressure, heart attack, stroke, heart failure, type-2 diabetes, non-alcoholic liver disease, and various types of cancer. These medical conditions occur far more often in people hospitalized with severe COVID infection, leading experts to believe that obesity is the common underlying factor.
Click through to see all 15 reasons why there has never been a better time to lose weight, once and for all, and to get through this pandemic at your healthiest, don’t miss these Sure Signs You’ve Already Had Coronavirus.
A recent UK study found that risk of COVID-19 infection increased as BMI and waist circumference increased. Being overweight, obese or severely obese (having a BMI higher than 40) increased the risk of COVID infection by 31%, 55% and 57%, respectively.
One recent study that analyzed 387,019 members of the UK biobank found that being overweight or obese increased the risk of hospitalization from COVID infection by 32% and 97% respectively.
A May 2020 study published in the British Medical Journal reported that people with obesity and severe obesity were respectively four and six times more likely to be hospitalized with COVID than people with a BMI less than 30.
A recent meta-analysis published in the Journal of Virology concluded that obesity increased the risk of severe COVID infection by a factor of 2.5, and the risk of a poor outcome by a factor of 2.3.
A recent meta-analysis published in the journal Obesity, Research and Clinical Practice looked at 403,535 COVID-19 patients and concluded that, compared to those with a normal BMI, being obese
- doubled the risk of being critically ill;
- almost quadrupled the risk of dying;
- and increased the risk of needing respiratory support almost sevenfold.
Many studies have reported that the risk of dying from COVID increases with higher BMIs. In May 2020, the British Medical Journal published a study of 20,133 patients with COVID-19. Those who were obese had a 33% higher risk of dying.
Obesity is known to impair immunity to other respiratory viruses (such as influenza) and reduces response to the influenza vaccine. High blood glucose and diabetes, both associated with obesity, have also been linked to more morbidity and mortality resulting from infection with other coronaviruses—for example, those that caused Severe Acute Respiratory Syndrome (SARS) outbreak in 2003, and the Middle Eastern Respiratory Syndrome (MERS) outbreak in 2012.
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Being obese results in impaired lung function because there are bigger fat deposits in the chest wall, chest cavity (thorax) and abdominal cavity (under the diaphragm). That means obesity makes the chest relatively compressed—so even without being infected with COVID-19, obese individuals have to work harder to breathe.
Obesity increases the risk of “cytokine storm,” an immune system overreaction that causes inflammation throughout the body, impairing breathing and other essential functions. It is seen in some of the most serious COVID-19 cases and can lead to Acute Respiratory Distress Syndrome (ARDS), which can be fatal.
Obesity is associated with chronic inflammation. People with higher BMI levels often have metabolic syndrome, a medical condition which increases the risk of cardiovascular disease and systemic (whole-body) inflammation.
When you’re overweight or obese, if you become infected with COVID-19, your immune system is already overactivated at the point of infection, giving you a higher risk of severe lung disease that can require hospital admission, critical care and mechanical ventilation.
The CDC reports that the risk of death is ten times higher from COVID-19 infection in people with metabolic syndrome and type-2 diabetes.
Adipocytes (fat cells) produce a hormone called leptin, which regulates appetite. High leptin levels make you feel full and tell you to stop eating.
Strangely, obese people tend to have higher leptin levels, probably because of leptin resistance. High leptin levels accelerate atherosclerosis, damaging blood vessels and lowering HDL (“good”) cholesterol. Leptin is a cell-signaling molecule which triggers the production of inflammatory cytokines and sets off the inflammation cascade.
The good news is that leptin levels fall with weight reduction.
Many studies have shown that people who are obese tend to have an unhealthy diet, often eating large amounts of fast food and processed food.
This diet causes changes to the gut microbiome, increasing the “leakiness” of the gut wall. That means bacteria, viruses and toxins can pass from the gut into the bloodstream, exacerbating systemic inflammation.
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Fat is not an inactive tissue. In fact, visceral fat (or belly fat) produces large numbers of cytokines, such as Interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α). Eating a high-fat diet has been shown to increase the production of these cytokines.
Lipotoxicity occurs when you consume so much dietary fat that fat cells can’t store any more. The excess fat spills over into the bloodstream, liver, heart, and kidneys. These fats are toxic and can cause organ damage like non-alcoholic liver disease, heart failure and kidney failure. Twenty-five percent of the US population are said to have lipotoxicity.
Obesity results in increased levels of oxidative stress, which can destroy tissue and impair your immune system. It also has effects very specific to COVID-19. Oxidative stress can prevent red blood cells from releasing oxygen, and it seems to increase damage to the air sacs in the lungs. It also stimulates blood clotting, which can lead to microvascular thrombosis, an often-fatal complication of COVID-19.
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Some researchers have suggested that COVID-19 may use excess adipose (fat) tissue as a hideout where it can replicate, facilitating viral shedding and transmission of infection.
There is some evidence that people living with obesity have worse COVID symptoms than those with a normal BMI.
If you’re overweight or obese, you don’t need to set unrealistic targets. Just lose 5% of your body weight. Really. Simply shedding 5% of your body weight will reduce insulin resistance and relieve oxidative stress—two major health benefits.
Besides that, do everything you can to prevent getting—and spreading—COVID-19: Wear your face mask, get tested if you think you have coronavirus, avoid crowds (and bars, and house parties), practice social distancing, only run essential errands, wash your hands regularly, disinfect frequently touched surfaces, and to get through this pandemic at your healthiest, don’t miss these 35 Places You’re Most Likely to Catch COVID.