Obesity and COVID-19

Preliminary data suggest that people with obesity are at increased risk of developing severe COVID-19.⁶  The US Centers for Disease Control and Prevention (CDC) states that people of any age with certain underlying medical conditions are at higher risk for severe illness from COVID-19, and being hospitalised and admitted to critical care units: ^2,5,7-10

• 48.3% of people hospitalised for COVID-19 had a BMI ≥30 (kg/m²)¹⁰
• BMI >40 (kg/m²) was the second strongest predictor of hospitalisation, after age³
• Patients with obesity and COVID-19 have an increased risk of mortality⁹

Studies have shown that each 1-unit increase in BMI was associated with a 12% increase in the risk of severe COVID-19.¹¹ In particular, the presence of obesity increases the risk of severe illness approximately threefold with a consequent longer hospital stay.¹¹

For step by step guidance on treating your patients with obesity, download the 5 steps on obesity document.

Additionally, you can also find more information about how to treat obesity here.

Current data suggest that usually, COVID-19 can result in more severe symptoms and complications in people over 65 years of age, ^5,7 and those with other chronic health conditions, including those living with obesity.³ However, in patients with COVID-19 younger than 65, the most common complication is obesity.⁸ Obesity is already known to be associated with other health complications including cardiovascular disease, diabetes and hypertension, which are also in populations indicated to have a higher risk of more severe COVID-19 complications.^1,7,12-14

For more information about the common complications associated with obesity, click here.

While data investigating the association between COVID-19 and obesity is still emerging, recent studies have suggested the increased severity of COVID-19 in people with obesity are due to specific pathways that link to: ^2,3

• Reduced cardiorespiratory protective mechanisms¹⁵

• Obesity-related complications and other comorbid conditions (such as cardiovascular disease and diabetes)¹⁵

• Metabolic factors (such as hypertension, insulin resistance and dyslipidaemia)²

• Increased viral exposure / OR Reduced immune response¹⁶

More research is needed to draw complete conclusions on the definite causal and pathophysiological relationship between obesity and severity of COVID-19 outcomes.¹⁷

It remains as important as ever to ensure people with obesity are able to maintain or start a healthy weight management plan, as easily as possible.^18,19 The current pandemic might contribute to an increase in obesity rates, as weight loss programmes (which are often delivered in groups) and interventions are being severely curtailed.¹⁹ The current lockdown measures introduced in some countries, could have an impact on mobility and enforced physical inactivity, even for short periods of time, increasing the risk of metabolic disease.¹⁹

This self-isolation has led to many people relying on processed food with longer shelf life (instead of fresh produce) and canned food (with higher quantities of sodium).¹⁹ Bariatric medical and surgical procedures have been among those cancelled, and regular appointments of other non-acute patients have been scaled down, which may lead to people with some chronic diseases without the appropriate care they need.^19,20 It is important to ensure vulnerable populations, such as people living with obesity, are receiving the best care possible now, to avoid longer-term implications for health systems.¹⁸