COVID-19 and Obesity: Reducing Risk with Healthy Habits

As the COVID-19 crisis continues to unfold, “flattening the curve” has become the driving imperative for governments, public health officials, hospitals, health care workers, and citizens across the globe. Amid warnings from an official at the World Health Organization that the United States could become a pandemic epicenter, worst-case scenario projections at the time of writing forecast the country could experience a staggering 1.1 million deaths from the novel coronavirus. New guidelines from the Centers for Disease Control (CDC) calling for continued social distancing, frequent handwashing, and cloth face coverings in public are certainly effective habits to adopt to mitigate the spread of COVID-19. But what about our most vulnerable populations? Can healthy habits reduce their risk?

Obesity increases COVID-19 risk. Are Americans more vulnerable?

Early findings from hospitals in Wuhan indicate that 48 percent of COVID-19 patients had a comorbidity, with hypertension and diabetes being the most common. Given that more than one in four Americans live with obesity - a complex disease associated with a number of chronic medical conditions including diabetes and hypertension - it would be unwise to ignore the unique risks facing this rapidly growing segment of the country’s population.

More research is needed into the impact of COVID-19 on specific populations, such as patients with obesity. However, the emergence of H1N1 in 2009 offers some insight into what we might expect. During that pandemic, patients with obesity experienced greater severity of illness and patients with extreme obesity saw increased rates of hospitalization.

The continued spread of COVID-19 should raise flags of concern for health care professionals and citizens alike.

How can patients with obesity reduce their COVID-19 risk? Adopt healthy habits.

The CDC’s guidelines are an excellent starting point for reducing COVID-19 risk during a global health crisis. However, the sheer volume of comorbidities and complications associated with obesity make the adoption of broad lifestyle changes within this vulnerable population both necessary and potentially life-saving during a widespread pandemic. After all, healthy lifestyle habits are associated with a significant decrease of mortality, regardless of BMI, but people with obesity experience the greatest benefit.

Key healthy habits that can help fortify patients with obesity against COVID-19 include:

●      Proper nutrition: Like other states of malnutrition, obesity causes inflammation, called adiposopathy, that reduces immune function. Research suggests that many foods, nutrients, and non-food nutrients modulate inflammation acutely and chronically.

●      Physical activity: Patients with obesity are often advised to “eat less and move more” to lose weight. Our understanding of obesity treatments is much more nuanced than this bit of conventional wisdom, but there is no denying the influence of physical activity on overall health and well-being - just 60 minutes of moderate-to-vigorous exercise has a positive impact on the immune system.

●      Stress management: We now understand that the strong link between stress, obesity, and inflammation can inhibit the body’s natural defense system. Stress management techniques, such as exercise, meditation, and talk therapy can help patients living with obesity strengthen their immune systems.

Certainly, starting a new healthy habit is different than sticking to one. And research suggests that it can take at least two months, or 66 days on average, to form a new habit.

What can health care professionals do? Access obesity medicine resources.

We all owe a tremendous debt of gratitude to the dedicated health care professionals on the frontlines of this devastating pandemic. Health care professionals who are not currently stationed in hospitals or emergency departments may be wondering how they can help during a time of great uncertainty. Pursuing advanced knowledge of obesity medicine can empower health care professionals with tools and resources to better meet the needs of their patients within this vulnerable population.

The Obesity Medicine Association (OMA) offers a trove of resources including continuing medical education, American Board of Obesity Medicine (ABOM) exam preparation, Obesity Treatment Proficiency Badges™, and The Obesity Algorithm®, which offers comprehensive clinical guidance on the latest obesity management trends and evidence-based medical approaches to treatment. To become an OMA member, visit: https://obesitymedicine.org/join/.

The COVID-19 crisis has revealed the vulnerability of certain populations, including people living with obesity, to emerging public health crises. As we all look to do our part to “flatten the curve,” promoting healthy lifestyle habits alongside the CDC guidelines is an easy, proactive way for clinicians and other health care professionals to reduce coronavirus risk among our patients.

For more obesity medicine resources, visit: www.obesitymedicine.org.

Craig Primack, MD, FACP, FAAP, FOMA, Diplomate, American Board of Obesity Medicine, is the newly-elected President of the Obesity Medicine Association. He is board-certified in internal medicine, pediatrics and obesity medicine. Dr. Primack has been named “Top Doctor” by Phoenix Magazine since 2008. He is also the author of the book, “Chasing Diets.”