New data published from the NHS this week demonstrated the latest evidence linking obesity and covid 19. If you are admitted to hospital with covid 19, being obese increases your risk of mortality by 40%. In fact, it looks like after age, obesity is the biggest risk factor for suffering complications with covid 19.
It is no secret we have an obesity problem in the UK. Two thirds of adults are overweight with 26% of us being obese.
It’s hard to lose weight, our entire society is geared towards gaining weight. I get it. We are the first generation who needs to go out of their way to exercise. We are also surrounded by high sugar and fat food that makes it easier to pile on the pounds. I’d even argue it’s easier to be overweight than it is to be a healthy weight.
So how do we classify obesity
Body Mass Index (BMI)
The tool mostly used in healthcare is body mass index or BMI. BMI is a quick comparison to show peoples weight range for their height. We can then categorise people based on their result.
To work it out divide your weight in kg by your height in m2.
For example; 75kg/1.73m/1.73m.
This will then tell you your BMI. You can see how you measure up using the below categorisations:
- <18.5kg/m2 = underweight
- 18.5 – 24.9kg/m2 = healthy weight
- 25-29.9kg/m2 = overweight
- >30kg/m2 = obese
BMI isn’t without its flaws. It won’t account for fat distribution or muscle mass. However, most patients I meet aren’t carrying excessive amounts of muscle and so BMI tends to work quite well. We also won’t use BMI blindly. We’ll combine it with eye balling the patient, looking at their blood work, taking waist circumference measurements and even possibly taking a body fat percentage.
Therefore, obesity is actually a medical term and not just a derogatory term used to label people.
So that’s how we calculate obesity scores.
The UK obesity and covid 19 stats
The UK currently has the highest death rate in Europe from Covid 19 at the time of writing. It’s likely no coincidence we are also one of the unhealthiest. Obviously, there will be many other factors that feed into these statistics such as how we live, work, how we manage the disease, government action and how we collect data, test for covid 19 and how we report the figures compared to other European countries.
In fairness, per capita, the UK is actually fourth in Europe. Nonetheless, we are top tier for both measurements so it is a worrying statistic.
Why obesity and covid 19 causes more deaths
There are several theories looking at the link between obesity and covid 19 deaths. One theory is the extra fat mass around the abdomen places extra strain on the lungs. Another idea is extra fat in the body causes inflammation in the body making it susceptible to dealing with infection. It’s also thought contracting covid 19 causes a cytokine storm, where the immune system gets confused and overcompensates to deal with the virus. As a result, healthy tissues also get attacked leading to increased risk.
We can probably simplify it though. People who are overweight tend to be less fit compared to non obese people. Excuse the obvious generalisation but I meet a lot of these patients. Their reason for being obese may also be perfectly valid. Many patients have health conditions meaning they can’t exercise. So they are missing the crucial piece of the jigsaw. As a result, even eating a healthy diet can lead to an excess of calories consumed compared to calories expended.
Therefore, these patients have reduced cardiorespiratory fitness. In other words, they are less robust when it comes to fighting infection.
Putting the statistics into perspective
Despite scouring the internet, I have come up short on UK hospital admission data for covid 19. Two reports I read suggested somewhere between 14-20% but I can’t be sure of the credibility of these sources. Whatever it is, it is a minority of people. Granted, the high risk individuals will make up the vast majority of these people so we need to consider that.
Current estimates suggest there is 1% mortality rate from covid 19. Again, this means the overwhelming majority are fine with this disease.
So obesity increases the risk of mortality in covid 19 once admitted to hospital. However, less than 20% will be admitted to hospital in the first place. Then, the overall mortality rate is around 1%. So it is still low risk overall.
Really, I think it comes down to recognising the risk. If you have other risk factors already such as your age or have any underlying health conditions and then you are obese as well, your risk is increasing. If you know you’re not overly fit and struggle to manage even modest exercise, your risk is increased. However, it doesn’t automatically place you in the morgue.
What you can do
We can’t do anything about non modifiable risk factors like age or genetics. We can modify risk factors like obesity though. I’m not saying it’s easy but everyone can lose weight one way or another.
Perhaps this covid 19 outbreak has shown us how vulnerable we are as a species. In fairness, we don’t help ourselves either with some of our lifestyle choices and a high rate of obesity. Therefore, this is almost my war cry that if you are overweight or obese this is a really good time to start thinking about your lifestyle. If you eat healthy but are still overweight it shows you there is still an imbalance between food going in and energy burned off. Therefore, don’t take it personally. You can do it but it might take some further work.
If you’re able, try to get active and start to improve your fitness. This will go a long way to helping you deal with viruses like covid 19. If you are fit, you are certainly less likely to encounter problems.
If you really struggle and need a helping hand, check out our programmes, which you can find here. These act as step by step guides showing you how to manage your type 2 diabetes and we are soon to publish our Winning Weight Loss Programme. Not only do these show you what to eat but also provide a bunch of educational material to help make you the expert in managing your condition. Each programme is all about long term results. These aren’t quick fixes but once you complete each programme, you will know what you need to do going forwards.
Anyway, I’ll leave it there guys. Check out the programmes if you need more help and I’ll see you next time.
Need more help
If you need more support we offer a range of 1:1 consultancy services and online programmes focused on helping you improve your glucose control and health for the long term. These include our type 2 diabetes recovery programme, type 1 glucose stability programme and winning weight loss programme. Go to the pages using the links above or in the headers or get in touch if you have questions.