The Grandmother

COVID-19: Short-Term Focus for Long-Term Risks

Obesity is a complex, chronic disease. However, it’s one that’s easy to ignore, because it burns slowly into a person’s health status. The problem isn’t immediate. It usually lies in the distant future – with long-term risks. That’s true enough, until those long-term risks come into short-term focus. Right now, this is precisely what is happening with COVID-19 in America. An odd thing is happening. More young people require hospitalization for the new coronavirus infection in America than in other countries. Could this have something to do with obesity and its complications?

For some time, many people have been reluctant to seriously consider obesity as a chronic disease. But now they are asking, “Is obesity a pre-existing condition?”

Invincible Youth

Spring Break, March 2020Early experience with COVID-19 told us that the biggest risk factor is age. In China, more than 80 percent of the deaths occurred in people 60 and older. Serious illness was rare in very young children. So it sounded like young people might be resistant to this nasty virus.

Despite the pandemic, that thought seemed to give permission for throngs of young people to flock to the beach for spring break. Don’t worry, be happy!

Then came a report from CDC to tell us that the pattern is different in the U.S. Yes, it’s still true that the risk of death is highest for the oldest patients. However, fully 20 percent of patients hospitalized with COVID-19 in the U.S. were 20 to 44 years old.

So now we know better. Young people are getting severely ill with this virus and pre-existing conditions are the key risk factor. These conditions include diabetes, heart disease, and lung disease. And these conditions are all important complications of obesity – especially severe obesity.

Because obesity rates in America are higher than most of the rest of the world, we have more of these complications in our young people. So obesity is clearly a risk factor for worse outcomes with COVID-19.

Focusing on What Matters

Chronic diseases – including obesity – are daunting because there’s no quick fix. However, in this moment, we can focus on some things that really do matter.

First and foremost we can focus on stopping the spread of this disease. It’s all about staying home and putting physical distance between you and the people you encounter. Using a tissue or your sleeve to cover sneezes and coughs is also important. Keep your hands away from your face.

Those are the basics. Just as important, though, is looking after the things that support your health. Eating healthfully and enjoying good, nourishing food is especially important now. So, too, is keeping active even while you keep your distance from other people. That might mean gearing up your home fitness routine. Getting outside to walk, hike, bike, or run can be therapeutic. It can be a big help for your mood and stress levels. Finally, don’t forget the importance of getting enough good sleep.

And guess what? All of these things are helpful for reducing the long-term risks of obesity.

Click here for further perspective from the New York Times on how people with obesity and other chronic conditions are coping. For perspective on healthy routines in this time of disruption, click here.

The Grandmother, photograph © Giulio Nesi / flickr

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March 21, 2020

2 Responses to “COVID-19: Short-Term Focus for Long-Term Risks”

  1. March 22, 2020 at 3:29 pm, Stephen Phillips said:

    Are People with Obesity at a higher risk for COVID-19?

    According to Stephen Phillips, director of the American Association of Bariatric Counselors, there is currently no empirical evidence that demonstrates that obesity increases risks for vulnerability to the virus or exacerbates the conditions.

    However, some obesities have comorbidities i.e. Diabetes, Cardiovascular Disease and Respiratory Diseases. These diseases can contribute to increased risks of being infected by the virus as well as resulting in complications requiring hospitalization, and needing intensive care. Patients with these diseases (obese and non-obese alike) are at a greater risk for developing life threatening conditions, and increased mortality

    To be clear, people with a BMI over 30 who have no evidence of disease have no higher risks than others. Historically the social disdain for obesity has burdened many people with obesity with involuntary social distancing. As health professionals we must advocate for reliable public health information and not add to the burdens of obesity.