Health and nutrition experts may get a rare and unexpected chance in the Covid-19 pandemic time to see whether Americans have experienced even a minor reset in their maintaining a more healthful diet, increased exercise, and maybe even reduction in weight gain and its associated problems.
To be sure, these have been times of high stress, and much popular discussion has focused on people’s “Quarantine 15,” the excess pounds packed on in recent days due to worry, couch sitting, and the availability of food in the close confines of the homes to which so many of us have been confined.
And many restaurants, notably fast food vendors, offered high-fat, high-calorie takeaway for weeks now, even as they make plans to re-open.
But the increased risk posed by excess weight to those infected with the coronavirus has intensified doctors’ push to help patients avoid one of the significant health problems confronted by too many Americans: obesity. As the Wall Street Journal reported:
“In the Covid-19 pandemic, people with obesity are at higher risk for severe illness and death—adding new urgency to efforts to rethink the way doctors treat what has long been a public-health problem. Instead of focusing only on diet and exercise, medical experts say, health-care providers need to shift to a multipronged strategy that includes new prescription weight-loss medications, behavioral therapy and possibly surgery. And to ensure the best results, they argue, this new approach should be overseen by clinicians specially trained in treating obesity … doctors have long known that combating obesity could involve a combination of approaches. But recent research has deepened the understanding of each strategy and how they work together, so doctors can offer more-effective guidance to patients.”
As the newspaper added:
“Scientists now know that excess fat tissue can become enlarged and turn into ‘sick fat,’ leading to abnormalities that result in high blood pressure, heart disease and cancer. Abdominal fat releases hormones that cause dangerous inflammation. Covid-19 puts the body’s response into overdrive, and the inflammation already present due to obesity may be one reason such patients do worse. Compared to people of normal weight, obese patients also are more likely to have other chronic conditions and pulmonary problems such as asthma and lung disease, that increase the risk for serious illness. ‘It has taken a devastating and potentially fatal illness like Covid-19 to shine a light on obesity, which has always been thought of as a background factor, chronic and hard to treat, so why bother? says Robert Kushner, a professor of medicine at Northwestern University and director of the Northwestern Medicine Center for Lifestyle Medicine.”
The Wall Street Journal says that doctors have learned more about which surgical procedures may benefit clinically obese patients most, and they may have a better handle on medications that may be helpful. Weight-loss also is becoming a specialty, including in offering doctors greater insight into how their own practices can hinder or boost patients’ diet, nutrition, and exercise regimen.
In brief, shaming and blaming is out, as modern medicine looks at patients’ excess weight as the result of a “complex interplay of biological, genetic, psychological and environmental factors,” wrote Laura Landro, a noted health and medical reporter for the newspaper.
Scare-mongering isn’t good science or medicine, but doctors have stressed that patients should know about the increased coronavirus risks posed by certain conditions over which patients may have greater control — like weight and its associated illnesses like diabetes.
As the federal Centers for Disease Control and Prevention cautions on its web site:
“Severe obesity, defined as a body mass index (BMI) of 40 or above, puts people at higher risk for complications from Covid-19 … Severe obesity increases the risk of a serious breathing problem called acute respiratory distress syndrome (ARDS), which is a major complication of Covid-19 and can cause difficulties with a doctor’s ability to provide respiratory support for seriously ill patients. People living with severe obesity can have multiple serious chronic diseases and underlying health conditions that can increase the risk of severe illness from Covid-19.”
Indeed, researchers long have found ties among excess weight, diabetes, and heart problems — with all three health challenges sharply increasing patients’ risk if infected with the novel coronavirus. French researchers have reported grim outcomes with diabetic Covid-19 patients so ill that they need hospitalization.
The Covid-19 pandemic has caused huge worry for Americans, especially with joblessness and hunger for too many, and the challenges for others of staying at home and juggling family and work lives.
If possible, and until full normality returns, patients may want to redouble their efforts to maintain or even improve their healthfulness, doctors and others say. Yes, it is good to support your favorite restaurants as they struggle now.
But you may want to minimize consumption of fast and over-processed and refined foods, including drinks and meals with excess fat, sugar, and empty calories. With warm summer weather upon us, we may want to enjoy the seasonal and available fresh fruits and vegetables. See if you and the other significant folks you’re living with can escape that extra Zoom meeting and take a long walk in the neighborhood, instead (wearing a face covering when near others, if it is required by local officials.)
Small, sustained changes can add up and be beneficial to your well-being. Recent research, conducted before the pandemic and based on analyses of more than 100,000 subjects, found an association with patients living longer, healthier lives if they: controlled their weight and drinking; stayed physically active; got sufficient sleep; and did not smoke.
In my practice, I see not only the harms that patients suffer while seeking medical services, but also the high value in their staying healthy and away from the U.S. health care system. Until medical science comes up with a way to prevent or better treat it, the coronavirus will continue to pose the possibility of swamping our health resources. In their better times, they already had notable problems with infections acquired in hospitals, nursing homes, and other medical care giving facilities, as well as major challenges with medical error and misdiagnoses.
That said, the system and the providers in it need our support. Sadly, they — and we — are learning that too many of the “leaders” we put in public offices (especially at the federal level) may not be demonstrating the competence demanded in extreme times to safeguard our health. So, we may need, as always, to do as much as we can ourselves to stay well — and to become even healthier and fitter.
