By Professor Dr. Mamunur Rashid (Professor & Head Of Department of Medicine, Quest International University Perak)
Humankind is still staggering from the health, social and financial impacts of the worldwide COVID-19 pandemic. Scientists are struggling to know more about the infection mechanism, who are at the highest risk, and how to limit the spread. It is uncertain how long the pandemic will prevail.
In this worrying situation, people with obesity might be more anxious than before. Researchers report that several factors, like impaired immunity, put obese individuals at a greater risk of severe COVID-19 infection. Research also suggests that obesity doubles the risk of hospitalisation and mortality from COVID-19. It is of paramount importance to understand how treatments and vaccines work in this vulnerable group as well as how to manage weight during the pandemic to be safe and healthy.
Obesity is an extensive and interlinked issue that warrants attention and compassion. Although frequently associated with poor dietary education, financial problems, or psychiatric issues, it can also be genetic or caused by disease or drugs.
Diabetes and high blood pressure are more common in obese people; these, in turn, can lead to more inflammation and reduce immunity against infection. Obesity, by itself, can lead to breathing difficulty and increased blood clotting. Moreover, many find it difficult to manage weight properly.
The CDC and a report on 4,000 patients with COVID-19 in New York City found that obesity is the most important condition that leads to hospital admission. In the hospital, care for patients with severe obesity is often compromised due to inadequate resources. This can include a lack of machines that are able to accommodate them for diagnostic imaging, more complex lifting and handling needs.
A survey reports deterioration of mental health and decline in positive behaviour among people with obesity during the COVID-19 pandemic. Individuals with obesity find it challenging to achieve their weight loss targets. They have reduced exercise, increased eating, as well as increased anxiety and depression.
Another email survey reveals that social distancing has led to loneliness and social isolation, which significantly affects weight management. Due to economic recession and unemployment, people are compelled to select energy-dense, nutrition-poor cheap foods which then increases their weight and causes malnutrition.
In this challenging time, it is important that we explore new lifestyle changes to stay healthy. A daily workout routine and a healthy balanced diet plan will benefit individuals with obesity during the COVID-19 era. There are tons of workout videos on the internet to help people exercise at home or in a small apartment. It is advised to measure body weight regularly and continue current medications.
Telemedicine can be of additional help for a person with obesity to connect with weight management specialists or peer groups for further support when face-to-face visits are limited. Also, it is highly recommended for obese people to wear a mask in public, wash their hands regularly and maintain social distancing to stay safe from the coronavirus.
At present, it is unclear what kind of illness, and if any, will be found in recovered COVID-19 patients. A few of them may require special dietary or nutritional support and psychological therapy. Because flu vaccines are less effective on obese people, scientists are concerned that the COVID-19 vaccine, when it is ready to be used, may be less protective for this population as well. In that case, adults with obesity might need a different vaccination protocol than others.
As the COVID-19 pandemic is likely to extend into the foreseeable future and returning waves are expected, updated guidelines for COVID-19 patients with obesity—including their nutritional and behavioral support—are necessary. A further initiative is needed to consider restrictions on promotions of ultra-processed foods, ensure nutritional fact labels of foods and drinks, and strengthen weight management services. Additionally, it is crucial to evaluate the efficacy of medications and vaccines on individuals with obesity.
