virus cells

Why is Covid Higher Risk for People with Obesity?

By Tracey Walton wlr team

The recently released World Obesity Federation report1 contained sobering, even shocking, numbers revealing 10-fold differences in death rates from Covid-19 in countries where over half the population has a BMI of over 25.

The report analysed obesity rates alongside COVID-19 deaths in 160 countries. Findings show that 2.2 million out of the 2.5 million global deaths were in countries with high levels of obesity and that those countries with lower obesity levels do not have high death rates.

The numbers may be particularly shocking to those of us going about our day-to-day lives, feeling in pretty good health in spite of having a body mass index that means they are in an overweight or obese BMI category.

So what’s going on in our bodies that’s having such a profound effect on the risk of dying from Covid?

According to Dr Sanjay Gupta, CNN’s2 Chief Medical Correspondent, it’s a mixture of conditions known to be associated with obesity and the effect that fat tissue has on our physiology and immune system. Here’s a summary, but the 2 minute video is well worth watching for Dr Gupta’s brief but clear explanations.

Covid-19 Risk Factors Associated with Overweight and Obesity

Fat in the abdomen limits lung capacity

lungs expanding and contracting to breathe
Diaphragm pulls down to expand the lungs when breathing in, contracts to breathe out

As the graphic above shows, when you breathe in your diaphragm pulls down to expand the lungs. Fat in the abdomen area can limit the space into which your lungs can expand, limiting the amount of air you can get into them.

Obesity related conditions

Other conditions often come along with obesity, including diseases of the heart and lungs and diabetes. These are all conditions that are associated with higher risk of death from Covid.

Body’s ability to deal with infection impaired

Impairment to the immune system, increased inflammation and blood that is more likely to clot can put people with obesity at higher risk from infection with covid-19 and other respiratory viruses like flu.

Fat tissue has a high level of receptors for covid

The virus attaches to our cells via a protein that is present at high levels on the surface of fat cells, Dr Gupta says this could act as a kind of ‘reservoir’ for the virus.

What can be done if you are affected?

In the UK, a Body Mass Index of over 40 is included in the list of Clinical Conditions which entitle adults of all ages access to a vaccine now. In the light of the Obesity Federation’s report many health experts and commentators are calling for qualifying BMI to be lowered to 35 or 30.

It makes sense for all of us to follow social distancing rules, for one another as well as ourselves. Those with obesity should try to eliminate risk as far as possible.

Losing weight decreases the risks. If your BMI is over 25 moving closer to the BMI category below the one you’re currently in will decrease your risk, every point down the scale.

Losing weight’s not easy, but it can be done without ruining your life - and the rewards are worth it. Possibly the hardest part is making a real decision and committing yourself to making it happen.

Having done that, there are many methods available that will work if they fit with your personality and lifestyle. The resources below will help you start exploring options.

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1 - COVID-19 and Obesity – the 2021 Atlas, World Obesity Federation PDF

2 - Why losing weight might protect you from Covid-19 CNN

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