The COVID-19 pandemic has pushed the obesity epidemic once again, showing that obesity is no longer a damaging disease but a disease that can have devastating effects. dire. New studies and information confirm doctors’ suspicions that the virus takes advantage of a disease that the current US healthcare system cannot control.
In the most recent news, the Centers for Disease Control and Prevention reported that 73% of nurses admitted to hospital due to COVID-19 were obese. In addition, a recent study found that obesity could affect the effectiveness of the COVID-19 vaccine.
I am an obesity specialist and clinician working on the front line of obesity in primary care at the University of Virginia Health System. In the past, I used to warn my patients that being obese could take years away from their lives. Now more than ever, this warning has become verifiable.
Damage more than believe
Initially, doctors believed that being obese only increased the risk of getting worse from COVID-19, not the risk of getting infected in the first place. Now, newer analysis shows that obesity not only increases your risk of illness and death from COVID-19; Being obese increases your risk of infection in the first place.
As of March 2020, observational studies noted that hypertension, diabetes and coronary artery disease were the most common diseases – or co-morbidity – in patients with more severe COVID-19. But it was the editors of the magazine Obesity who first raised the alarm on April 1, 2020 that obesity will likely prove to be an independent risk factor for more serious effects. of COVID-19 infection.
Additionally, two studies including almost 10,000 patients showed that patients with both COVID-19 and obese were at a higher risk of death on days 21 and 45 than patients with a body mass index. normal, or BMI.
And a study published in September 2020 reported higher rates of obesity in patients with critically ill COVID-19 requiring intubation.
It is clear from these and other studies that obese people are facing a clear and present danger.
Stigma and lack of understanding
Obesity is an interesting disease. It’s one of the things many doctors talk about, often frustrating that their patients can’t stop or reverse it with the overly simplified treatment plan we were taught in ban training. head; “Eat less and exercise more.”
It is also a medical condition that causes physical problems, such as sleep apnea and joint pain. It also affects a person’s mind and spirit due to prejudice by society and medical professionals against obese people. It can even adversely affect the size of your salary. Can you imagine the outcry if the headline read “High blood pressure patients make less money”?
Our doctors and researchers have understood for a long time the long-term effects of being overweight and obesity. We now recognize that obesity is linked to at least 236 medical diagnoses, including 13 types of cancer. Obesity can reduce a person’s life expectancy by up to eight years.
Despite this knowledge, US doctors are not prepared to prevent and reverse obesity. In a recently published survey, only 10% of medical school deans and curriculum specialists felt that their students were “well prepared” for obesity management. . Half of medical schools responded that expanding obesity education was a low or not a priority. A total of 10 hours are reported to be dedicated to obesity education throughout their training in medical school.
And doctors sometimes do not know how or when to prescribe drugs to obese patients. For example, eight FDA-approved weight loss drugs are marketed, but only 2% of patients qualify to receive a prescription from their doctor.
What happens in the body
So here we are, with the impact of the obesity pandemic and the COVID-19 pandemic. And the question that I see patients increasingly ask me: How does obesity make it worse and the complications from COVID-19 infection?
There are many answers; Let’s start with the structure.
Excess adipose tissue, where fat is stored, exerts a mechanical compression in obese patients. This limits their ability to inhale and release air completely.
In obese patients, breathing takes more effort. It produces restrictive lung disease, and in more severe cases, hypoventilation syndrome, which can leave a person with too little oxygen in the blood.
And then there is the function. Obesity leads to an excess of fatty tissue, or what we often call “fat”. Over the years, scientists have known that adipose tissue is harmful to itself. One could say that adipose tissue acts as its own endocrine organ. It releases many hormones and molecules that lead to chronic inflammation in obese patients.
When the body is in constant low-level inflammation, it releases cytokines, the anti-inflammatory proteins. They keep their bodies active, active, and ready to fight disease. All are good and good when they are examined by other systems and cells. However, when they are released chronically, an imbalance can result in bodily harm. Think of it as a small but containment forest fire. It’s dangerous, but it doesn’t burn the entire forest.
COVID-19 causes the body to induce another cytokine forest fire. When an obese person has COVID-19, two small cytokine fires combine, leading to a raging inflammatory flame that damages the lungs even more than patients with normal BMI.
Additionally, this chronic inflammation can lead to something called endothelial dysfunction. In this condition, instead of opening, blood vessels close and contract, reducing the amount of oxygen reaching the tissues.
In addition, the increased adipose tissue can have more ACE-2, the enzyme that allows the coronavirus to enter cells and begin to damage them. A recent study has shown an association of increased ACE-2 in adipose tissue rather than lung tissue. This finding reinforces the hypothesis that obesity plays a major role in more severe COVID-19 infections. So, in theory, if you have more adipose tissue, the virus could bind to and penetrate more cells, causing a higher viral load, which lasts longer, possibly making an infection. get worse and prolong the recovery time.
ACE-2 may be helpful in fighting inflammation, but if it binds COVID-19, it cannot assist this.[[[[Deep knowledge, everyday. Sign up for the newsletter of The Conversation.]
The novel SARS COVID-19 virus has forced the medical industry to deal with the reality that many American doctors already know. When it comes to preventing chronic diseases like obesity, the US health care system is not working well. Many insurance companies reward doctors by responding to the indicators of treating the effects of obesity rather than preventing it or self-treating the disease. Doctors get a refund, for example, when helping a Type 2 diabetes patient reach a certain A1C level or a set blood pressure goal.
I believe the time has come to educate the doctors and provide them with the resources to fight obesity. Doctors cannot deny that obesity, one of the strongest predictors for COVID-19 and at least 236 other medical conditions, must become the number one enemy.
This article was republished from The Conversation, a non-profit news site dedicated to sharing ideas from academic experts. It was written by: Cate Varney, University of Virginia.
Cate Varney does not work, advise, own shares in or receive funding from any company or organization that may benefit from this article and does not disclose any relevant affiliates beyond the academic appointment. their.