Pandemic Perspective #35 November 21, 2020

Could COVID-19 be a turning point in the obesity epidemic?

            In nearly a year since SARS-CoV-2 invaded our lives it has established itself as one of the deadliest plagues of mankind. By this year’s end it will have infected more than 60 million persons worldwide and will have killed more than 1.5 million persons. These figures are far below the catastrophic numbers of the influenza pandemic of 1918-1919. The most conservative estimates place that death toll at 40 million while others claim it to be 100 million at a time when the world’s population was only 1.8 billion, less than a third of today’s figure.

            As one who has watched the explosion of obesity and type 2 diabetes during a medical career that began more than 60 years ago I find myself wondering what the death toll would have been like if our grandparents were as fat-challenged as we are. After all, we have known for a couple of decades that overweight and obesity are critical risk factors in influenza, nearly doubling the mortality rate.

            The publication of more than 500 medical journal articles so far in 2020 has made it obvious that obesity is a major comorbidity in the current pandemic. Obese patients are nearly twice as likely to require hospitalization, to be admitted to an intensive care unit and to be intubated. A rather bizarre indirect indicator of this phenomenon is the job requirement that morgue workers should be able to lift bodies weighing more than 175 pounds!

            It is not only the scientific community that has become aware of the dangers of excess weight. This knowledge has apparently begin to percolate among the masses. (Forgive the inadvertent pun!) At the same time the lockdown and its consequences — people staying at home, being less active, eating and drinking more, locked out of fitness centers – have led to weight gain. I’m not sure if Weight Watchers and similar groups have seen an increase in membership but medical centers that specialize in bariatric surgery are reporting that they are receiving more inquiries from potential patients.

            Could COVID-19 be the tipping point that marks the reversal of the twin epidemics of obesity and type 2 diabetes? That may be a bridge too far but we can hope that it will encourage at least some thinking individuals to make some lifestyle changes. One of these changes might be the use of fasting, which I discussed in the November 15th Carvings and that I’ll explain further in the December 1st blog.