Overweight risk exaggerated?

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Two facts:

1. 60% of CV-19 patients in intensive care in hospitals are overweight. (NHS)

1. 63.8% of adults in England are overweight. (Public Health England)

As the overall proportion of those seriously ill and overweight is lower than the overall proportion of the general public that is overweight, does that therefore mean that being overweight actually helps protect you if you become ill from CV-19?

Interesting thread. As a doctor can I make a related side point. I don’t think people realise quite how much of medicine is not designed for the modern obese population. I’m not talking people who are a bit over weight. But people who are obese may not realise: it’s more difficult for us to examine you and come to the correct diagnosis. I can’t hear breath sounds properly as my stethoscope is further away from the actual lungs. Examining the abdomen is pretty pointless. If there’s a small mass I won’t feel it. It’s much harder to get a line in in an emergency as we can’t access the veins. The scanners are not built for heavy weights and this can cause delays and even require transfer to a a different hospital for bariatric imaging. If people are obese and immobile it affects recovery from all kinds of diseases as it’s always good to get up and walking and get your strength back after being sick. Plus higher risk of bed sores, skin fold infections, hospital acquired pneumonia in the recovery period. Not directly related to Covid I know but it’s think the risks of obesity and being more unwell go further than just the effect of weight on your organs.

You would need to perform the analysis by age cohort and also to provide sub data e.g. percentage overweight vs population, percentage morbidly obese per population

Yes exactly. The oft repeated "70%" in the uk shows overweight people in ICU at a lower percentage than they exist in the population.

Most of the studies being cited here don't show that overweight people are more likely to be in ICU, they cite various people assuming that its a factor.

They also rarely distinguish between moderate overweight (which may even be protective in disease) and high degrees of obesity. They don't distinguish between obesity and other co morbidities.

Most particularly in the US figures, blaming obesity is a politically expedient way to avoid citing poverty as a factor in poor health (which is a correlation in many studies).

People like to jump on weight as the root of all evil and for a bit of prurient finger pointing but we simply don't have the data to show the effect of weight specifically in this illness.

Most of the adult UK population is overweight though.

I’m diabetic (t1) but my bmi is 18. I’m hoping that will help offset the diabetes. 😬

I have a bmi of 26 and I'm trying hard to get it down. I am very pear shaped though so carry lots of weight on my bum, hips and thighs and way less on my stomach, waist and bust so hoping that would help somewhat. I'm doing well losing weight at the moment as this has motivated in a way that nothing else has before!

According to an American study being overweight or obese is the second largest risk factor for ending up critical with this. You can see this by looking at many of the younger people who have sadly died. Obviously heart disease, diabetes and obesity are linked by poor diet/health choices and often one with coexist with the other.

Most of the studies being cited here don't show that overweight people are more likely to be in ICU, they cite various people assuming that its a factor.

From the ICNARC data- of the people in ITU with COVID- 73.5% were overweight or obese ( BMI >25) which compares to 60.4% of those with viral pneumonia. In the UK generally 63% are overweight or obese.

What the figures do show is that of the people seriously ill with CV, people who are morbidly obese are more likely to die than people with BMIs of less than 25. The risk increases with increasing BMI.

French figures show a staggering correlation between severe cases of Covid19 and obesity.

https://www.lemonde.fr/planete/article/2020/04/07/les-personnes-obeses-sont-plus-fragilisees-par-le-virus60358311_3244.html

Yes I think that as with other health risks, fat distribution makes a big difference. People who tend to gain on the legs and hips have more leeway than those who tend to gain around the middle.

You’d need to do quite a complicated cross analysis of the various factors to get to the bottom of this. For example, the overweight/obese percentages usually quoted are of the whole UK population, not of the London population which has been disproportionately affected to date and where the population are significantly thinner.

AmeliaE that french research is interesting as there are less obese people in France. Unlike the UK it can't be argued that the correlation is simply refecting normal population distribution.

What I would like to know is can you still get just the mild version of Covid if you are obese? Or is getting it an immediate death sentence? (Which is what it feels like at e moment). Or does overall health/diet/fitness play a part too? Ie are obese people surviving it if they get it?

Aseem Malhotra is always worth following.

www.europeanscientist.com/en/article-of-the-week/covid-19-and-the-elephant-in-the-room/?

I think it's very unlikely that every overweight person who gets it dies.
But we know so little, I assumed that being healthy and having a good immune system would help fight the illness, then heard about people on immunosuppresive drugs recovering well.
An "expert" said that low immunity might be an advantage as an overactive immune response can cause a cytokine storm which could be fatal.

Aseem Malhotra is always worth following.

He is on the interview I posted earlier from the BBC

@Darcydashwood it's definitely not an immediate death sentence. Even for those who were obese and ended up in the ICU (ie the very sickest people), over 40% lived. The odds of survival go get better though the slimmer you are which is why I am trying to lose weight (I've only got half a stone to go until I am out of the obese category woohoo! And then 2st to normal weight).

I haven't actually seen stats on how many obese people get it mildly vs severely and how this compares to the general population. I think there aren't many firm stats on the number of mild cases due to lack of testing.

I agree with Aseem Malhotra that this it is absolute neglect from the government not to highlight this to people.

They know it is a significant risk factor and they know that people can shift their metabolic health in a matter of weeks if they have the correct advice, and it is just unforgiveable that people are not given the right information.

As pp have said, this has been building up for years and we have spoken about the obesity epidemic very quietly and let it just build and build without giving the correct public health information. Truly, if people actually knew what that chocolate bar or Dominos pizza was doing to their health, and had not been duped by the "it's just such a pleasure in life - what would life be without a pizza" thing from all the mass marketing of these products, they would never touch them again.

I even know just writing this will incite people to accuse me of being extreme and a kill joy. But the fact that 50% of all food consumed in the UK is highly processed junk food is a national disgrace (not an individual's disgrace as I do not think individuals are to blame - the advice and mixed messaging around 'food fun' is just so rife) ,yet it seems to be a no go area of discussion.

We could save the NHS billions if we sorted out dietary advice.

Thank you Panic. That’s a bit reassuring in the sense that at least you can survive it if you have a high BMI. I have a high BMI and am genuinely terrified of catching it. I had a health check when I turned 40 and everything bar BMI wasn’t bad at all and my lung health was very good. I exercise (cardio HIIT classes) a lot (always have) and don’t drink or smoke and eat plenty of fruit and veg. So I feel like I am generally in good health. I am just so scared that my BMI will outweigh everything else and if I get it I will die. I’m going to try to lose weight though

I am just so scared that my BMI will outweigh everything else and if I get it I will die. I’m going to try to lose weight though

BMI is just an indicator, concentrate on your metabolic health (you will lose weight automatically)

Any of these diets are scientifically based and designed to improve metabolic health:

• Ketogenic diet
• Low carb diet
• GI diet
• Blood sugar diet
• 16:8 diet

They all say and do the same thing - reduce your blood sugar so your body is not inflamed by excess sugar in it's system

On each of these your body will need a week of adjustment as it shifts to being metabolically healthy (I am telling you you may feel like shit for a week) but once you are through that, you are entering the realm of being metabolically healthy.

And the weight will drop off without any excessive or crippling hunger. Real foods satiate you.

• Do not do slimming world or WW. They are bad science and very unsustainable, aside from the fact they make you fucking miserable.

A question for those who have said this has spurred them on to lose weight - why this?

Don’t get me wrong, it’s good that people are trying now to lose weight and any motivation someone personally has is fine; but I’m genuinely curious as an obese person myself - what is it about COVID-19 that scares you compared to cancer, stroke, heart disease etc?

Is it that those other diseases are too abstract?

Do you think if we started publishing daily death figures from these other diseases that you would have been motivated before COVID?

I’m aware I need to lose weight, and I am trying. Unlike what some of the posters here seem to think I’m not labouring under the impression that pizza or chocolate is healthy for me .

I looked at the increased risk of mortality from COVID and slotted it into all the other risks like heart disease etc; so I’m interested that others have really taken this particular risk to heart.

I think I read (not sure where so can't provide a link), that the levels of peoples weight in ICU match that spread of peoples weight in general population so risk isn't clear. But, (again, happy to be corrected by a medic) that being on the larger side provides a better outcome if needing to be ventilated?

NB. I'm not a medic, I do not know the truth behind these claims, and sadly can't provide the link.

I think I read (not sure where so can't provide a link), that the levels of peoples weight in ICU match that spread of peoples weight in general population so risk isn't clear.

The research from France, cited by PP, shows that obesity is definitely a factor.
There are less overweight people in France so the findings are clearer.

medicine is not designed for the modern obese population
So much for 'healthy at any size' 'big and beautiful etc'
Obesity is the 21st century version of 'live fast die young' ...without the thrill of living fast

Just let it build and build without giving the correct public health information
Probably because those who profit from obesity, the diet industry, the food industry, are in a position to lobby the government and quash anything which threatens their profits 😡
Healthy people who are in control of their appetites are not good for business!

@PanicOnTheStreets85 I'm very very similar in terms of needing half a stone to get out of obese and 2 stone to get under 25. We can do this!