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?

I think some doctors suggest people require about twenty percent fewer calories to maintain a weight after loss than if they had never gained.

I saw a programme (maybe last year) following up participants from one of those Biggest Loser programmes. The chap who won had put all his weight back on, plus more. To lose it again, and then maintain that lose, he was having to exercise 3 or 4 hours a day intensively, plus cut his calories to something crazy like 900 calories. It was unsustainable and miserable.

@Dyrne That's an interesting question. I think it's the immediacy of this threat. It's not that cancer, heart disease etc are less frightening, it's just that the threat of them seem like something more vague that I can do something about "tomorrow" if you see what I mean. I also think that I am finding healthy eating easier at the moment. I am at home all the time and can control the food that is around me whereas at work I am on the go all the time and often in an environment where biscuits, cakes etc are very readily available.

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

I genuinely am unsure how you missed it. It’s on all official communications of the list of risk factors, it’s on the government website and it was also stated at one of the press conferences. They have informed the public. Repeatedly.

Really good points about having the time to exercise/meal plan; plus the availability of snacks. I think it’s an interesting point about cancer/heart disease being a bit abstract, and the justification of how you can always deal with the weight issue “later” and pretend to yourself that you’ll sort the weight issue before it causes knock on effects to health (I certainly do that!)

incredibly, i agree with a lot that you say.
some people like crowing over others and are not worth bothering with.
your diet is interesting. you are obviously working v hard on it all.
you sounds much fitter than i am.
do you eat fish, what about beans or lentils. sounds a bit short on protein. but i am no expert. if you dont have bread, what do you use the butter for. and the cream, apart from coffee. could you use milk in that.

I know several people who eat very healthily, don't smoke, and two of them are teetotal. All gained weight after a period of limited mobility. One developed a chronic illness. Her GP told her it was depression and anxiety. She only got diagnosed by chance after seeing a locum at the surgery. In the meantime she'd been put on antidepressants. The side effect of many modern antidepressants is increased appetite and tiredness - with the resulting weight gain. The other two people I know both had a period of inactivity because of impaired mobility. One suffered an injury (ironically exercise related), the other was in too much pain to move around much whilst waiting on (a long) NHS waiting list for a procedure. They'd been refused earlier treatment because "it wasn't yet bad enough".

Obesity is also strongly linked to poverty. It's harder to eat well on restricted budgets. Food banks aren't known for fresh unprocessed foods. Some people don't have access to proper cooking facilities. Cheap carbs are more accessible for some.

It isn't always as simple as telling someone to eat healthily and exercise more. A lifestyle isn't always a choice.

absolute neglect from the government not to highlight this to people

As Bluntness100 says, it has been stated, and written about, and listed. You couldn't miss it. However, sadly, it doesn't really change anything, you can't magically become un-obese in a few weeks. Perhaps it will finally put a stopper in all this body positive nonsense, where people are being misled into believing that obesity isn't a general health risk.

The side effect of many modern antidepressants is increased appetite and tiredness - with the resulting weight gain.

I refused one because it had a very common side effect of weight gain. They couldn't believe it. I'm not overweight, but am right on the cusp of being so even though I exercise a lot and eat a healthy diet - I'm in my 50s, post-menopausal, and REALLY had to up the exercise to stay this weight. Quite a few commonly prescribed medications cause weight gain but it's easier to just blame the 'fat' person.

I genuinely am unsure how you missed it. It’s on all official communications of the list of risk factors, it’s on the government website and it was also stated at one of the press conferences. They have informed the public. Repeatedly.

They have said BMI over 40, but this is much more than that, it is people with a BMI of over 30. There is a big difference.

she literally cannot lose weight
the body has a limited capacity for safe storage of fat, once those storage depots are 'maxed out' fat is sent to other organs and tissues where is causes permanent damage/metabolic dysregulation,
The safe storage capacity for fat also decreases with age, as muscle mass decreases so we lose a storage area for excess energy in the form of muscle glycogen, instead this excess energy is sent to other areas and stored as fat.
this, broadly speaking, is my understanding.

Thank you for your replies

@ToffeeYoghurt - what was the person diagnosed with, the one by the locum?

@alexdgr8

incredibly, i agree with a lot that you say.
some people like crowing over others and are not worth bothering with.your diet is interesting. you are obviously working v hard on it all.you sounds much fitter than i am.
do you eat fish, what about beans or lentils. sounds a bit short on protein. but i am no expert. if you dont have bread, what do you use the butter for. and the cream, apart from coffee. could you use milk in that

No, I'm vegetarian. Vegetarians don't eat fish
Beans &Lentils are, unfortunately, high in carbs. Yes, it is short in the conventional amount of protein hence the inclusion of certain soy/tofu products. Veg does have protein but lie compared to say meat. Butter & cream are required to up the fats in a low carb diet (especially if you don't eat meat) Butter is used in cooking (some people eat it cold/sliced, but I couldn't do that) Milk is much higher in carbs than cream is.

Despite knowing better (you need fats on a low carb diet! I did try cutting out cheese/cream/butter - old thoughts still niggle despite now knowing better!! But over 2 months it made no difference.

@hamstersarse

Are you sure you do not have auto-immune response to foods

Errr no, not sure at all?! Many years ago I saw naturopaths/herbalists & someone re food intolerances etci tried various herbs, naturopathic remedies etc (dandelion tea was a low point). Do you have any
Suggestions/links/thoughts re auto immune response to food? 🌷

Amelie It was a thyroid issue. I'm not sure if under or over active. She seems much happier and she's lost weight since she had her diagnosis and started correct treatment.

@ToffeeYoghurt. Thank you for your reply. I've had my thyroid tested a few times. Like many other tests I'm Borderline, so they won't do anything.

To lose it again, and then maintain that lose, he was having to exercise 3 or 4 hours a day intensively, plus cut his calories to something crazy like 900 calories. It was unsustainable and miserable.

That's the trouble nightsky. Studies have been done on the minority of people who do keep weight off and their lifestyle has to be very extreme. It's not sustainable for most people, least of all those who are coping with the reasons they put on weight in the first place.

I agree about some medications, SSRIs etc. The worst for me was pregabalin. I was just getting bigger every week on that, and the second I stopped it the weight gain stopped even though I was eating the same. I had to make a effort to diet to lose it, but the minute I came off the drug the gain stopped in its tracks. If I had been taking the drug for epilepsy I might not have had that choice.

re the icnarc data posted upthread, thanks for the link. Am I right in thinking the screenshot is on data from April 4th?

The latest report, 17 April, has more than four times as many patients who died in critical care or were discharged from critical care, and whose BMI was recorded. This has a slightly worse death rate for BMI

I think some doctors suggest people require about twenty percent fewer calories to maintain a weight after loss than if they had never gained.

I think it's now been found that the metabolic drop is temporary. Although most people don't keep the weight off for long enough to discover this.

Do you have any symptoms @IncrediblySadToo? It must be frustrating for you. I think the UK has a higher threshold for treatment than many other countries. Our borderline would be treated in some places. I don't know what to suggest. I think some doctors have concerns about side effects of thyroid medication. It's a balance of risks really and quality of life is so important. Obviously it's not possible at the moment but could you afford to see someone privately after the pandemic? They could discuss options with you. Also test for T3. The NHS doesn't tend to include that.

Both my friends who work in the NHS happen to be obese. They have both been redeployed from roles in small clinics to the COVID19 emergency department (am not a nurse myself and have doubtless got the terminology wrong, sorry). It boils my piss that their own vulnerability to this virus has been ignored. One of them is satisfied with the PPE offered, the other DEFINITELY isn't.

My child's teacher is also a large lady, but thankfully she is now working from home.

@ToffeeYoghurt

Hi again thank you for your concern 😊. Symptoms?! Well I never have any energy at all, I'm permanently tired & struggle to get ordinary tasks done. Reading about what some people do in a day exhausts me. I don't usually sleep well, but even when I do, I still wake up tired. My eyes are tired, my limbs feel heavy. Just a general groggy tiredness all the time. Possibly other things that I put down to weight/age.

I'd happily see someone, but who🤷🏻‍♀️ I saw naturopaths/herbalists, did the run of osteopath, chiropractor, physio. Haven't been tested for T3. Had bloods done by GP - lots of borderline results, but nothing dramatic

As I say, happy to consider anything, but I'm all out of ideas?!

Fed up of hearing 'maybe this (CV) will make people take responsibility for their obesity' and other judgemental comments. What the hell else more would they like me to do? 😢

@UponTheBlueGuitar.

That's worrying for your friends I'm incredibly thankful to have been furloughed and be able to stay home right now. I think I will either be made redundant (probably best outcome for me) or have to resign in a couple of months as I'm not 'shielded' but with weight diabetes and high blood pressure I don't feel comfortable working in a situation where I'll be in contact with lots of students and I can't work from home. It's a shame as I live my job, and financially I'll be fucked as I won't get another position the same or another job paying the same, but neither are much use if you're dead 🤷🏻‍♀️

It's hard but try to ignore those comments. A lot of people lazily victim blame when it comes to things like being overweight. I don't think it's always nastiness. Some just aren't aware of the many different causes.

I know a few people who've seen private endocrinologists. It's not cheap so I'm aware that's not possible for e veryone. If you could afford one private consultation you could probably then transfer to their NHS list. I'm not sure for thyroid but a private GP might be willing to initially prescribe you medication. If they think it would benefit you. I don't know if you need to have regular blood tests when on thyroid medication?

Can you get a telephone consultation at the moment with your NHS GP? Might be worth discussing with them again and asking for a trial period on medication. Have you been checked for iron (including ferritin) levels, vitamin B12? You mention age. Some of those symptoms could be perimenopause but as your thyroid bloods are borderline it's definitely worth speaking again to a GP. Emphasise how badly you're being affected by the symptoms.

I agree Guitar, so worrying for your friends. The trouble, I guess, is purely from anecdote and personal observation quite a high number of nhs staff are obese and so protecting all of them would be very disruptive to the workforce. I hope they are doing all they can to rearrange staffing where possible.

"Also once you have gained and lost weight, maintaining that lower weight again is much harder due to changes in muscle tissue, changes in metabolism and in hormones affecting hunger."

So you go on a diet and you cut calories and you lose weight but your body adjusts to the amount of calories you need just to survive (lie down & breathe), your basal metabolic rate. Each time you want to lose weight you have to cut more and more calories. It's miserable, you cheat and the weight goes back on.

If you change your lifestyle to one that is healthier (less processed food, sensible portions) and sustainable and add exercise to increase your cardio vascular health you can lose the weight and keep it off.

The problems with WW, SW, Keto, Lighter Life and all that other bollocks is it's very good at getting to where you want to be quickly but you will 90% of the time go back to your crappy way of eating once you reach your goal.

I've a friend who has lost 4 dress sizes in 9 months, she's gone from being totally sedentary (not being able to talk whilst walking or run for 30 seconds) to running 5k 3 times a week and doing 2 classes, she eats sensible healthy food but still has the odd treat, she now has a lifestyle where she isn't denying herself anything, one that she can stick to forever.

@ToffeeYoghurt

Sorry,I lost the thread!

Yes, maybe a private endocrinologist would be worth a try.

My GP 🙄. I asked in Dec if I could some bloods done -she said no, it's too soon. I was looking at the results last night as we were discussing VutD on another thread. I've been asking for help (injections?) for VitB12 & a DECENT dose of Vit D but she just says they're borderline. Looking back at it just night. Despite taking oral supplements, both have been low for over 6 years - all the while she knows I feel like death warmed up and have NO energy. Hormones tests were 'odd' too. Vit D says 'Insufficiency may require replacement consider treatment in line with local guidelines.

Similar comments every time for previous tests going back 6 years.