Overweight Populations Add to COVID-19 Risk in US and Abroad

Before COVID-19, another epidemic plagued the United States.

And though it’s not a communicable disease, the condition behind that plague—obesity—continues to spread unchecked.

According to the most recent estimates from the US Centers for Disease Control and Prevention, an astounding 74% of Americans meet the criteria for obesity, with a body mass index (BMI) above 25 kg/m2. Now, a new report from the World Obesity Federation (WOF) suggests that countries in which more than half the adult population is overweight—like the US—experience up to 10 times as many deaths from COVID-19 as nations with lower (pun intended) weight problems.

“Any country with a high prevalence of obesity is at high risk for increased morbidity and mortality for COVID-19 [and] by the time that people with obesity (please note and use people first language) are infected, it is too late,” William Dietz, MD, PhD, director of the Sumner M. Redstone Global Center for Prevention and Wellness at George Washington University in Washington, DC, told Contagion.

Dietz was not part of the WOF report.

The WOF researchers analyzed COVID-19 data from Johns Hopkins University, which has been tracking the pandemic, and the World Health Organization (WHO). Of the roughly 2.5 million COVID-19 deaths reported globally by the end of February, 2.2 million occurred in countries where more than half the population is overweight.

In addition, using data from more than 160 countries, the researchers found that COVID-19 mortality rates increased in parallel with the prevalence of obesity in individual countries—a link that remained even after they adjusted for age and national wealth.

For example, in the US, with its aforementioned prevalence of obesity at 74%, there were nearly 500,000 COVID-19 deaths reported by the end of February (105.7 per 100,000 in the general population). Similarly, in the UK, where 63% of the adult population is overweight, there were 100,000 COVID-19 deaths by the end of February (110.7 per 100,000 in the general population).

Conversely, South Korea, where 30.3% of adults are overweight, officials report 1.8 COVID-19 deaths per 100,000 population. Dietz is hopeful that the pandemic will raise awareness of the importance of diet, exercise, and nutrition in overall health.

“We now have an effective range of treatments for obesity, but what is missing is the will to invest in prevention and treatment through training in the curricula of providers, engaging people with obesity in primary care and reimbursing providers for the treatment of obesity,” Dietz said. “My hope is that the recognition of the significant severity and mortality associated with COVID-19 infections in people with obesity will emphasize how important it is to take obesity seriously.”

He added, “Obesity is a disease. One of the principal barriers to addressing obesity is the stigmatization of people with obesity and blaming them for their disease.”