How to stay safe from COVID-19 if you have a weight problem

People who are overweight or living with obesity that become infected with Covid-19 have a number of issues that potentially make them more vulnerable to severe illness.

1. Increased adipose tissue increases how much Angiotensin-converting enzyme 2 (ACE2) your body produces. This enzyme binds to the Covid virus and may therefore increase disease severity.
2. People with weight problems are more likely to have diabetes, high blood pressure, heart disease, respiratory disease (sleep apnoea, asthma, reflux-related lung disease), kidney disease and other conditions that increase risks of causing severe illness from Covid.
3. People with weight problems are harder to look after in ICU and are more prone to complications when on a ventilator for a prolonged time.
4. We now know that people carrying extra weight are also far more likely to die after a covid infection.

 

So, what can be done about this?

First up, it’s important not to let fear dominate our lives, as that gets in the way of living. It is possible however to use legitimate concerns as a “call to action” to improve not just our health as it relates to Covid but our health overall. Experts have a number of suggestions that will help.

• Get vaccinated. Any vaccine is ok for a very large number of people over the age of 20. The risks of the AZ vaccine that everyone is concerned about have been massively blown out of proportion, this has led to people taking bad advice which has led to preventable illness and death.
• • If we vaccinated the whole Australian population in 2 weeks with the AZ, we would get around 25 vaccine-related deaths and around 50-100 ICU admissions. In NSW alone we have had a tiny percentage of the population infected with COVID leading to many ICU admissions and an increasing death rate. It’s likely that almost all these ICU admissions and deaths would have been avoided had the people affected had the AZ vaccine.  
  • 25 people die every week crossing the road in Australia and about 60 people a week from suicide. Clearly, the risks of vaccination need to be understood in this context.
  • We should, as adults, be more concerned about our children’s welfare. Every time someone over the age of 50 has a Pfizer COVID vaccine they are effectively preventing a dose from being available for a child or adolescent, and it’s clear that they won’t get their schooling, friends and future opportunities back until they are vaccinated.

• Take social isolation and personal hygiene seriously and ensure that those around you do as well. Official government guidelines have been consistently accurate for the last few weeks, and they do a far better job to inform us of the steps we need to take than what may pop up from unofficial sources and armchair experts.

 

• Ensure your medical conditions are optimally controlled. Now is a perfect time to get in touch with your GP and get a check-up.

 

• Work on your fitness. This will improve respiratory health, reduce your blood pressure and help control your blood sugars.

 

• Eat well and avoid snacking. If you are eating more than 3 times a day you are highly likely to be gaining weight. Calorie containing drinks (milky coffee, alcohol, juice etc all count as snacks). Weight gain increases stress on all your body’s vital functions if you are overweight.

 

• Consider short or long-term weight management strategies. While many traditional weight management options are not available during this time there are things you can try that can work well. Losing 5-10% of your weight can have profound effects on many illnesses if you are carrying too many kgs.
  • Very Low-Calorie Diets (VLCD) such as Optifast ™. These high protein/low carbohydrate meal replacements can replace 1-2 meals a day to promote weight maintenance, or 2-3 meals a day for rapid and safe weight loss.
  • Intermittent fasting. The 5:2 diet whereby you fast 2 days a week or the 16:8 diet where you only eat or have calorie-containing liquids for 8 hours a day are options that may work while our new routine is in “lock-down”.
  • Medically supervised options. These are more complex and rely on a mix of exercise, dietary change and VLCD. There are also several new and very effective weight-loss medications available that can help people lose up to 15-20 kg (10-15% of starting weight).

While bariatric surgery has been proven to provide a sustained weight loss greater than 5-10 times what can be achieved with the methods above, there are many people who may not wish to do this during the Pandemic. Now however could be a good time to consider a long-term weight management plan that could help protect you from this and other dangerous health problems in the future. Our offices are open to offering medical advice to people with a weight problem or people who have had previous weight-loss surgery to help keep them safe during this time.

A/Prof Michael Talbot