Obesity and COVID-19

By Dr. Bassem Safadi, Professor and Chair, Department of Surgery

Some reports claim that high percentage of obese people are likely to contract COVID-19. Why is that?

Most reports have indicated that being overweight or obese increases the likelihood of getting a more serious form of COVID-19 infection. This is especially true if there are obesity related medical problems such as diabetes. Obesity is known to weaken the immune system and reduce the lung capacity so patients can develop shortness of breath and low oxygen levels faster than lean patients. We are not sure if obese patients are more likely to contract the virus itself (SARS-Cov-2) but they appear to be more vulnerable to the disease (COVID-19).

What are the added complications in treating an obese person infected with COVID-19? 

The most difficult part in managing obese patients with COVID-19 is helping them with breathing and oxygenation. To start with, the lung is restricted in most obese patients and does not expand to full capacity. Many obese patients also have obstructive sleep apnea and are more likely to require a breathing tube in the trachea and a ventilator. Most COVID-19 patients are kept in the prone position when they are on mechanical ventilation and that is difficult to do when the patient is obese. Lastly, obesity increases the risk of diabetes, stroke, blood clots and other conditions that make patients susceptible to serious COVID-19 complications.

Would COVID-19 complications in obese people vary according to age? 

The statistics are emerging from Europe and the US that age and obesity are both independent factors associated with higher morbidity and mortality from a COVID-19 infection. Intuitively, the combination of both should further increase the risk, but to date I am not aware of a study confirming that statistically.

With the lockdown, people are turning to food for comfort (cooking, baking and eating) which, without the regular exercise regime, might lead to weight gain and possibly reaching obesity. What is your advice on this? 

Unfortunately, lockdown is not healthy. The combination of stress, anxiety, social isolation, inactivity and the abundance of food and “empty” time provide the perfect recipe for gaining weight. One should work hard to stay as active as possible, develop a routine when it comes to exercise and food, engage family members in fun activities and not succumb to stress and anxiety. This is hopefully a short-lived period that we will go through and emerge with strong spirits and hope.