As we face this pandemic head-on, there is another problem we cannot afford to lose sight of, the problem of overweight and obesity. Nearly 70 percent of the people in the USA suffer from either overweight or obesity. The stress this pandemic is putting on us as individuals and as a society is unprecedented. While people are grappling with the current threat of coronavirus, the constant fear of getting infected exponentially increases the stress levels. Add to that, the stress of all the lost jobs. This is not only true for the general public but more so, for the frontline workers who often work long hours. What does this all mean for people suffering from obesity? Stress seems to have a detrimental effect on anyone suffering from obesity. The research into obesity tells us that chronic stress may actually hijack your brain into making the wrong food choices. Stress makes you lean towards energy-dense “comfort foods,” that rich in sugars and fat, hence the term, “stress eating.” Elevated cortisol also predisposes to abdominal deposition of fat. It is the abdominal fat that has been implicated in the increased risk of cardiovascular disease. Shelter in place order around the country is putting limitations on people’s activities as well. Humans are beings of habit, and a change in routine can be very challenging for people with obesity. People suffering from obesity can often recall specific incidents when their daily routine changed causing their weight to spiral out of control. While shelter in place is probably the need of the hour, it creates an additional challenge for people to come to terms with the new normal. This also puts limitations on their daily physical activity, although it is heartening to see all over the social media, people finding new and innovative ways to stay active. Night shift workers get a double whammy. The disruption of the circadian rhythm due to the nature of their work makes it harder to lose weight. The added stress wreaks havoc on their health. Another question that arises is, does obesity lead to worse outcomes in COVID-19 infection. A study that was recently conducted in New York looked into this very aspect. After analyzing data from 3615 patients, the authors concluded that in patients aged less than 60 years with a BMI (Body Mass Index) 30-34 were twice as likely to be admitted to acute care and 1.8 times more likely to be admitted to critical care when compared to patients with a BMI <30. The patients aged less than 60 years with a BMI of ≥ 35 were 2.2 times more likely to be admitted to acute care and 3.6 times more likely to require critical care. Potentially complicating the care of patients suffering from obesity is the fact that management of their airways may be more difficult. More than a third of the country is suffering from obesity. This study sheds light on the possible vulnerability of this population to severe COVID-19 infection. It is important to understand that while there is talk about people less than 60 years of age being less susceptible to severe COVID-19 infection, that may not be the case for people suffering from obesity. So where do we go from here? People suffering from obesity will need to exercise extra caution as the nation battles the COVID-19 pandemic. Fighting stress remains paramount in the current environment as does making conscious food choices. People can still go out for walks and exercise as long as social distancing is observed. Social distancing does not mean social disconnect, and people can use technology to stay connected. It is imperative that as we fight this pandemic, we must not let our guard down on the other epidemic we are currently fighting. Avishkar Sabharwal is an internal medicine physician and can be reached on Twitter @DoctorSabharwal and Facebook. Source
