What was known about excess weight pre-pandemic
(PHE – GOV.UK Excess Weight and COVID-19 – Insights from new evidence)
- Most (63%) of adults in England are overweight (BMI 25.0-29.9 kg/m2) or have obesity (BMI ≥30 kg/m2); some groups have higher levels than others including those aged between 55-74 years, those living in deprivation and some BAME groups.
- Excess body fat increases the risk of people developing a wide range of chronic diseases, including type 2 diabetes, cardiovascular disease, many cancers, liver and respiratory disease, and of dying prematurely. These risks increase as BMI increases.
- It is hard to study the effect of weight loss on diseases that take many years to develop, such as cancer, however evidence shows that reducing weight towards a healthier BMI range improves biological markers associated with better health (such as blood pressure) and reduces the risk of type 2 diabetes, and improves quality of life scores, depression and mobility.
Summary of current evidence on COVID-19 and obesity
LINK: PHE – GOV.UK Excess Weight and COVID-19 – Insights from new evidence.
- Patients with COVID-19 living with overweight (BMI ≥25 kg/m2) or obesity (BMI ≥30 kg/m2), compared with patients with a healthy weight (BMI 18.5 to 24.9 kg/m2), are more likely to be hospitalised if infected with COVID-19.
Admission to intensive/critical care and treatment
- Patients living with overweight or obesity (BMI ≥25 kg/m2), compared with patients with a BMI<25 kg/m2 , are more likely to be admitted to intensive/critical care and to require advanced treatment for severe COVID- 19 symptoms.
Risk of death
- There is potentially a higher risk of COVID-19 related death with increasing BMI
- Where studies have looked at other factors that might also affect the risk of dying such as age, sex, measures of socio-economic status (SES), ethnicity and other health problems, the relationship between excess weight and COVID-19 risk was still present.
You can calculate your BMI here: How Do I Calculate MY Body Mass Index (BMI)?
Frequently Asked Questions
Why does obesity increase severity of COVID-19?
At the moment we don’t know exactly why obesity increases the severity of COVID-19 as this is a new infection and we are still learning about the effect it has on people. Some of the current theories (ideas) being explored at the moment are:
- Obesity leads to a generally increased level of inflammation in the body
Fatty tissue releases a range of chemicals that increase inflammation in the body. This low level of inflammation associated with obesity leads to the immune (defence) response being less effective and so greater vulnerability to viral infection.
- Less breathing reserve
Diseases that affect the lungs such as asthma, obstructive sleep apnoea are more common in people with obesity. In addition, excess fat tissue can prevent the lungs expanding fully. This means that people with obesity often have less breathing reserve.
- Increased ACE-2 receptor reservoir
The virus that causes COVID-19 enters the body by binding to a protein called the ACE-2 receptor. This protein is found throughout the body for example in the nose, eyes, mouth, lungs, gut and in fat tissues. People with obesity are thought to have a larger amount of this protein, due to having more fatty tissue, allowing more virus to enter the body and a greater response of the body’s defence system (immune system).
- Low vitamin D levels
People with obesity are known to be at higher risk of low vitamin D levels and this may contribute to the increased risk of severe COVID-19 infections.
- Delay in seeking medical attention
People with obesity may be more reluctant to come to hospital because they have faced a lifetime of stigma.
More research is needed to better understand how obesity affects COVID-19 and to explore these theories further.
If my obesity and diabetes put me at a high risk of COVID-19 complications where do I go for support?
We would suggest your GP practice as a good first point of contact. There is also further information available that might be helpful just Click Here.
There is so much advice on the internet and media, who should I trust?
Your first port of call for current information about COVID-19, should always be the Government website – https://www.gov.uk/coronavirus.
We know it can be really confusing with all the information available on the TV, in newspapers, social media and the internet, much of which may not always be accurate or from a reliable source.
So we have developed this advice resource with this specific question in mind, and for this reason all the questions here have been answered by the members of the Royal College of Physicians – Nutrition, Weight & Health Committee members and Dr. Abd Tahrani, who are all experts in obesity. In addition, all links are to “Trusted Sites” that are reliable and updated in a timely manner.
What can I do as a person living with obesity, who struggles to lose weight to help lower my risk of complications if I contract COVID-19? (are there breathing exercises I can do to strengthen my lungs?)
Trying to eat a healthy diet avoiding high sugar drinks and sugar and fat containing snacks and with plenty of fresh fruit and vegetables will also help. If you have any obesity related diseases such as high blood pressure or Type 2 diabetes, then improving blood pressure or glucose levels might help reduce the risk of severe COVID-19. Ultimately weight loss might be needed to reduce the risk, but there is no evidence regarding this yet. No particular breathing exercises are of proven benefit. You might want to try and increase your levels of physical activity as this helps improve your mental health along with your general health.