By now you’ve probably heard it said that people with preexisting conditions are among those most at risk of becoming seriously ill due to COVID-19. One preexisting condition from which almost half of U.S. adults suffer – and one we all are likely to underestimate – is obesity.
A healthy body mass index is between 18.5 and 24.9. Registering a BMI of 25 to 29.9 is considered overweight, according to the Centers for Disease Control and Prevention. While having a BMI of 30 or above is defined as obesity.
“The higher the BMI, the greater the chance of developing chronic diseases like high blood pressure, diabetes, high cholesterol and heart disease,” says Angela Harden-Mack, M.D., a physician with Ascension Medical Group, specializing in obesity medicine. “Also, when there’s increased weight and increased BMI, those issues are commonly worsened.”
Black Americans had the highest age-adjusted rates of obesity in 2017 and 2018, according to the CDC, at 49.6%. “Those numbers are significant for our community, and, also, we know that the weight gain may progress. So, that’s why we may commonly see that the numbers are higher in older adults compared to younger adults,” Dr. Harden-Mack says.
Varied and interconnected factors contribute to the obesity problem not only in Black America but across communities, from physical activity to genes to nutrition to socioeconomics.
Even if the extra pounds have not led to other chronic conditions, the reason obesity is concerning to health experts and physicians like Dr. Harden-Mack is due to chronic inflammation. The theory is that the coronavirus may amplify inflammation already present in the body due to excess weight.
“Inflammation is the process the body has to defend itself and heal itself. When the inflammatory response is operating like it should, it turns on to deal with the injury, and then it turns off,” she says.
With obesity, the body stores more fat in the fat cells, impairing their function and making them less healthy than normal sized cells. As a result, they can produce an inappropriate low-grade inflammatory immune response that never shuts off, and then something like, say, a COVID-19 infection can intensify that response and further weaken the body.
For example, “If there’s a heightened inflammatory response in the lungs, breathing is not as easy, and additional support like oxygen and other things are needed.”
Dr. Harden-Mack says, “Treating the disease of obesity is far more involved than simply adjusting calories.” Her work involves evaluating patients to determine possible causes, screening for associated conditions like sleep apnea or irregular periods, and more – all of which may include collaboration with other specialists like mental health providers. “Obesity is best treated by a multidisciplinary team. Not just a physician, not just a dietitian, but several professionals working together.”
For severe obesity she says, “Metabolic and bariatric surgery is one of several therapies available. It is very important and very effective in the treatment of severe obesity, that means individuals with a BMI of 35 and higher, especially when there is the presence of other diseases like diabetes, heart disease and sleep apnea.”
Dr. Harden-Mack recommends that we first arm ourselves with knowledge from reliable sources like the CDC, and then start a conversation with our primary care physicians or an obesity specialist. Unsure what your BMI is?
Find out by dividing your weight in kilograms by your height in meters squared (BMI = kg/m2), and even if it’s within the healthy range, Dr. Harden-Mack recommends finding out what you can do to maintain that healthy weight.
And, of course, nutrition is key. Ask yourself, “Can I cut back on foods high in sugar? Can I cut back on some of the processed food? Can I eat more vegetables?” Or, if you’re sitting at a desk all day, consider where you may be able to squeeze in opportunities to get moving.
Walk around your home or office for five minutes every hour, or take the family for a walk around the block in the evenings. Dr. Harden-Mack says, “These things add up. It’s just part of it, but, again, those are great places to start.”
Get more health information and find a doctor near you by visiting ascension.org/michigan or calling 866-501-DOCS (3627)