Is weight a factor for severe Covid? It's not clear!

[Johnny2X2X]

I think the answer is it’s maybe a slight factor. We’ve all heard the stat by now that 78% of Covid hospitalization patients were obese or overweight. But what that leaves out is almost 72% of adult Americans are overweight or obese. 78% is almost within a reasonable margin for error. If it were 66% instead of 78%, no one would be saying being thin is an increased risk for severe Covid.

That number is misleading. 78 is not much greater than 72, researchers might dismiss a number like that altogether as not being a significant factor. But the media and the public has pounced on this as another way to blame people for getting severely sick from Covid when weight doesn’t appear to be a large factor at all.

And did you know that if you’re 5-10 and weigh 175 lbs as a man, you’re considered overweight.

So articles like this are garbage. They don’t give real interpretations of the data. Does t mean the obesity epidemic isn’t a national health crisis, just means that don’t be so quick to blame obesity for Covid sickness.

https://www.cnbc.com/amp/2021/03/08/covid-cdc-study-finds-roughly-78percent-of-people-hospitalized-were-overweight-or-obese.html?__twitter_impression=true

[secondwind]

1. I guess there's no point in posting an article like this, then.

[Johnny2X2X]

4. The point is to show how this article is misleading

This article falls to give context, the context is that 72% of the population is overweight or obese so 78% isn’t that far from what you’d expect of weight wasn’t a factor at all.

[Aristus]

2. You mean all these years I've been encouraging my patients to lose weight

I’ve been wasting my time?

Who knew?

[Johnny2X2X]

5. Did you even read my op?

Obesity is a health crisis, but it’s probably just not a big factor for severity of Covid.

[Aristus]

7. The only reason it's not a banner headline

is because obesity is a risk factor for everything.

[WhiskeyGrinder]

3. Don't worry, people will continue to blame lots of stuff on being fat!

It's an all-purpose target.

[Deep State Witch]

34. Yup

Fat person goes to the doctor for a flu shot, gets handed a diet sheet.

Fat person goes to an ER for a broken arm, told to lose weight.

[Amishman]

47. and it often has at least a kernel of truth

Obesity is a huge health problem in this country

The one area where it is exaggerated is the overreliance on BMI, as it becomes increasingly inaccurate the further one is from the average height. BMI does not scale correctly, from wikipedia:

The BMI depends upon weight and the square of height. Since mass increases to the third power of linear dimensions, taller individuals with exactly the same body shape and relative composition have a larger BMI

Not to mention the lack of distinction between body fat and other types of body mass.

We absolutely collectively have a weight problem in this country. We are also sorely in need of better tools to measure it.

[Ocelot II]

6. Obesity is a well-documented aggravating factor.

I thought the article was pretty clear. A person with a BMI of 30 or more is obese; 35 or more is severely obese. Obese people do have an increased risk of serious consequences if they get covid. Being labeled overweight at 175 lbs/5' 10" and a BMI of 25 per the standard weight chart isn't going to make you drop over dead with covid, but actual obesity is another matter, and that has been listed as a complicating condition almost from the beginning. The excess weight makes it more difficult to breathe, and there seem to be metabolic consequences arising from the presence of excess fat in the body, especially in diabetic people. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492082/

[Johonny]

25. yes

[lindysalsagal]

29. I would assume that being seriously overweight makes all kinds of healing more difficult

in all circumstances. Americans need to drop the fast food/sugar addiction. Fast food is everywhere and it's killing us.

I'm not a vegan or vegetarian: I eat lean meats and fish. So this isn't a moral stance: It's a fact that american fast food is engineered like tobacco to cause addiction, and in order to beat it, you just have to go off it totally.

If we didn't have multi-national conglomerates saturating the market, local family businesses might be able to offer healthier scratch cooking and remain in business. But as things stand, they can't compete with the advertising and street marketing and brain washing. Plus, the franchises can pay far less for raw foods, making their profit margins higher.

[LisaL]

8. Well, it appears to be pretty clear to most.

Diabetes and obesity are main risk factors for covid complications.

[Karma13612]

9. My understanding

Is that obesity comes with increase chances of co-morbidities like diabetes, heart disease and even lung problems. All those co-morbidities complicate cases with COVID.

[Buckeye_Democrat]

10. I caught only part of "Real Time with Bill Maher"...

... this week while channel-flipping, hearing him smugly mention this link. I then changed the channel while thinking, "Shut up about science, you anti-vaxxer arrogant twit!"

That's all I've got to add.

Well, this too... I'm "overweight" according to BMI, but most people find that hilarious from looking at me. I have much broader shoulders than most people, and it throws it off.

Yet my waist-to-height ratio is deemed healthy.
https://www.ajmc.com/view/waist-to-height-ratio-beats-bmi-for-finding-obesity-study-says

[empedocles]

12. Maher can be funny for me . . . when he agrees with me.

[Buckeye_Democrat]

15. Lol... I'm indeed guilty of that sometimes.

I mostly don't watch his show anymore, though.

The format of "Last Week Tonight" is far superior, for me. No time wasted from interviewing celebrities and the like.

And there's just something about Maher's demeanor that I don't like, even when his writers give him good material. But the jokes are indeed very funny on his show sometimes, I'll admit.

[Johnny2X2X]

14. Bill Maher is close to overweight.

He’s right in the border at 5-6, 150 lbs. I bet if he eats a lot over a week he can cross into overweight. 5-6, 155 lbs is overweight, I’d bet he’s over that sometimes.

Obesity is a health crisis, but in America, if it were a huge factor for Covid severity it would be a lot more than 78% overweight or obese with severe Covid. More like 90% to establish a strong correlation.

It’s just another way for the public to explain away how terrible Covid is. That the people who get really sick were just fat so it’s their own fault. It’s wrong and is not necessarily true.

[Casady1]

20. He's 5'8 and he is not close to being obese. n/t

[lindysalsagal]

30. I'm the opposite: I wish my waist to height were better, but my bmi is great.

[Beakybird]

11. I know that baldness is a factor, and I've purchased several toupees to mitigate this.

[empedocles]

13. .

[LisaL]

17. That should work very well.

Virus will be scared shitless.

[BornADemocrat]

16. "Of those who were admitted... 50.2% were obese ...42% of the U.S. population was considered obese"

It seems being overweight isn't an increased risk (27.8% of admissions vs 30% of population), but being obese is an increased risk (50.2% of admissions vs 42% of population), however.

[Johnny2X2X]

18. Another way to look at it is 22% of thin people

So in the US, only just over 1 in 4 adults is not overweight or obese. 28%. 22% of severe Covid cases were from this group. Reduced risk? Sure, slightly or maybe it’s just in the noise of the data.

Almost 3 out 4 people in this country are overweight, yet fat shaming persists. Obesity is a severe health crisis in the US, but not even being able to honestly look at the data is a hinderance to addressing it.

[Ocelot II]

19. Here are some data:

Coronavirus disease-2019 (COVID-2019), caused by the highly pathogenic virus SARS-CoV-2, demonstrates very heterogenous clinical severity, ranging from asymptomatic to devastating forms connected with the development of severe acute respiratory syndrome (SARS) accompanied by extensive pulmonary fibrosis (PF). There is rapidly emerging evidence highlighting obesity and type 2 diabetes (T2D) as comorbidities of SARS development in COVID-19 (Drucker, 2020; Fk et al., 2020; Muniyappa and Gubbi, 2020; Orioli et al., 2020). Clinical studies conducted in different countries demonstrated that obesity and T2D are linked to severe forms of COVID-19 in all ethnic groups. A prospective cohort study on 2741 patients hospitalized in the US health care system revealed that obesity was one of the most important factors associated with hospitalization and critical illness (Petrilli et al., 2020). Another US study on 5700 patients hospitalized with severe forms of COVID-19 reported that many of them had either obesity (41%) or T2D (33%) (Richardson et al., 2020). According to results obtained in China, individuals with obesity compared to patients with normal weight demonstrate significantly more severe forms of COVID-19 (Cai et al., 2020). A meta-analysis based on 33 studies revealed that T2D is associated with mortality and severity of COVID-19 with pooled odds ratios of 1.90 and 2.75, respectively (Kumar et al., 2020). A UK study with 6142 patients indicated that diabetes is an independent prognostic factor in the COVID-19 critical care (Dennis et al., 2020). A retrospective study on 1158 patients hospitalized in Kuwait revealed that patients with morbid obesity and T2D were much more likely to be admitted to the intensive care unit, demonstrating odds ratios of 5.18 and 9.38, respectively (Al-Sabah et al., 2020). Statistically significant correlations were found between the officially reported obesity prevalence and the corresponding number of total deaths of patients with COVID-19 in a number of different countries (Ekiz and Pazarlı, 2020). A strong negative correlation was found between age and BMI in 265 patients admitted to an intensive care unit (ICU), and it was concluded that obesity can shift severe forms of COVID-19 to a younger age (Kass et al., 2020). A single-center retrospective study from Germany based on computed tomography (CT) measurements of visceral and subcutaneous adipose tissue in 30 COVID-19 patients (13 of which had severe forms of disease), revealed that an increase of visceral fat area by one square decimeter was associated with 22.5-fold increased risk to be admitted to ICU and 16.1-fold increased risk for mechanical ventilation (Petersen et al., 2020). Also relevant to this discussion, SARS-CoV-2 clearance is delayed in patients with diabetes (Chen et al., 2020a; Chen et al., 2020b), and T2D as a single comorbidity negatively impacts the severity of COVID-19 (Guo et al., 2020). Additionally, a multi-center retrospective study demonstrated that the high fasting blood glucose is an independent predictor for mortality in patients with COVID-19 without previous diagnosis of diabetes (Wang et al., 2020).

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492082/

This isn't my opinion. It's a peer-reviewed study from a reputable scientific source.

[SoonerPride]

33. Seems pretty clear to me. This is not fat shaming. It is a clear risk factor.

[Maxheader]

21. Skinny strong baby! Skinny strong!

As l.a. used to say...

[smirkymonkey]

22. If it was, then 95% of MAGAt's would be in serious trouble.

Just look at that crowd. Almost every single one of them is obese or close to it, including their messiah.

[Bettie]

23. Thanks for giving it a shot

but fat people are hated and derided here.

It's the last bastion of commonly accepted bigotry; hatred of fat people cuts across political lines, it unites right and left.

[Johnny2X2X]

24. Thanks

I think I could have worded it better, but yeah, people do want to hate overweight people and the irony is that 3/4s of the country is overweight, so those doing the hating don't realize that they're included in these stats them selves in most cases.

I myself struggle with my weight, but maintain a fairly healthy weight, but would be considered overweight, just short of obese.

When people see that stat, 78% of US Covid patients are overweight or obese, it absolutely must include the fact that almost 72% of Americans are overweight or obese. In fact, with Covid, I'd bet that 72% will be closer to 75% or over when the new data comes out because the restrictions have clearly caused weight gain. So we could be looking at a 75% overweight or obese country where 78% of Covid hospitalizations are overweight or obese. That's basically about what you'd expect.

Now it might explain why it's worse in the US vs other countries, but in the US, 78% of Covid hospitalizations being overweight/obese with a 72% overweight/obese population is not a massive statistical difference.

People think of Covid patients dying and they think of massive 350 lb patients, when in fact this 78% metric includes a ton of people who are like 5-10, 180, 5-4, 130, 5-11, 185 etc etc.

Obesity is an epidemic in the US, it's a national health crisis, hating on "fat" people makes it worse, not better. And we're to the point where people don't even know that they themselves are considered overweight.

[Ocelot II]

26. Acknowledging that obesity is a significant complicating factor in covid cases

isn't fat-shaming; it's just established fact based on many studies. Diabetes, heart disease and lung disease are also comorbidities, and pointing that out about those conditions isn't diabetes-shaming, heart disease-shaming or lung disease-shaming. Likewise, the fact that obesity is a condition that could make covid worse isn't a criticism. It's just reality, and many studies have established it. Nobody is blaming people for it, or for being diabetic or having heart or lung disease. Or, for that matter, for being old. These comorbidities are why vaccines were made available to people who have them, along with the elderly, before the general public. That doesn't sound like shaming to me, it sounds like helping. Fat-shaming is real, but this isn't it.

[Bettie]

28. Right, sure

I've also been told that sinus infections are caused by fatness.

Oh, and when strep is going around, if I get it, it is 100% because I'm fat.

It also isn't "fat shaming" when I go to the doctor and get shuttled through every room there because there is no way my blood pressure can be "correct".

Oh, it also isn't fat shaming when they insist on fasting blood draws a second time because the lab must have made a mistake.

I don't go to doctors anymore, because if you are fat, they don't give care, they give bariatric surgery brochures.

It isn't about health, it is about aesthetics.

[Drunken Irishman]

31. There is a difference between being fat and morbidly obese.

I agree that doctors can be harsh about weight, especially if you're just overweight or even marginally obese.

It's a whole nother story if you're significantly obese. People who are so overweight they struggle to even remain mobile are likely going to hear it from the doctor.

Why? Because someone that overweight can't be healthy. And the doctor is going to get on your case about it knowing continued ignoring of that morbid obesity is going to lead to further health problems.

It's no different than smoking.

My parents smoked for years and years and even when they seemed healthy, the doctor was always bringing it around to their smoking because it was wholly unhealthy and could lead to debilitating issues down the road. So, it's not a surprise a doctor will harp on someone's weight - especially if they're significantly obese.

The astonishing thing for me is just how little accountability super morbidly obese people take with their weight. It's a mix of denial and the inability to want to change. I get the last part because it's hard but if you're a couple hundred pounds overweight, don't get upset if the doctor points it out. Just like I'm sure smokers have accepted they'll be called out too about their smoking.

I'd expect that from any doctor and so should you. Why would a doctor ignore an unhealthy habit, even if it wasn't directly tied to the reason you're visiting at the time? That's just straight up malpractice.

[Deep State Witch]

35. Because I'm paying them to take care of my sinus infection

Why should a fat person who goes to a doctor for something common, that has nothing to do with weight, get another f*cking lecture? Just STFU and write the scrip for a Z-Pack already!

[Drunken Irishman]

40. Because they're a doctor. What a silly comment,

If you walk into a doctor's office wanting help with your sinus infection but your leg is about to fall off because it's riddled with gangrene, you don't expect them to step in and look at that as a major concern?

I don't mean to be mean here but that attitude is so child-like.

FWIW, obesity IS tied to sinus issues:

https://pubmed.ncbi.nlm.nih.gov/17956019/

[Celerity]

43. You have far more patience than I do, DI.

[ecstatic]

45. If it's any consolation, my doc shamed me

for being too thin. Which I'm NOT, though I was 10 to 15 lbs less than I was at my previous visit 2 years prior.

[Deep State Witch]

37. Exactly!

N/T

[Bettie]

38. Good to know there's someone else here

who doesn't see "being fat" as an automatic death sentence or an indication that they are of no value.

I'm so tired of people judging the worth of other humans by the shape of their bodies or the color of their skin or any number of other things that don't take into account anything but what they look like.

I really appreciate you speaking up. Thank you.

[Act_of_Reparation]

27. Weight is usually related to other conditions that might be more significant.

Heavier folks are at higher risk for cardio-pulmonary conditions that may exacerbate COVID infection.

[SoonerPride]

32. The evidence is pretty clear. It is a co-morbility. The more one is overweight the more deadly it is

Excessive weight and the various complications that arise from weight, especially obesity and morbid obesity, increase the likelihood of hospitalization and death from COVID 19.

That is not fat shaming.

That is empirical evidence.

[Deep State Witch]

36. Victim-Blaming

There's an awful lot of victim blaming here. "It's your fault that you got COVID because you're a fatty, fat, fat! You're a drain on our health care resources!"

Well, f*ck you all. Everyone is at risk of getting COVID. I know a woman who is normal weight, walked about 5 miles a day, and got it this time last year. She's a long-hauler. One of the first people to get COVID in the U.S. was an ultra-marathoner.

[Johnny2X2X]

39. Exactly

Even looking at the research posters provided, heck, one of the says 41% of serious Covid patients were obese and therefore obesity is a comorbidity. Wait a second, 41%? Well 42% of the US population is obese, so what gives?

Here's what people are doing, they're painting with too broad a brush, they're acting like the majority of people who are hospitalized are morbidly obese, they aren't, they aren't even obese, the majority are either underweight, normal weight, or overweight but not obese. Just like the population of the United States.

It's an effort to downplay Covid as "mostly" affecting people who brought the severity on themselves by being so "fat." Well that's not the reality. The reality is this is affecting everyone, and obesity isn't the single biggest factor on severity. The 78% number is totally misleading since the article did not mention that 72% of the country are obese or overweight.

And that's the catch, I bet you3 out of 4 of the overweight people don't even know they are considered overweight.

[Celerity]

44. Being obese or heavier increases your chances of serious illness and or death from C. To deny it is

to completely ignore basic science-based evidence. It is not victim blaming, despite your false framing attempts.

You are conflating simply getting COVID (which of course anyone can do) verus serious illness and/or death, the chances of which are definitely increased overall by overweight issues at least starting at the obese level and escalating from there as the excess weight on a person goes up. A morbidly obese person has a serious comorbidity factor (and quite possibly more, such as diabetes, etc.).

Btw, you saying this

Well, f*ck you all.

is not exactly an effective way to win hearts and minds.

[JCMach1]

41. We are still learning. That whole blood type BS was just recently debunked

By testing

[Edim]

46. I think yes - there are many studies, also with non-Americans

Here is an interesting study, slightly off topic but somewhat related, about physical (in)activity and covid19:

Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients
https://bjsm.bmj.com/content/early/2021/04/07/bjsports-2021-104080

"It is notable that being consistently inactive was a stronger risk factor for severe COVID-19 outcomes than any of the underlying medical conditions and risk factors identified by CDC except for age and a history of organ transplant. In fact, physical inactivity was the strongest risk factor across all outcomes, compared with the commonly cited modifiable risk factors, including smoking, obesity, diabetes, hypertension, cardiovascular disease and cancer."!!!

!!!