In two previous articles on our blog we have already discussed the relationship between the coronavirus and obesity and the relationship between this virus infection and increased mortality in patients suffering from obesity. There are studies (Annals of Internal Medicine journal) that place obesity as an even greater risk factor for mortality than diabetes and high blood pressure in patients with coronavirus

We want to emphasize the importance of maintaining a healthy weight during this pandemic since by limiting our trips out of home, our physical activity will be affected to a greater or lesser extent.

Our best recommendation is that although we limit our outings and physical activity, we find a way to replace them so as not to lose our routine if we already had one, and if we did not have any exercise routine, it is the ideal time to start.

Why is the issue of avoiding obesity so important in these times of pandemic?

The answer is very simple: the CDC and other international institutions focused on infectious diseases, and chronic diseases confirm that mortality is much higher in those patients who suffer from obesity.

More than double when the BMI is 45 or higher and almost double in BMI of 40 to 45). They even changed the classification of what was considered as risky obesity from a body mass index of 40 to a body mass index of 30, that is, it changed from a BMI of morbid obesity to obesity only.

With the evidence accumulated over the months and the multiple cases of patients who end up in an intensive care area due to COVID-19 infection, it has been verified that they do not need to be extremely obese to be at a higher risk of suffering from a more severe disease. 

Only suffering from obesity, their risk is higher than in the general population, and if they suffer diabetes, high blood pressure, obstructive sleep apnea, asthma, or some other obesity related disease, the prognosis is even less favorable.

All of the above without taking into consideration that in obese patients, general management in an intensive care unit is more difficult from the moment they need to be intubated, mobilized, clinically assessed, and even at the moment in which an imaging study is required, like a CT scan.

Why talk about obesity and coronavirus in an obesity surgery blog?

Although we still do not have clear guidelines to decide how and when bariatric surgeries (gastric sleeve, etc) should be restarted for the treatment of obesity and also to define which patients need to be operated first: if the healthiest or those who are at greater risk, at Obesity Free we believe that under the standards of evaluation and scrutiny of coronavirus infection, patients who are ready for surgery with evaluations done, should be operated as soon as possible, as long as they have the aforementioned tests and evaluations and their surgery can be performed in a hospital without COVID-19 cases.

The reason is simple: considering the great risk that a combination of obesity and severe coronavirus infection will present, we believe that it is worth the risk of going to a hospital to solve a problem that has probably been years in the making (obesity without response to medical treatment) in which case the risk of acquiring the infection is low when the appropriate measures are taken.

In this way, the obesity problem will be solved, not immediately but in a period of time that can range from 6 to 18 months, a time that will certainly pass quickly and without the certainty of having managed to control the pandemic situation and therefore still running the risk of infection although now, lower thanks to weight loss surgery.

Why so much emphasis on losing weight during this pandemic?

In addition to what has already been mentioned, due to the situation in which we find ourselves, whether out of solidarity, civility or self-esteem, we must keep ourselves as isolated as possible for those who may become ill and require isolation and are alone or with little assistance. In addition to the fact that for a considerable period of time they will not be able to have physical activity, much less exercise, it must be taken into consideration that these people will be more exposed to unhealthy foods such as canned or non-perishable. This means that these foods are high in sodium and in general of lower nutritional quality, which in the medium and long term leads to greater weight gain in these patients.

We must do everything possible as a society and as doctors to avoid the conjunction of this new pandemic with the obesity epidemic that affects so many US and Mexican citizens, let's not forget that we are the number 1 and 2 countries in obesity worldwide.

References:

https://www.worldobesity.org/news/statement-coronavirus-covid-19-obesity

https://www.ajmc.com/view/kaiser-severe-obesity-boosts-risk-of-covid-19-death-especially-for-the-young

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