As infectious disease experts continue to study COVID-19, they have been able to uncover many of the factors that lead to more severe symptoms.
It’s become clear that people with comorbidities (more than one disease or condition present in the same person at the same time) tend to experience more severe coronavirus symptoms. And one health condition, in particular, is contributing to worse outcomes in people with COVID-19: obesity.
Unhealthy excess weight has been known to increase risks for a variety of diseases and complications. Now, the Centers for Disease Control and Prevention (CDC) reports that a person is three times more likely to be hospitalized for COVID-19 if they have a body mass index (BMI) of 30 or higher.
And now, the CDC is warning that even moderate excess weight may be a risk factor for severe symptoms. This means that nearly 32% of Americans who aren't obese but are still categorized as overweight are now more likely to have harsher symptoms if they contract COVID-19.
The good news is that with the right lifestyle changes and choices, you can lose weight and better protect yourself against COVID-19. Even better, managing your weight will both lower your risk for severe COVID symptoms and help you prevent other chronic diseases, from heart disease, diabetes and stroke to cancer.
Why is obesity linked to severe COVID-19?
Naomi Parrella, MD, medical director of the Rush Center for Weight Loss and Bariatric Surgery, explains that there are several reasons why COVID-19 is exacerbated by obesity.
“What we see is that patients who are admitted into intensive care units and put on ventilators have a higher prevalence of obesity. We believe it’s related to this massive response by the immune system,” Parrella says.
A main cause is the fact that obesity leads to a number of chronic illnesses that can worsen COVID-19 symptoms.
Obesity can lead to heart disease, diabetes, cancer, high blood pressure (hypertension), stroke and many more. Diseases like these can make you up to 3 times more likely to be hospitalized for COVID-19.
While Parrella explains that it would be impossible to conduct studies on how losing weight proactively protects you from COVID-19, what doctors do know is that losing weight can reduce baseline inflammation and prevent other comorbidities. Reducing inflammation and preventing these other chronic diseases may, in turn, prevent many of the severe symptoms COVID-19 can cause.
There are a variety of ways to lose weight and manage obesity. Whether you choose weight loss surgery or not, you will need to adjust your lifestyle — including both your diet and exercise habits, among others.
All about diet
One of the driving factors in losing weight is what food you put into your body. Many of these diet changes can be simple. According to Parrella, cutting out sugars, loading up on non-starchy vegetables and eating enough protein are great ways to help lose weight and be healthier.
Ditch sugary beverages
An easy way to cut down on your sugar intake is to re-examine what you are drinking.
“Don’t drink your calories,” Parrella says.
And that doesn’t just mean soda. Parrella explains that many people make the mistake of drinking a lot of juices, such as orange juice, to be “healthier” and get their Vitamin C. “But orange juice is really just a major sugar cocktail — equivalent to as many as 12 oranges per glass — that can do more harm than good if you’re trying to manage your weight,” she says.
Instead, Parrella suggests beverages with few or no calories. Water, unsweetened tea and black coffee are all good options. And, if you need a little flavor with your water, try squeezing in a bit of citrus: lemon, lime or orange. You can also make a pitcher of cucumber or berry water and keep it in the fridge for healthy refreshment any time.
Whether you are leaning toward weight loss surgery or just making lifestyle changes, managing your weight is a marathon, not a sprint.
Choose natural foods
When it comes to food, Parrella says avoiding processed foods in favor of vegetables and proteins is one of the best changes you can make to your diet.
“In the simplest terms, increase the foods that nature created,” Parrella explains.
That means eating vegetables that are all different colors of the rainbow — from leafy greens to yellow squash to vibrant red tomatoes.
And you don’t have to spend a fortune and buy from the organic section at Whole Foods to eat healthy. Frozen vegetables are cost effective and can even have more nutrients than fresh produce. If you prefer canned veggies, that’s OK, too. Just look for reduced-sodium versions and rinse them off before cooking.
For proteins, Parrella recommends chicken, turkey, pork, lamb, grass-fed beef, as well as fish, tofu and, yes, eggs. “Eggs are an outstanding source of protein,” she says. “Having some eggs, cottage cheese or yogurt is a great way to boost your protein intake.” Legumes are vegetarian and vegan options for proteins as well.
Boosting your activity level
Along with a change in your diet, regular exercise is a major part of any weight loss journey. Staying active can be challenging during the COVID-19 pandemic, but all movement counts. Whether you are staying at home or going to a gym, look for ways to move more.
“The most important thing is to break up the sitting down,” Parrella explains. “When we talk about being stuck at home, it's so easy to sit for long periods of time.”
One of the best ways to break up the sitting down is walking. If you don’t want to walk outside or in a gym, Parrella recommends looking on YouTube for home workouts. Youtube and many smartphone apps have a variety of low impact workouts as well as numerous virtual walking paths to choose from.
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Aim for 7,500 or more steps every day — and you don’t have to do it all at once. Try to take several activity breaks throughout the day. Do a few laps around the block, walk up and down a flight of stairs 10 times, or even march or jog in place for 10 to 15 minutes. The key is to boost your heart rate and get your blood pumping.
Parrella also suggests using a fitness app, if available. Apps like those on the Apple Watch will send reminders to stand up or get moving if you’ve been sitting too long, as well as daily fitness goals that can motivate you to get your exercise in.
Is weight loss surgery right for me?
Sometimes, diet and exercise may not be enough to achieve your desired weight loss. If that’s the case, bariatric surgery may be an option for you.
For many people who are affected by obesity, bariatric surgery is the most effective way to lose weight and reduce the risk of obesity-related health problems. Bariatric surgery may be right for you if your body mass index (BMI) is at lease 40, or if your BMI is at least 35 and have an obesity-related disease such as diabetes, heart disease or high blood pressure.
If you are considering weight loss surgery, the Rush Center for Weight Loss and Bariatric Surgery offers a full range of procedures, including minimally invasive techniques. Rush is accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQUIP), and Rush surgeons have performed more than 2,000 weight loss procedures to help patients realize their weight loss goals.
A lifelong journey
Whether you are leaning toward weight loss surgery or just making lifestyle changes, managing your weight is a marathon, not a sprint.
“In our clinic we invite all of our patients — whether or not they go for surgery — to continue to connect with us even after they reach their weight loss goals,” Parrella says. “We are committed to our patients for the long term. It’s like being BFFs for a lifetime.”
While some may find it challenging at times, committing to lifelong weight management has many health rewards — including helping to protect against the ravages of COVID-19.
“Even though we don’t yet have a proven way to prevent or treat COVID-19, taking steps to combat obesity can help if you do get the virus,” Parrella says. “Treating obesity helps not only with COVID 19, but with so many chronic diseases and comorbidities. There isn’t a single other condition we can treat that makes a difference in so many parts of the body simultaneously.”
