Experts call for more weight loss treatment in UK as studies show obese people are more vulnerable.
Less than a year ago, Boris Johnson was taking a stand. Milkshakes, he said, should not be taxed.
“If we want people to lose weight and live healthier lifestyles, we should encourage people to walk, cycle and generally do more exercise. Rather than just taxing people more, we should look at how effective the so-called ‘sin taxes’ really are, and if they actually change behaviour.”
Prof Barry Popkin, a professor of nutrition at the University of North Carolina at Chapel Hill School of Public Health in the US, says obesity “weakens greatly our immune system”.
The European Centre for Disease Prevention and Control says 73% of critically ill patients with Covid-19 in Italy, Spain, Sweden, Switzerland and the Netherlands are obese.
In the UK, according to Prof John Wilding, the president of the World Obesity Federation, obesity doubles the chances of death.
The non-profit organisation is publishing a dossier of evidence and guidance about obesity in Covid-19 on its website on Wednesday, setting out what has been established so far.
According to a yet to be peer-reviewed study of the electronic health records of 17 million adult NHS patients, the risk of a coronavirus-related hospital death increases from between 1.5 to 2 times for people with a body mass index of 30, which is the lowest level of obesity, to more than 2 for those with a BMI of 40 or more. “It is a very significant increase,” says Wilding . “And the reasons for that are probably pretty complicated.”
Although not an intensive care doctor, Wilding says one of the reasons is the difficulty ventilating somebody who is obese.
“It’s much harder to ventilate you effectively if you have a higher bodyweight. The lung capacity for the body size is lower, so there’s less reserve in the system. So of course, if you do have a severe respiratory infection, that affects the ability of the lungs to help get oxygen into the blood. The system is going to have to work a lot harder for you than it is for somebody who is much lighter and much smaller.”
Over 40 is morbid obesity – and the point at which people can be referred to specialist care and may be eligible for bariatric surgery to reduce their stomach size. Johnson was vulnerable when he was infected – and he appears to have recognised his weight was a factor.
This is exactly what doctors at the British Obesity and Metabolic Surgery Society (BOMSS) have been waiting to hear; they have long feared that the UK is not taking the condition seriously.
Hospitals deal with the consequences of obesity – such as soaring rates of type 2 diabetes, blindness and amputations – and the cost to the NHS is high. But the UK offers only a tenth of the stomach-reducing surgery that France does: 6,000 operations a year compared with 60,000.