by Robert Farrell, MD
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As preliminary data becomes clear regarding the COVID-19 pandemic, some early trends simply cannot be ignored. Patients suffering from excess weight have endured a higher rate of hospitalization.

While the relationship of weight and COVID-19 is not fully understood, most medical professionals believe it involves myriad factors. Patients who are obese (BMI >30) have higher resistance in their airways, leading to lower lung volumes, likely due to weakened respiratory muscles. This deficiency becomes a setup for pneumonia, which can lead to a cascade of events, ultimately landing patients in the hospital and the Intensive Care Unit (ICU). In addition, overweight and obese patients are at a much higher risk of pre-diabetes, diabetes, and hypertension (high blood pressure), making them more susceptible to infection.

The numbers do not lie. Obesity is on the rise nationwide. Per the CDC, the percentage of adults considered obese has increased from 30% to 42% over the last twenty years. Severe obesity (BMI >40) nearly doubled in the same time period.

Why have we seen such an astronomical jump in numbers in just the last twenty years? Again, the answers are multifactorial. There has been slow acceptance by the medical community to see this as a stand-alone disease. While many physicians have no issues treating diabetes, hypertension, joint pain, and sleep apnea individually, they have neglected to attack the root of the problem. Patients are often quickly dismissed with comments such as, "This should be easy, just cut your meals in half." Experts in the field of obesity and metabolic medicine understand this is a complex neurochemical disease with elements of genetics, behaviors, and the environment - all playing a role in each individual patient's weight. In addition, patients either suffer from denial or feel shameful, preventing them from reaching out for help. Patients do not want to be overweight. If treatment was easy, everyone would do it.

The great news is that options for help do exist. Patients who struggle with weight need to be referred to programs that can provide education, structure, and monitoring to revitalize their health. Behavioral modification through proper nutrition and exercise needs to be the pillars of therapy. The use of FDA approved medications can often be a helpful adjunct, especially in the beginning to provide patients with a much needed boost. Ultimately, for some patients surgery may also play a role.

COVID-19 is a serious virus reaping significant repercussions on the global population. Unfortunately, it won't be the last illness we face. There is nothing special about COVID-19 that makes it attack overweight or obese patients, it is just overweight and obese patients are attacked more harshly. Let's take these lessons to heart and improve our health, so that when the next pandemic crisis comes knocking, more people are able to successfully fight it.