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Obesity is becoming more and more prevalent in our modern society every year. People who suffer from obesity are at an elevated risk of experiencing adverse health outcomes – and this is unfortunately also true in regards to COVID-19 infection complications.

As COVID-19 continues to spread worldwide, millions of people have been infected and have had to recover from disease symptoms. Many people with pre-existing medical conditions (including obesity) are at an elevated risk for requiring hospitalization for severe disease complications.

In this article, we will discuss obesity, COVID-19, and the impact obesity can have on the body’s ability to respond to a COVID-19 infection. We will also discuss ways to reduce the risk of complications by improving general health.

What is Obesity?

Obesity is an abnormal or excessive accumulation of adipose (fat) tissue throughout the body that poses a risk to general health. 

Adipose tissue is found throughout the body, but most commonly in the trunk (torso) area. Fat tissue can be subcutaneous (under the skin) or visceral (within the abdominal cavity, surrounding organs). Excessive fat surrounding organs like the liver, lungs, and kidneys can dramatically impact organ function and lead to health issues.

In 2017-2018, approximately over 42% of American adults were obese—and the numbers are increasing every year. A diet high in processed foods and a sedentary lifestyle are considered contributing factors to the continued rise in obesity rates nationwide.

People who suffer from obesity are at an elevated risk for experiencing adverse health outcomes. Diseases like type II diabetes, heart disease, stroke, heart attacks, and certain types of cancer are more common in obese people. Carrying excess fat weight can also contribute to breathing difficulties, joint pain, and decreased abilities to engage in physical activity.

Body Mass Index

Traditionally, obesity is diagnosed with the body mass index (BMI) chart. According to this chart, a person with a BMI of 25 – 30 is classified as overweight, 30 – 39 is considered obese, and over 40 is categorized as severe obesity.

It is important to note that while BMI can provide some insight into general health, it is now regarded as an inaccurate way to measure obesity. Body mass index is calculated by dividing a person’s weight by the square of their height. So, a short bodybuilder (who will have a heavier bodyweight from dense muscle mass) will often be categorized as severely obese using this method.

Other more accurate ways to diagnose obesity include measuring waist circumference and determining the percentage of body fat (PBF). Typically speaking, the larger a person’s waist circumference is, the more likely they will be diagnosed with obesity. But, the best diagnostic tool for determining obesity is a correct calculation of PBF. 

A person can have their PBF measured in several ways, including tape measurements, using calipers, or using a body composition scale. The higher a person’s PBF is, the more excess weight and fat tissue they have on their body.

What is COVID-19?

While we think we would be hard-pressed to find someone nowadays who hasn’t heard of COVID-19, it is crucial to explain the basics of how this infectious disease impacts the human body.

COVID-19 is a type of coronavirus that causes respiratory symptoms and distress. Believed to have started spreading around the world in late 2019, COVID-19 has since spread worldwide. Officially considered a pandemic, COVID-19 has caused many countries to instigate shutdowns and stay-at-home orders in an attempt to curb the spread. 

COVID-19 spreads primarily via the contact-droplet method, meaning that a person infected with the disease can infect others through unprotected coughing and sneezing. Infections can occur from direct contact with a droplet in the air (if a person is within 2 meters of a contagious person and is not wearing a mask) or if they touch a surface that contains active droplets of COVID-19.

Common symptoms of COVID-19 include:

  • Sore throat
  • Cough
  • Fever and chills
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Nausea, vomiting, or diarrhea
  • The loss of taste or smell
  • Runny nose and congestion
  • Muscle and body aches

People with pre-existing conditions like asthma, diabetes, heart disease, and obesity are at an elevated risk of developing complications of a COVID-19 infection. Some common examples of complications include requiring hospitalization for symptom management, intensive care (ICU) stays, and, in severe cases, requiring intubation and ventilation.

The Delta Variant

The Delta Variant is the newest strain of COVID-19 that has been rapidly spreading across the United States. It was first identified in December 2020 in India and was detected in the United States in March 2021. As of July 2021, the CDC reported that 80% of positive COVID-19 tests were the Delta Variant. This variant is affecting unvaccinated people at a significantly higher rate than vaccinated individuals; 97% of hospitalized COVID-19 patients in July 2021 were unvaccinated. 

The CDC reports symptoms are similar to the original strain of COVID-19 including, 

The most common symptoms include:

    • Fever
    • Dry cough
    • Tiredness

Seek immediate medical attention if you develop serious symptoms. Always call before visiting your doctor or health facility.

The Impact of Obesity on the Response to a COVID-19 Infection

As the COVID-19 pandemic continues to progress, information has been collected on the impact that obesity has on the risks of developing disease complications. Like many other pre-existing medical conditions, obesity has been proven to be connected with increased risks of severe complications and an increased likelihood of requiring hospital care due to a COVID-19 infection.

As we discussed before, obesity can have an impact on respiratory function. Excess weight from the adipose tissue on top of or surrounding the lungs can impair breathing patterns. Decreased lung capacity (the total volume of air a person can hold in their lungs) frequently affects people with obesity—and this can contribute to worse health outcomes for those diagnosed with COVID-19. Difficulty catching their breath and higher requirements for oxygen supplementation can be symptoms of COVID-19 felt by people who suffer from obesity.

Between March and November of 2020, approximately 30% of all hospitalization for severe COVID-19 symptoms were in people diagnosed with obesity. It is estimated that people diagnosed with obesity are three times more likely to require hospital care due to a COVID-19 infection. 

Additionally, people with obesity are more likely to require intensive care while in hospital, including intubation and ventilation in severe cases. During intubation, the patient is placed into a medically induced coma, and their airway is artificially kept open with a tube to ensure that they get sufficient oxygen. Then, the intubation device is connected to a ventilator machine, which artificially “breathes” for the person. All patients who require intensive care due to a COVID-19 infection are at an elevated risk of prolonged or life-threatening health impacts.

While all of this information is certainly eye-opening, there are ways to improve your response to COVID-19. Reducing your PBF, increasing your muscle mass through regular weight training and exercise, and improving your overall heart and lung health are all ways to reduce the risk of developing a severe complication of COVID-19.

So let’s explore some ways to strengthen your body’s response to COVID-19!

Ways to Improve Your Body’s Response to a COVID-19 Infection

Taking steps to control your body fat percentage is an essential component of reducing your risk of having a severe complication from COVID-19.

A popular recommendation for decreasing the amount of fatty tissue is to increase your level of physical activity. And it doesn’t need to be anything crazy! You don’t need to jump into hour-long sessions at the gym—starting with regular walks and stretching can improve your endurance, cardiovascular health, respiratory health, and muscle tone.

During the journey to better health, it is necessary to understand the difference between losing weight and losing body fat. While it is very easy to become focused on simply reducing the number on the scale, that is not always the best indicator of improved health. 

When a person begins to work out and gain strength, their skeletal muscle mass (SMM) and lean body mass (LBM) will increase. So, while you may be dramatically improving your fitness, it is possible to see little to no changes in your weight during some phases of your health journey. But this is not a source of concern! Fat tissue takes up more space than muscle tissue—so it is OK to “gain” weight by replacing fat tissue with strengthened muscle mass. In the context of COVID-19, individuals with higher SMM have been linked to improved survival rates when admitted into the ICU for care. So it’s worth the effort!

Other helpful body composition measurements to consider while improving your health are waist circumference (WC) and trunk fat ratio (TFR). Individuals with higher values for their WC are more likely to be carrying around excess fat tissue. A reduction in WC can indicate a loss in fat tissue and reduce stress on the vital organs.

Additionally, having an elevated TFR has been linked to an increased risk for developing cardiometabolic symptoms such as insulin resistance, high blood pressure, and high cholesterol. Abdominal fat loss can help reduce your TFR value and improve your overall health.

All of the body composition values mentioned above and more can be tested and documented through body composition testing. Getting regular body composition scans done is a great way to document your health journey!

Regular assessment of body composition can help provide insight into body changes and health improvements made through physical activity and dietary adjustments. Body composition monitoring can be used as a motivational tool throughout weight loss journeys.

Through fat loss, you can decrease your risk of developing health conditions, control or reduce current disease symptoms, improve physical and mental health, and reduce the risk of a severe COVID-19 complication.

Putting It All Together

Obesity is a medical condition that is becoming more and more prevalent every year. Limited activity and a diet high in processed foods and refined sugars are likely contributing factors to the increasing rates of obesity seen in America and around the world. Obesity is traditionally measured using the BMI scale, but body fat percentage is a more accurate and comprehensive measurement method.

COVID-19 is a coronavirus infection that targets the lungs. Individuals with pre-existing medical conditions like diabetes, heart disease, asthma, or obesity are at an increased risk of experiencing severe complications of a COVID-19 infection. Complications from COVID-19 often require hospitalization and, in some cases, may require intensive care and possible intubation.

People diagnosed with obesity are three times more likely to experience a severe complication from COVID-19. It is estimated that up to 30% of all COVID-19 cases that required hospital care were in people with obesity.

Managing obesity through increased exercise and dietary changes can reduce the risk of a person developing severe symptoms of a COVID-19 infection. Losing weight while improving skeletal muscle mass is the best way to mitigate COVID-19 risks, improve overall health, and reduce the risk of developing additional medical comorbidities.

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