The Obesity Pandemic

While most of the news and attention these days has been directed at the COVID-19 pandemic, little attention has been spent on the obesity pandemic, in spite of the fact that there are many similarities between the two.

Obesity Prevalence has Doubled to Tripled

Obesity rates across America (and the world) have doubled to tripled over the past 30 years. In Colorado, the obesity rate in 1990 was 9%, and now it is 23.8%; across the United States, the rate is closer to 42.4%. In spite of the fact that this increase in obesity is a worldwide phenomenon and clearly is an environmental / biological issue, many still believe that obesity is a personal choice, and that if people could simply eat less and exercise more, the problem would be solved (in spite of an enormous body of scientific evidence to the contrary).

Both Obesity and COVID-19 are Risky Propositions

COVID-19 can cause a range of problems ranging from a mild upper respiratory infection to mechanical ventilation or death, having killed roughly 650,000 Americans at the time of this article. Similarly, obesity can cause a range of problems – 236 to be exact, ranging from joint pain and fatigue to diabetes, heart disease, 13 forms of cancer and approximately 330,000 deaths in America per year.

Can COVID-19 be prevented? How about obesity?

Because COVID-19 is spread by contact with infected individuals, it could be prevented if everybody stayed home; however, we have a need to leave our houses to be part of society, get to work, go shopping, get food, and experience the joys life has to offer. Similarly with obesity, if we all stayed home, cooked healthy meals, and spent hours exercising in our basements, obesity could largely be prevented. However, we have a need to leave our houses, eat socially, work long hours, spend time commuting in our cars, and food manufacturers and restaurants make their foods irresistible.

The spread of COVID-19 could be prevented by mandating facemasks and vaccination; however, masks are uncomfortable and people prefer to see each other’s smiles. Further, not all Americans are choosing to become vaccinated. Similarly, obesity could be prevented by mandating healthy nutrition, requiring physical activity in certain settings, limiting the number of hours spent at work and so on. Further, obesity can be treated and prevented with prescription medications. Imagine a world without ice cream, doughnuts, or French fries…

Obesity Pandemic <—> COVID-19 Pandemic

Finally, these two diseases are related to each other – those with obesity (including young people) who contract COVID are far more likely to die or require ICU admission and/or mechanical ventilation than those without obesity. And, people are commonly reporting gaining a lot of weight since being stuck working at home since the pandemic began.

So, what can we do to get out of this mess?

• First, prevention is key – try not to get exposed to COVID. Similarly, try to get the weight under control early. Get the weight down before it gets way out of control! It’s never too early to treat or prevent obesity!
• Second, we can take measures to improve our environment. With COVID, the most effective measures are vaccination and masking, followed by distancing, testing, and staying away from others if you have symptoms. With obesity, we can work towards less stress, better sleep, healthier food options, healthier menu choices, easier access and time for physical activity.
• Third, we can treat symptomatic illness. Hopefully in the coming months and years we develop effective anti-viral medications that can reduce the burden of disease with COVID-19. Like other infectious diseases, presumably the earlier we get a confirmatory test and start treatment, the better the health outcomes will be. Similarly, there are many FDA-approved safe and effective anti-obesity medications. Unfortunately, they are underutilized, prescribed to only an estimated 1.4% of those eligible for treatment. With improved utilization of these medications by trained obesity medicine physicians, physician assistants and nurse practitioners, we could similarly lower the burden of disease for those affected by obesity.

Take home message about the obesity pandemic…

So, what is the take home message with regards to stemming the obesity pandemic? First, avoid exposure to “Obesogenic” foods. Think about environmental reshaping to make your environment more conducive to sustaining a healthy body weight. Find strategies to lower stress and improve sleep. And, if these measures aren’t adequate, consider whether or not an anti-obesity medication might improve the odds of success.

And finally, I’d be remiss if I didn’t suggest that if you are still on the fence about getting vaccinated against COVID-19, discuss your concerns with your doctor and make an informed choice. And, as you consider your choice, know that in a recent survey reported by the AMA, 96% of physician respondents are fully vaccinated.