Link between extra pounds, severe COVID-19 illness grows stronger

The Centers for Disease Control and Prevention (CDC) has expanded its coronavirus risk warning to include people who are considered overweight. Obesity and severe obesity have been included on the CDC's list of conditions that put people at in increased risk of severe illness from the virus that causes COVID-19. However, now, the CDC is saying adults of any age who are simply overweight might be at increased risk of severe illness from COVID-19.

Dr. Donald Hensrud, director of the Mayo Clinic Healthy Living Program, explains why obesity, with its complications, increases the risk of COVID-19 exponentially.

"Obesity by itself is associated with a number of complications: diabetes, high blood pressure, dyslipidemia and heart disease. That was all present before COVID-19. In addition, over two-thirds of the population is overweight or obese," says Dr. Hensrud. "Now COVID-19 comes along, and we've got all the issues we had before plus some additional ones. Obesity is associated with low-grade inflammation and an effect on our immune system. This affects our susceptibility to COVID-19. People who are obese are more likely to develop COVID-19 and complications from it, including dying, than people who aren't obese. In addition, people with diabetes and some of the other complications from obesity are also at increased risk. So obesity and its complications independently take the risks of COVID-19 and elevate them significantly."

The definition of overweight is having a body mass index (BMI) between 25 and 29.9. A BMI of 30 or greater is classified as obese.

Dr. Hensrud says it's been interesting seeing the variability of how the COVID-19 pandemic has affected people's eating habits.

"I've had patients who have gained a lot of weight because they're less active. They're eating comfort food. They're stressed out. And all this has caused increased weight gain and contributed to obesity," says Dr. Hensrud. "On the other hand, I've had patients who've lost weight. They're eating out less. They're cooking more at home. They're eating healthfully. They're trying to get in some activity, and, so, they've lost weight. The variability of how this has affected people is really wide."

Dr. Hensrud says it takes a little time, planning and effort, but there are several things people can do to manage their weight and improve their health to maximize their chances if they become infected with COVID-19:

Try to get in a little activity every day. That doesn't have to mean going to the gym and could be as simple as taking a walk.

For those working from home, try to take breaks every 30 minutes to move, whether that movement is stretching or walking around.

Make healthy food choices, whether it's takeout or cooking at home.

While improving health in these ways is important, Dr. Hensrud stresses making small changes and not going to extremes.

"We know that before COVID-19, New Year's resolutions, for example, people try and do something with exercise that they haven't done in years, and it doesn't work. Similarly now, I think we have to be realistic about what they can do. In fact, losing too much weight, if people lose more than 10% of their body weight in six months, that can adversely affect immune function. It's important to do what we can to improve health but not go to extremes," says Dr. Hensrud.