Evidence of Obesity’s Role in Severe COVID-19 Symptoms Continues to Grow


As the world grapples with COVID-19, the delta variant, the heightened debate around vaccine effectiveness and government intervention, and the controversy surrounding various treatment options, one constant remains: the correlation between COVID-19 patients suffering from severe symptoms and the prevalence of obesity.

The link to this article highlights a pediatrician in North Carolina who makes a startling observation around COVID-19 and his young patients who are suffering from severe symptoms leading them to an ICU:

At least 9 out of 10 patients that we’re seeing who are sick enough especially to be in the ICUs throughout the state, obesity plays a part in this

Dr. Daniel Donner, physician at Novant’s Pediatric SouthPark Clinic

Dr. Donner also confirms data we have reported from other sources, saying that 1 in 5 of his patients 6 years and older are considered obese.

Obesity & COVID-19

COVID-19 has been devastating on the obesity rates of children, with the latest CDC report showing that, during the pandemic, the rate of BMI increase doubled among those aged 2 – 19. The increase was the worst among those who were overweight or obese prior to the pandemic.

At business-fit.org, we have been writing about obesity, metabolic syndrome and the link to COVID-19 since April, 2020.

Earlier this year, in March 2021, this article from the BMJ cites data from the World Obesity Federation demonstrating some shocking and disturbing data points regarding COVID-19:

  • COVID-19 death rates are 10X higher in countries where more than half of the population is considered overweight (defined as a BMI > 25)
  • Of the 2.5M COVID-19 deaths reported worldwide through February 2021, 2.2M were in countries where over 50% of the population is overweight
  • Comparing countries such as Vietnam, with an overweight population of ~ 18%, to the U.K and USA, with overweight populations of ~ 64% and 68%, respectively, confirm the huge disparity in death rate from COVID-19. Vietnam’s death rate was 0.04 per 100,000, where the U.K. rate was 184 per 100,000 and the USA rate was 152 per 100,000.

What’s even more disturbing is we knew this was going to happen, as during the MERS and H1N1 influenza epidemics, worse outcomes were correlated to those who were overweight. Yet, our public officials, including both political and medical leadership, sweep this under the rug as an inconvenient truth. As an example, North Carolina Health & Human Services Secretary Mandy Cohen regularly gives updates with the Governor, both imploring people to get vaccinated, but rarely mentioning obesity as a major risk favor. In fact, the CDC’s own “risk factor” assessment places obesity far down the list of severe risk factors, choosing to group the severe risk factors in alphabetic order vs. level of risk. To demonstrate why this is important, here’s a sample data point for reference:

  • In reviewing six months of COVID-19 death data from Mecklenburg County, there were 165 deaths among Americans 65 years old or younger during that time where a cause of death was reported. Of those 165 deaths, 76 (46%) had either obesity or diabetes listed as an underlying factor, compared to cancer, which was listed as a factor in 5 deaths.

Why Overweight & Obese Individuals Suffer More from COVID-19

We know obesity is linked to 8 out of 10 leading causes of death, is the #2 contributor to cancer (behind tobacco use), is directly correlated with Type II Diabetes, and is a major factor in metabolic syndrome. But why do overweight and obese patients suffer so much worse from COVID-19?

This study is a very good reference point of why an obese host is so vulnerable to COVID-19, so I encourage you to read it for a more detailed understanding. Three major factors are: (1) At a fundamental level, COVID-19 enters the body through ACE-2 receptors found in the lungs, pancreas, kidneys and gut, and obese patients typically have a much higher number of ACE-2 receptors than a non-obese patient; (2) Obesity is also not an inert disease; the fat accumulation creates more inflammation and impairs immune function through hormonal variations among insulin and leptin; (3) In addition to blood clots, obesity’s role in aging and reducing the effectiveness of the immune system can result in a hyper-active immune system and the production of cytokines, which can trigger powerful immune responses that can attack healthy cells and further weaken the body.

Rather than relying on a vaccine or draconian political mandates around masks & lock-downs, the best way to reduce your risk of becoming sick from a pathogen like COVID-19, and suffering from severe symptoms, is to create an inhospitable environment for that pathogen. That means, a healthy immune system, low levels of inflammation, reduced stress, a healthy lean body mass level with low levels of fat, and a dietary approach that ensures a healthy metabolic state.

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