A major factor in the number of deaths and serious illness from Covid-19 is diabesity, aka the modern-day combination of diabetes and obesity.
The condition is associated with a higher risk of contracting severe forms of bacterial and virus respiratory infections, including H1N1, influenza, SARS, MERS and Covid-19.
Obese patients are three times more prone to severe infections than those of a normal weight.
Worldwide, obesity has nearly tripled since 1975 and along with it has come a higher prevalence of obesity-related complications. In many countries, an epidemic of obesity co-exists alongside under-nutrition and poverty, with people living in overcrowded conditions with a lack of sanitization, health insurance and social security. Into this the complex scenario an unexpected pandemic disease emerged: Covid-19.
Severe obesity is present in 10 to 30 percent of populations, with underlying chronic disorders adding to the risks across the spectrum of treatment. Obese patients are at greater risk of acute respiratory distress syndrome, inserting and removing breathing tubes and intravenous lines is more difficult , there is a greater risk of blood clots, pressure ulcers. Size also puts limits on diagnostics. Furthermore, most medical units and intensive care units are not designed to accommodate obese patients.
To face the challenges of these two pandemics, the focus must shift to making nutritious food available to everyone, encouraging physical activity and providing psychological support, telemedicine and insurance coverage.
Even after this pandemic in under control, we need to continue our efforts with sanitization, immunization, healthy food supply and boost educational training in obesity.
Health care providers must recognize obesity as a chronic disease that deserves diagnosis, adequate treatment and follow-up.
Workplaces should promote and provide healthy work environments, while the general population should adopt permanent lifestyles changes. Breastfeeding, protecting the environment and asking for help should all be promoted.
This is a time when societies and policy makers need to act to do something not only about Covid-19, but about obesity. Physicians need to get involved in lobbying their governments and the food industry to help prevent obesity.
The message the whole world needs to hear is that the coronavirus pandemic has revealed a great deal about inequities and contradictions in global food systems. We know that people with underlying obesity and obesity-related chronic diseases are at much higher risk of a poor Covid-19 outcome. The virus may not be preventable, but obesity and its related conditions are.
It is high time that we stop promoting high-fat, high-salt, high-sugar foods – immediately. It’s time for health policies that will make it mandatory to reformulate unhealthy food and drink. Reducing salt, sugar, and saturated fat across the board would improve the diet of the entire population and bring even greater benefits for the people who are most socially-deprived.
The toll of morbidity and mortality from Covid-19 has made this more apparent and more urgent than ever.
• Dr Abdul Jabbar is a consultant endocrinologist and diabetologist at Medcare Hospital in Dubai.