US obesity crisis to blame for it having one of the world’s worst Covid death tolls, major report

The US may have suffered the highest coronavirus death toll in the world because almost 70 per cent of its adult population is overweight, according to a major report. 

Research by the World Obesity Federation found Covid deaths have been 10 times higher in countries where over half of adults are overweight, and they have accounted for a staggering 90 per cent of global deaths. 

So far almost 518,500 Americans have died from the virus, which is the highest death toll of any nation and double the number of victims in second worst-hit Brazil. The US has the eighth worst Covid death rate globally when the size of its population is factored in, with 152.5 victims per 100,000 people.

It is also home to the highest percentage of overweight people, according to the WOF, with more than two-thirds (67.9 per cent) of adults having a body mass index (BMI) above 25. A healthy range is between 18 and 24 and people with a BMI of over 30 are considered obese. More than 70 million Americans are obese.

Many US states have included obesity in their lists of chronic conditions that make people eligible for earlier access to Covid vaccines, as the Centers for Disease Control and Prevention (CDC) recommended. 

But vaccines come too late for thousands of Americans who struggled with obesity and died of COVID-19. 

Thousands of lives might have been saved if the population was slimmer, experts said, and lockdown measures may not have needed to be as drastic if fewer people were overweight or obese and had a lower risk of ending up in hospital.  

The World Health Organization (WHO) warned the finding was a ‘wake-up call’ for the West, where sedentary jobs and processed foods mean being overweight has become the norm for the majority of adults.     

Source: Covid-19 deaths from the Johns Hopkins Coronavirus pandemic tracker and World Health Organization (WHO) Global Health Observatory adult overweight estimates

Source: Covid-19 deaths from the Johns Hopkins Coronavirus pandemic tracker and World Health Organization (WHO) Global Health Observatory adult overweight estimates

Source: Covid-19 deaths from the Johns Hopkins Coronavirus pandemic tracker and World Health Organization (WHO) Global Health Observatory adult overweight estimates 

A breakdown of self-reported obesity in each state by the US Centers for Disease Control and Prevention (CDC) in 2019. Some of the hardest-hit states are the same ones that have obesity rates of 30% or higher

A breakdown of self-reported obesity in each state by the US Centers for Disease Control and Prevention (CDC) in 2019. Some of the hardest-hit states are the same ones that have obesity rates of 30% or higher

A breakdown of self-reported obesity in each state by the US Centers for Disease Control and Prevention (CDC) in 2019. Some of the hardest-hit states are the same ones that have obesity rates of 30% or higher 

The report, which compared countries’ obesity rates and Covid death tolls, found that the Covid death rate was 10 times higher in countries where 50 per cent or more of the population is overweight. 

It saw that 2.2million of the world’s 2.5million deaths so far had happened in countries with these high obesity rates. 

‘Increased body weight is the second greatest predictor of hospitalization and a high risk of death for people suffering from Covid-19,’ the report said.

WHY DOES BEING OVERWEIGHT MAKE COVID WORSE? 

People who are overweight or obese are more likely to develop severe Covid-19 and die from it because they are generally less healthy and have worse immune systems.

The coronavirus has been found to prey on people who don’t have good health – it causes fluid build-up in the lungs, blood clotting, swelling in the airways and blood vessels, intense fever and can trigger immune over-reaction. All of these can seriously damage vital organs.

Overweight people are more likely to suffer severe versions of these effects because their bodies are already struggling to cope as a result of the strain of carrying excess fat, hormonal and chemical changes triggered by obesity, and higher rates of long-term illnesses like diabetes and high blood pressure. 

Fat in the belly pushes up on the diaphragm – the breathing muscle – and compresses the lungs, making them weaker and less able to chuck out the viruses when they get in, Science magazine explains. 

Blood is also more likely to clot because vessels are damaged and don’t work properly, partly because of constant swelling and irritation caused by chemicals released by fat. One researcher told Science obese people with Covid had ‘the stickiest blood I have ever seen’. These clots then travel to the lungs and other organs and can be deadly.

The immune system is also weaker in overweight people because fat cells intrude on organs that would normally make white blood cells, such as the bone marrow, meaning their capacity to work as normal is reduced. This means it takes longer to fight off the virus, if the body is able to do it at all.

And any organ dysfunction, such as that caused by heart disease, lung disease, diabetes, high blood pressure or dementia, has been found to make Covid-19 worse as it preys on damaged parts of the body and worsens existing problems. All of these are reported to be more common in obese people. 

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‘Only old age rates as a higher risk factor. The unprecedented economic costs of Covid-19 are largely due to the measures taken to avoid the excess hospitalization and need for treatment of the disease. 

‘Reducing one major risk factor, overweight, would have resulted in far less stress on health services and reduced the need to protect those services from being overwhelmed.’

It’s not the first signal that obesity has been a major driver of the toll COVID-19 has taken on the US. 

A recent Tufts University study estimated that about two thirds of US COVID-19 hospitalizations were attributable to four chronic conditions: obesity, diabetes, heart disease and high blood pressure. 

Obesity raises risks of the other three conditions as well, and complications from all three can be lessened with healthy diets and exercise. 

‘We know that changes in diet quality alone, even without weight loss, rapidly improve metabolic health within just six to eight weeks. It’s crucial to test such lifestyle approaches for reducing severe COVID-19 infections, both for this pandemic and future pandemics likely to come,’ said Dr Dariush Mozaffarian, lead author and dean of the Friedman School at Tufts. 

And countries where healthy lifestyles are more common – and where governments have prioritized initiatives to encourage them – have fared better against COVID-19. 

Data from the John Hopkins University on Covid deaths and the WHO’s Global Health Observatory adult overweight estimates shows that the UK had the third highest coronavirus death rate per person – at 182 per 100,000 people, lower only than Slovenia (183) and Belgium (192) – and the fourth highest overweight rate, at 64 percent. 

A total of 123,783 people have died of Covid-19 in the UK, according to the Department of Health.

The Czech Republic (180.8 deaths per 100,000), Italy (158.4), Portugal (155.3) and Montenegro (152.7), all had higher rates than the US. The rate of overweight people in all eight nations was above 56 per cent. 

Scientists say overweight or obese people are more likely to develop severe Covid and die from it because they are generally less healthy and have worse immune systems.

They also have higher baseline levels of inflammation. Inflammation from the body’s attempt to fend of coronavirus has been shown to be as damaging as the virus itself, if not more so. The compounding effects are especially dangerous for obese people. 

The coronavirus has been found to prey on people who are in poor health – it causes fluid build-up in the lungs, blood clotting, swelling in the airways and blood vessels, intense fever and can trigger immune overreaction. All of these can seriously damage vital organs.

Overweight people are more likely to suffer severe versions of these effects because their bodies are already struggling to cope as a result of the strain of carrying excess fat, hormonal and chemical changes triggered by obesity, and higher rates of long-term illnesses like diabetes and high blood pressure.  

No country where less than 40 percent of the population is overweight has Covid-19 death rates above 10 per 100,000, the report showed.

The country with the lowest Covid death rate was Vietnam, which has one of the lowest global rates of obesity at 7.3 percent. Japan and Singapore were also singled out for their low levels of obesity and deaths from Covid-19.

Two thirds of COVID-19 hospitalizations were 'attributable' to obesity, high blood pressure, diabetes or heart failure, meaning they likely could have been avoided if the patients hadn't had these preventable conditions, the Tufts University study estimates

Two thirds of COVID-19 hospitalizations were 'attributable' to obesity, high blood pressure, diabetes or heart failure, meaning they likely could have been avoided if the patients hadn't had these preventable conditions, the Tufts University study estimates

Two thirds of COVID-19 hospitalizations were ‘attributable’ to obesity, high blood pressure, diabetes or heart failure, meaning they likely could have been avoided if the patients hadn’t had these preventable conditions, the Tufts University study estimates 

These countries managed to avoid disaster during the pandemic despite being close to China and having some of the first international coronavirus cases in early 2020.

In 2008, Japan introduced the ‘Metabo law’ which requires everyone between the ages of 40 and 74 to get annual measurements of their waist circumference. Employers of those with waistlines above approved limits are required to provide weight loss classes. 

The World Health Organisation (WHO) said the report should act as a ‘wake-up call’ for governments, particularly in wealthier countries, to tackle their obesity problems. 

Director-general Dr Tedros Adhanom Ghebreyesus said: ‘This report must act as a wake-up call to governments globally. The correlation between obesity and mortality rates from Covid-19 is clear and compelling. 

‘Investment in public health and coordinated, international action to tackle the root causes of obesity is one of the best ways for countries to build resilience in health systems post-pandemic. We urge all countries to seize this moment.’

Author of the report Dr Tim Lobstein, senior policy adviser to the World Obesity Federation and visiting professor at the University of Sydney, said: ‘We now know that an overweight population is the next pandemic waiting to happen.

‘Look at countries like Japan and South Korea where they have very low levels of Covid-19 deaths as well as very low levels of adult obesity.  

‘They have prioritized public health across a range of measures, including population weight, and it has paid off in the pandemic.

‘Governments have been negligent and ignored the economic value of a healthy population at their peril.

‘For the last decade they have failed to tackle obesity, despite setting themselves targets at United Nations meetings.

‘Covid-19 is only the latest infection exacerbated by weight issues, but the warning signs were there. We have seen it in the past with Mers, H1N1 and other respiratory diseases.’ 

Johanna Ralston, chief executive of the World Obesity Federation, said: ‘The failure to address the root causes of obesity over many decades is clearly responsible for hundreds of thousands of preventable deaths.’

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