Americans with obesity and overweight are at greater risk for more severe COVID-19. Clinicians can support them best by asking how they can help.
It is hard to miss the fact that obesity is amplifying the risks of COVID-19 for many patients in primary care. Roughly 42% of Americans have a BMI that puts them in the range of obesity. Another 32% are in the range of overweight. On top of that, CDC has steadily broadened its warnings that excess weight is a risk factor for severe outcomes with a coronavirus.
The agency started with a warning that severe obesity was a problem. Then it expanded the warning to state that any degree of obesity confers added risk. Finally, in October, CDC added that even overweight (BMI 25-30) might bring increased risk.
Rest assured, if patients are paying attention, they have heard this. Every newsfeed on health contains a steady flow of headlines telling them about this risk. So, unsurprisingly, research tells us that this situation is bringing anxiety and other issues.
Mental health and stress eating
In new research presented at ObesityWeek 2020, researchers from the University of Texas Southwestern Medical Center found that 84% of their patients with obesity were experiencing depression. Increased anxiety, reported by 74%, was also significant. Thus, stress eating was a problem for 62% of their sample.
These findings are consistent with results reported in a global survey of 7,753 individuals both with and without obesity during the pandemic lockdown. They found increased anxiety was greater in the respondents with obesity. One bright spot was the finding that healthy eating scores improved during the lockdown. This was because people were cooking more and eating less food from restaurants.
In yet another study, researchers found that 68% of participants in health-related research reported moderate or severe symptoms of PTSD. These symptoms presented a problem for patients trying to adhere to behavioral health recommendations.
Different patients, different needs
It is worth noting that the effects of the pandemic are quite different for different patients. Some are in a position to adopt healthier habits, as noted by the findings related to cooking more and eating out less. Some have actually lost weight and coped with the pandemic by getting more physical activity and commuting less. Others find themselves gaining weight and facing extreme anxiety about their risks because of obesity.
Some are coping by more aggressively seeking obesity treatment. Bariatric surgeons have lately reported an increase in patients pursuing gastric bypass and sleeve procedures. Others might put their health at risk by avoiding medical care because of COVID-19.
In short, COVID-19 presents special risks to your patients living with obesity.
What’s the best way to support them? Boilerplate advice for these patients is unlikely to be helpful because different patients are having vastly different experiences and thus will have different needs. What might be helpful advice for one patient could actually be harmful for another.
The best approach in this situation is to practice truly patient-centered care and meet each patient where they are. In this stressful time when a third wave of the pandemic is upon us, they will remember the care you provide.