Even as we continue to grapple with the pandemic’s massive challenges, it’s clear that the healthcare industry has been transformed in a number of significant ways by COVID-19. Some of these changes are emerging due to problems that are systemic in scope. For example, worker burnout and supply chain issues are critical issues that need to be addressed on a systemic level.
But in many cases, the pandemic has set into motion changes that are specific to the healthcare industry. Obesity medicine has been especially critical for understanding and treating many patients who are at greater risk from the pandemic. According to research published in the Journal of the American Heart Association, obesity is one of the four major cardiometabolic risk factors for COVID-19 hospitalizations. In one study of over 900,000 US coronavirus disease hospitalizations, 30.2% were estimated to be attributable to obesity. Patients with obesity have the highest risk for severe complications, including death, from this viral pandemic compared with those with nearly any other malady.
Patients with obesity and their health providers should, therefore, be mindful of a number of challenges that are unique to obesity. For example, patients with obesity are at increased risk for adverse outcomes from viral upper respiratory tract infections. Obesity often leads to chronic diseases, which contribute to worsening health outcomes that are further intensified with the addition of COVID-19. Specific to obesity, an increase in body fat can often result in adiposopathy or “sick fat.” Along with abnormalities of hormone function, this can also lead to deficiencies of immune function. Disruption of the immune system can make patients with obesity more susceptible to infections, contribute to more severe symptoms, and delay recovery time when compared with those without obesity. This is especially true regarding upper respiratory tract/lung infections. Individuals with obesity may already have lung dysfunction, breathing abnormalities (reduced tidal volume and reduced forced expiratory volume FEV1), and sleep apnea. Patients with obesity and day or nighttime hypoxia may have little margin to tolerate further hypoxia, making upper respiratory tract/lung infections especially perilous.
Obesity can also contribute to debilitation, immobility, and orthopedic challenges that can limit access to appropriate medical care. However, the pandemic has made medicine more mobile, pushing healthcare out to where patients are through mobile and electronic devices. Obviously, activities like physical exams must still be done in person, but consults that involve mostly counseling and medical advice will probably continue to be conducted with much more flexibility.
With the greater application of obesity medicine research and treatment, practitioners could help reduce the severe risks associated with COVID-19. Keeping on top of the latest research and education has never been more important.
Healthcare professionals can learn how to address the specific challenges posed by obesity at the Obesity Medicine Association’s fall conference, which will be held in person September 23-26 in Chicago and October 14-23 virtually via the Digital Experience. For more information and to register, visit https://obesitymedicine.org/fall.