With a reportedly effective vaccine for COVID-19 promising to help torpedo the largest pandemic in 100 years, is America’s biggest health problem soon to be ignored once again?
But first another question: What do these five countries – Vietnam, Bangladesh, Timor Leste, India and Cambodia – have in common besides warm climates that tend to favor most diseases and widespread poverty?
The average annual income in Cambodia is $1,480, according to World Data. It’s $2,540 in Vietnam with the other countries between these two.
These are countries where life is, in general, harder than in this one, but they also happen to be countries with very low death rates from COVID-19.
Timor-Leste has reported no deaths, according to the World Health Organization’s (WHO) dashboard of infections and death. Only 35 people have been reported dead in Vietnam since the pandemic started in February, according to WHO.
India’s death rate is about a ninth that of the U.S. as a whole and about a twentieth that of New Jersey, the U.S. leader in per capita deaths. It is about an eighteenth of New York, a sixteenth of Massachusetts, a 15th of Connecticut and North Dakota, and a 14th of four other states that have helped to drive up the U.S. death toll.
Two of those states – Mississippi and Louisiana – are among the nation’s top five states for obesity rates, according to the Brittanica Group. But compared to Vietnam, Bangladesh, Timor Leste, India and Cambodia, every U.S. state is fat.
Brittanica reports the country’s skinniest state as Colorado, where only 23 percent of residents are obese.
These are the world’s five skinniest countries, and the SARS-CoV-2 virus that causes COVID-19 isn’t doing to them nearly what it is doing to the heftier, better off Western world where many are falling victim to their profligate lifestyles.
Study after study has found obesity a serious risk factor for death from COVID-19.
The big picture
A peer-reviewed, meta-analysis of COVID-19 studies published prior to September found the obese had a 48 percent greater chance of death from the pandemic disease than the non-obese.
“You have more than double the likelihood of going into the hospital if you’re obese and 50 percent more likelihood of dying,” Barry Popkin, one of the researchers involved in that study told the JAMA, a medical journal. “Those two statistics really shook me.”
The data should not, however, have come as a surprise.
As Popkin, a University of North Carolina at Chapel Hill professor, admitted in an interview with JAMA, “we’ve known for some time that obese individuals’ immune systems are impaired. We also know that there’s a lot of metabolic dysfunction that goes on with obesity, and that the adipose tissues become inflamed quite readily. So those three things we’ve had some sense of. They’re very much linked to the [underlying COVID-19] risks of diabetes, hypertension, hyperlipidemia, and kidney and liver disease. So those are known pathways.”
English and Chinese researchers involved in an earlier meta-analysis of the accumulating data on the danger of COVID-19 to the obese recognized that even before the new virus appeared obesity was “a global disease with at least 2.8 million people dying each year as a result of being overweight or obese.”
Their meta-analysis published in the July-August issue of the peer-reviewed journal Obesity Research & Clinical Practice concluded that COVID-19 simply upped the ante on obesity, an already deadly disease. They found the obese more than three and a half times more likely to die from COVID-18 than the non-obese.
Sadly, SARS-CoV-2 – the newly evolved virus that causes COVID-19 – wasn’t and isn’t the only form of death haunting the overweight.
As the U.S. Centers for Disease Control have observed, “obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer…are some of the leading causes of preventable, premature death.
“The estimated annual medical cost of obesity in the United States was $147 billion in 2008 US dollars; the medical cost for people who have obesity was $1,429 higher than those of normal weight.”
The costs have only gone up since 2008 as Americans have responded to the obesity epidemic the easy way – by letting their belts out another notch.
A new report out from the National Center for Health Statistics just days ago reported nearly three-quarters of Americans are now overweight with most of those – 42.5 percent – obese, and 9 percent of them severely so.
The percentage of Americans who are fat has been increasing so steadily for so long that overweight now borders on the new normal.
One-hundred and ninety-seven-pound Dorothy Bradley, who featured in a March 1954 Life magazine article titled “The Plague of Overweight” really doesn’t look all that heavy compared to Hunter McGrady, Sports Illustrated’s “curviest” bikini model who is reported to weigh in at 238 pounds.
Of Bradley, Life reported, that “embarrassed at (a) shop because she wears a size 40, Dorothy tries on new dress. A friend encouragingly points out that dieting has reduced waistline by two sizes.”
The story ended with a photo of McGrady after documenting her weight-loss efforts:
No mainstream news editor in America today would touch a story like the one Life did on McGrady 66 years ago. The story then was about “the most serious health problem in the U.S. today…obesity.”
The story hasn’t changed since, but attitudes have. Obesity is now among the many things Americans don’t talk about in polite company even if it is killing them.
The annual number of excess deaths due to obesity in the U.S. each year has been put somewhere between 112,000 and 400,000. And this year obesity has played an undeniable role in helping to push COVID-19 deaths in the country to 299,177 as of today, according to the counter run by the John Hopkins University of Medicine.
The costs of the obesity epidemic were staggering before the SARS-CoV-2 pandemic. The latter only drove costs higher.
The pandemic is expected to end at some point. And the obesity epidemic?
The future doesn’t look good.
Childhood obesity, a precursor for problems as an adult, has slowed this decade but continues to creep upward. It is way beyond any historic precedent.
Those who reach obesity in childhood seldom slim down as adults. The 5 percent childhood obesity rate of the 1970s grew into the giant obesity problem of the 2000s.
What is the 19.3 percent rate of 2019 likely to mean 30 or 40 years on, and what can be done about it?
American children today face the same problem as so many American adults: They eat too much and exercise too little.
Most of the population enjoys eating and finds exercise too much like work. The result is predictable.
Weight gain like weight loss is as simple as calories in and calories out. Yes, some people are naturally skinny because they are genetically driven by smaller appetites or burn more calories when sitting still.
But for most people, the physiological reality is as simple as the CDC outlines:
“When losing weight, more physical activity increases the number of calories your body uses for energy or ‘burns off.’ The burning of calories through physical activity, combined with reducing the number of calories you eat, creates a ‘calorie deficit’ that results in weight loss.”
Weight gain works the same way in reverse. Combining reduced physical activity with increased numbers of calories creates a calorie surplus that mammals deal with by storing fat.
That’s good if you’re an Alaska brown bear. It’s not good if you’re a human. It was slowly killing people before COVID-19. Now it’s more quickly killing people if they catch the pandemic disease.
And COVID might be making the obesity epidemic that preceded it worse even as knowledgeable people worry more about their weight because of the disease.
If their working from home means getting out of bed, going to a computer, and spending the day sitting there before going back to bed, they’re headed for trouble.
Obesity was a health threat before the pandemic, and it will continue as a health threat after the pandemic. It just happens that during the pandemic it is an oversize health threat.