The Pre-Pandemic That Drove Severe COVID-19

Studies demonstrate strong, causal link between obesity-driven comorbidities, severe COVID-19 outcomes

Globally, the number of obese individuals has tripled since 1975.LightField Studios/Shutterstock

In 2021, one year into the COVID-19 pandemic, two studies, rich in data, showed that the greatest risks for severe COVID-19 outcomes were preexisting health conditions. These conditions are strongly linked to obesity.

These studies, and many others like them, weren’t widely reported in the press, and despite the trillions of dollars spent on COVID-19, little in the way of public health messaging or investment was spent on addressing the obesity connection. This preexisting pandemic, and the diseases that come with it, were already a leading contributor to early death before the COVID-19 pandemic.

The U.S.-based studies, done independently, make clear that preexisting health conditions are most significant in driving severe outcomes from a COVID-19 infection.

The first study, published on July 1, 2021, in Preventing Chronic Disease, examined the records of 540,667 individuals, 18 and older, who had been hospitalized with COVID-19 between March 2020 and March 2021. The study’s authors focused on the relationship between chronic comorbidities and severe COVID-19 outcomes.

Consequences of Comorbidities

A comorbidity is an existing disease or bodily dysfunction that someone has before contracting something else. A chronic condition is a disease or dysfunction that develops slowly and persists for a long time, as opposed to an acute condition, one that develops suddenly and lasts a short time. According to the study, of those hospitalized with COVID-19, 95 percent had at least one underlying chronic comorbidity, such as high blood pressure or obesity.

The second study, published on July 7, 2021, in Risk Management and Healthcare Policy, examined the records of 1.4 million U.S. individuals, from infants to the elderly, with confirmed COVID-19 infections.

The researchers examined the relationship between severe COVID-19 outcomes and the presence of one or more of the four most common chronic comorbidities in the United States: diabetes, cardiovascular disease, chronic lung disease, and renal (kidney) disease.

For their study, the authors defined “severe outcome” as either being hospitalized, admitted to the intensive care unit, placed on a ventilator, or dying.

The authors then compiled a table in which various age groups and their respective COVID-19 outcomes were presented three times: First, those with no chronic comorbidities, then those with one chronic comorbidity, and finally, those with two or more chronic comorbidities.

For any of the listed age groups, the difference in outcomes of any severity, depending on the existence of one or more comorbidities, was within a magnitude of 300 percent to 900 percent.

For example, in the 50 to 59 age group, the percentage of those with no comorbidities who were hospitalized because of COVID-19 was 8.54 percent. For those with two or more comorbidities, it was 55.69 percent, an increase of more than 550 percent.

Although not the focus of either of the two listed studies, obesity has been shown, in several studies, to be a significant causal factor of diabetes, cardiovascular disease, and renal disease.

Figure 1: Table listing the increase in severe COVID-19 outcomes related to comorbidity. Source: Journal of Risk Management and Healthcare Policy, 7 July 2021 Volume 2021:14, page 2880.

Globally, the number of obese individuals has tripled since 1975, with most of the world’s population now living in countries where being overweight kills more people than malnutrition, according to the World Health Organization. These figures have led some researchers to write about a “dual pandemic” of obesity and COVID-19, with a bidirectional impact, that is, both increasing the severity of the other.

A Missed Opportunity?

In the United States, some physicians have openly expressed their concern that the current approach to public health by organizations such as the Centers for Disease Control and Prevention (CDC) isn’t addressing the known causal relationship between lifestyle, obesity, comorbidities, and severe outcomes from diseases such as COVID-19.

“Thirty years ago,” Dr. John Littell told the Epoch Times, “when I first started practicing medicine, the primary approach to disease prevention was a focus on lifestyle, diet, and exercise, with medical interventions secondary or tertiary. Now, that has completely flipped, and vaccinations and medical interventions are pushed as primary interventions.”

Littell practices family medicine in Ocala and Kissimmee, Florida. He’s the author of “The Hidden Truth: Deception in Women’s Health Care” and recently was the host of the national conference “Florida Summit on COVID II: The Future of Medicine in post-COVID America,” which was featured on Epoch TV.

In taking a vaccine-first, behaviors-second approach to public health, Littell believes that the CDC has missed an opportunity to warn the public about the dangers of obesity and the connection between comorbidities and severe disease outcomes.

Littell is concerned that the CDC has too completely adopted the agenda of large pharmaceutical companies, including those making biologics such as vaccines.

“Other organizations, like the National Institutes of Health (NIH), as an arm of the federal government, are increasingly focused on population health strategies and are less patient-centered,” he said.

“Most of my patients, after dealing with the many adverse consequences of COVID-19 vaccines, mask, and quarantine mandates, are now skeptical of much of the medical information they are getting from the media.”

There’s an upside, however.

“They are choosing to pursue healthier lifestyles, including weight loss,” Littell said.

Avoiding Severe COVID-19 Outcomes

Across the United States, nearly 60 percent of the population has contracted COVID-19, and physicians expect that number to continue to rise, even among those who have been vaccinated. While the extent of obesity’s effect on COVID-19 infections isn’t fully understood, many independent studies now clearly indicate that obesity and obesity-related comorbidities are the most significant causal factor in severe COVID-19 outcomes.

Organizations such as Strategies to Overcome and Prevent (STOP) Obesity Alliance, which is composed of groups and individuals from inside and outside the health care industry, have formed to combat obesity and its impact on COVID-19 outcomes. Through its “Weight Can’t Wait” campaign, STOP Obesity Alliance urges primary care providers to initiate conversations with patients about their weight, being careful to avoid judgment or stigma.

STOP Obesity Alliance emphasizes that these conversations can’t wait since, as it points out on its website, nearly 75 percent of the American population is overweight.

To determine if someone is overweight or obese, health care providers use a calculated ratio of the percentage of body fat to total mass, the body mass index (BMI).

Although not an absolute gauge of obesity because it doesn’t take muscle mass into account, a BMI at or above 30 indicates that someone is too heavy and/or likely obese. One can calculate one’s own BMI by entering height and weight into an online BMI calculator.

Lowering one’s total weight by as little as 5 to 10 percent has been shown to reduce susceptibility to comorbidities such as diabetes and cardiovascular disease. Accordingly, reducing one’s exposure to any of the four most common COVID-19 comorbidities—diabetes, cardiovascular disease, chronic lung disease, and kidney disease—is a proven way to reduce the risk of severe infection.

Live and Lose Weight

Losing weight doesn’t have to require any extreme diets or exercise programs. If someone is overweight, several simple lifestyle steps can be taken to reduce body weight and the health complications associated with excess weight.

Avoid Added Sugars

Limit (or eliminate) dietary sugar, especially from processed foods and soft drinks. Researchers note that the increase in dietary sugar parallels the rise in obesity, with the average American now consuming more than 300 percent of the recommended daily intake of refined sugar.

Get 7 to 8 Hours of Sleep Nightly

Several studies have found a connection between a lack of sleep, poor health, and obesity. Less than six hours of sleep nightly, which experts call “short sleep,” has been on the rise among American adults since 2013 and adversely affects mental and physical health.

Limit Screen Time

Several studies have linked screen time, whether television watching or computer or phone use, to increased weight and obesity. The reason for this relationship includes increased eating while watching and an overall decrease in physical activity. Screens can also disrupt melatonin levels and sleep.

Increase Physical Activity

Experts agree that even moderate exercise, such as walking just 30 to 40 minutes daily, has been proven to aid in weight loss of 10 to 15 pounds in less than two months.

Taking any of these steps alone, or a combination of several of them is a straightforward way to reduce overall body weight.