Obesity - the elephant in the room

I fully expect I will get a reaction that I am “fat shaming” but, there is an expression in management “If you don’t measure it, you can’t manage it” and I feel that there needs to be much more understood about the impact of our obese lifestyle on the “success” of the Covid virus. For example, is that one reason why cases and deaths in the UK and the US are higher than in places like France, because a higher proportion of the population are overweight?

It seems to me that all too often when someone young dies of COVID the associated comment is “and he/she had no underlying health issues” and I’m wanting to yell at the TV. Yes they do! They are overweight/obese and all that that means in terms of “accepted” health issues like strain on organs, ongoing minor conditions like eczema, constipation, dehydration, early arthritis, pre-diabetic symptoms, and so on and so on. Fertile ground for a virus to thrive.

Those of you who are working on the frontline, maybe can help me understand, but I watch the videos from ICU units and I see it takes EIGHT people, four each side, to turn patients to help their lungs function. That is a HUGE drain on resource and exhausting for those doing it and I wonder how many of the patients they are turning are obese? Or would it still take eight people to turn me? I weigh 8 1/2 stone.

Maybe we will learn from all of this in time, but it seems to me that until the food industry is taken to task for its appalling addictive practices in the same way the tobacco industry was, there will be no end to the increasing, seemingly unrelated health issues and early deaths that we face as a society.

And we need an inventor to come up with a way to turn large patients easily that does not require the exhausting way it has to happen at the moment.

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Greater than 40 BMI is considered a risk factor for NHS staff. One of my colleagues suffering badly from long Covid is very overweight
Proning a patient is a very specific procedure and does require several staff ,although 8 could be excessive, some hospitals have set up proning teams to carry it out properly as they have so many in that position

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Agreed. I see this as an aspect of the environmental movement: as currently constituted, the food industry is destroying human health as surely as it is destroying soil chemistry, bio-diversity, etc…

The tobacco industry has been called to account - and taken to court - because it actively disguised its health impacts; big pharma and big oil are on the verge of the same debacle - because it can be shown that they deliberately withheld knowledge of the adverse effects of their products - and the giant food multinationals are just as culpable.

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People know to eat well, they (we) just choose not to. Is it really correct to blame industry they don’t put it in your mouth.

To Matt…if marketimg didn’t work companies wouldn’t spend millions on it. People can be influenced, and the lack of knowledge is staggering. Eg people think low fat yoghurts are less fattening - no they just contain less fat but are v similar in calorie content…

But there is work going on re covid and obesity:

In July Public Health England estimated that having a BMI of 35 to 40 could increase a person’s chances of dying from covid-19 by 40%, while a BMI greater than 40 could increase the risk by 90%. But why is this?

Stephen O’Rahilly, director of the Medical Research Council’s Metabolic Diseases Unit at the University of Cambridge, also speaking at the briefing, said, “Two things happen when obesity occurs: the amount of fat increases, but also you put fat in the wrong places. You put it in the liver and in skeletal muscle. And that disturbs metabolism. The key disturbance is that you get very high levels of insulin in the blood.”

This disturbance is associated with a range of abnormalities, including increases in inflammatory cytokines and a reduction of a molecule called adiponectin that directly protects the lungs, he says.

It’s also possible that fat increases in the lung itself, which may disturb how the lung handles the virus, he adds. “The simple stuff you read about—big chest, big bellies, et cetera—is all grossly oversimplistic. What is really going on is metabolic, and we know that because if we look at genetic markers for the metabolic disturbance they are much more closely related to the bad outcomes than genetic markers for obesity itself,” O’Rahilly says.

And this interesting meta analysis which also hints that vaccination may not be as effective in the obese - worrying

https://onlinelibrary.wiley.com/doi/full/10.1111/obr.13128

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I don’t believe they do Mat. Poor quality food with (notably) high sugar content and multiple additives is cheap food. For many people cheap food is all that they can afford. Fast food (for people who are working crazy hours) is cheap and unhealthy. Cooking has become a hobby, so many people do not know how to cook other than to shove something in the microwave or put a pizza in the oven.

High sugar food is as addictive as tobacco and heroin. If not more so. With drugs, one can chose to stay out of the crack den. With food, one cannot unless one lives totally self-sufficiently. Supermarkets are crack dens that addicts walk into every day and renew their addiction. We can stop smoking and taking drugs and stop feeding the habit. We cannot live without food - so the habit is (literally) fed every day.
Food manufacturers and retailers use some of the most sophisticated marketing ploys on the planet to get us to eat their foods - even so-called “healthy foods” without any morality.
Yes, there are earnest chefs like Jamie Oliver who are doing the best they can to re-educate - watch his TED talk where he empties a barrow load of sugar on the stage. But the great majority in this world are not watching TED talks.
A friend of mine was working in the slums of Mexico City as a nutritionist in the 80s. A cheap, well-rounded basic meal for Mexicans in the countryside is kidney beans, rice and greens from their own land. They come to Mexico City and they start eating McDonalds and drinking coca cola, because they think that is the clever, sophisticated thing to do and they are ashamed of their rural diet and then have health problems. This is being repeated the world over.

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Jane, thanks so much. This is JUST the information I’ve been looking for. :+1: :+1:

Maybe 6 - the numbers are for safety.

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Absolutely, a very obese friend with type 2 and breathing difficulties is about the last person who needs covid but despite being very careful they caught it and we were all very concerned for him. He is progressing well and not required hospitalisation. One of his staff a strapping man who is fitness obsessed meanwhile is suffering very badly.

Exposing the fallacy that ‘people choose’ is not hard - just think back to any ready-prepared food you have eaten (eg. a ready-meal, take-away, restaurant meal, or indeed any ready-prepared ingredients such as sauces, etc) and ask yourself whether you really knew exactly how much sugar, or other harmful ingredients it contained; or whether anything in it was grown or treated with harmful chemicals or processes. I can pretty much guarantee you didn’t know - and nor does anybody else.

The fact is that nearly everything you really need to know to make a genuine choice - an informed choice is hidden - and the multinational food industry has fought everywhere against properly informing people - or indeed any curtailing of misleading advertising (as a Hugh Fearnley-Whittingstall campaign and television series recently pointed out).

But the problem goes much deeper than this. The fact is that we live in an economic system that is fundamentally based on getting us to consume more and more of anything and everything – regardless of our well-being, or that of our natural environment, or any consideration except extracting the maximum profit.
Why does the food industry put junk like huge doses of sugar in our food? For 2 reasons:

  1. It’s cheap – so they make more profit;
  2. It makes other cheap ingredients taste better – so we buy it – and they make more profit.

This is unhealthy – but it’s an ill health that is not just built into the food – it is built into the economic basis of food production, distribution and retailing.

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Even in hospitals snack machines are filled with sugar based crap! It has lead to me being old school and preparing food to take with me when going out.

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For anyone though, surely? I mean over 25 is overweight and over 30 is obese so I can’t even imagine how fat you have to be to have a bmi over 40.

Or choose not to eat industrial food. I have always cooked from scratch and the result is that now so do my children. Packet food doesn’t usually taste as good anyway.

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I used to work in housing, and whereas in social housing there are standards for kitchens, in private new builds there are not. And in many areas a “kitchen” consisted of 2 hobs, a microwave and a fridge freezer as part of open plan living area which might include a table big enough for some of the family to eat at. Sometime a mini dishwasher in place of an oven…The expectation is that people wouldn’t want to cook, so it all becomes self-perpetuating.

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BMI’s not all it’s cracked up to be - IIRC lowest overall mortality is in the 25-30 band (though remember fit lean individuals with high muscle density have a higher BMI than you’d “expect”).

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Isn’t that where a lit of people are? And they probably people who suddenly think oh no, get fit, go running and keel over with a heart attack. I don’t imagine the morbidly obese do the same thing.

Yes of course, back in the distant past when I swam several hours a day and looked just like Popeye my bmi was a source of amazement to my tiny birdlike Fr mother, we took the same size in jeans but I weighed about 15kg more. I couldn’t get my shoulders into her shirts, obviously :joy:

Of course it’s bad for anyone but I was answering in terms of the OP that an organisation (whose workers are often front line )considers that the point where a risk assessment is triggered

@Eddie
Yes - I understand but frankly I’m surprised that 40 bmi is the trigger point. It can’t be easy even at say 30+

It isn’t necessarily about ease but the potential of having a bad outcome if you become ill

‘But the problem goes much deeper than this. The fact is that we live in an economic system that is fundamentally based on getting us to consume more and more of anything and everything – regardless of our well-being, or that of our natural environment, or any consideration except extracting the maximum profit.’

If we imagine for a moment a large, powerful and influential country (I will not mention by name but it’s currency is the dollar), where healthcare is uniquely private and expensive, and it citizens therefore pay first for food which makes them ill, and then treatments in a futile bid to get well again.
Call me cynical…but before the Covid crisis the government were bent on dissolving the NHS (with what motive we can only guess at).
So it made my blood boil to see Bojo behind that lectern last year with the slogan ‘Protect our NHS’, the epitome of hypocrisy!

Apologies for jumping right in here without introducing myself. I follow lots of interesting discussions and learn a great deal from this forum, and don’t normally feel I have much to add which has not already been said. But I really needed to get that off my chest.

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