Illustration of masked diverse people of all body sizes.

Obesity: Why excess weight is a COVID-19 risk factor

As more data is collected on the coronavirus COVID-19, experts are starting to locate and identify trends. One disturbing trend is the correlation between obesity and the severity of symptoms.

“We have seen an increased risk for people with a BMI over 30 of having severe illness from COVID-19,” said Dr. Brian Curtis, vice president of Clinical Specialty Services for OSF HealthCare. “About 40% of the U.S. population falls into this category.”

Dr. Curtis’ experience with COVID-19 patients reflects the national statistics. If your BMI is over 30, you are 27% more likely to have severe disease. If your BMI is over 40, you have doubled your risk. For people under 55, obesity is the No. 1 risk factor for developing a severe case of COVID-19.

How excess body weight factors in

While data has shown a definite trend, experts are still unsure why. However, breathing difficulties and overall health issue complications can play a role.

“Obese people have hormones and proteins in their blood that can make them more prone to clot and cause inflammation, making it harder to fight infections,” Dr. Curtis said. “When someone gets COVID-19, they have a high incidence of developing blood clots. So, if you’re obese, you have an even greater risk.”

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Dr. Curtis points out that COVID-19 uses the ACE 2 receptor to enter the body. Adipose (fat) tissue has this type of receptor. So obese people will have higher amounts of that receptor, causing a higher viral load and difficulty fighting the infection.

In addition, obese people tend to have a higher incidence of insulin resistance, which means they have higher levels of insulin circulating in their blood. The elevated levels of insulin also cause an increase in the ACE 2 receptor. Therefore, the higher your BMI, the more at risk you are.

“Obesity increases the chance of having a severe disease that includes admission to the ICU and intubation,” Dr. Curtis said. “Obesity can also come with other health conditions such as hypertension, diabetes and poor physical conditioning. These factors can interfere with your body’s ability to fight off infections and make one prone to have more serious illnesses and complications from illnesses.”

What you can do

If you fall into a higher risk population, you should practice extra caution in your daily activities. Prevention is the best way to avoid complications.

  • Avoid crowds, non-essential travel and people who are ill
  • Avoid touching your eyes, nose or mouth
  • Call your health care provider if you have concerns or feel sick
  • Follow your health care provider’s recommendations for nutrition and physical activity
  • Practice physical distancing
  • Practice good hand hygiene
  • Start a weight loss program
  • Take your medicines for any underlying health conditions exactly as prescribed
  • Wear a mask

Consult with your doctor to ensure your health conditions are optimally managed,” Dr. Curtis said. “Finally, support your immune system by eating healthy, exercising and getting the appropriate amount of sleep.”

Last Updated: April 13, 2022

About Author: David Pruitt

David Pruitt is a writer for the Marketing & Communications division of OSF HealthCare. He has a bachelor’s of journalism from Southern Illinois University Edwardsville and worked as a reporter before joining OSF HealthCare in 2014.

An avid golfer and fisherman, David was born and raised Alton, Illinois, which is where he currently resides with his son, James.

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Categories: COVID-19, Diet & Exercise