COVID-19 and the worrying implications linked to obesity

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Obesity reduces the effectiveness of the influenza vaccine by 50%, so could it affect the efficacy of the COVID-19 vaccine?

Words by Cynthia Bou Khalil, Nutritional Consultant and Clinical Manager Excellence, Allurion

There is no doubt that a properly functioning immune system is important for survival, especially in the times we are currently living in. The COVID-19 pandemic has changed life as we know it, affecting health, the global economy and our lifestyles, be it directly or indirectly. One such impact is the effect on people’s weight. It is true that the strategies employed to combat the spread of the pandemic, such as the lockdown policies, have been positive from an epidemiological standpoint, however, it has had a negative influence on other health measures including the obesity epidemic. 

As a healthcare professional in the UAE, a country with over 70% of the male Emirati population under 30 suffering from obesity, it is my duty to offer guidance and assistance to those looking to lose weight, as well as educate the masses on the need to lead healthier lives. However, with two in three people overweight in the UAE, dieting itself is often not enough for many and rather there is a need to induce weight loss by increasing the feeling of fullness. This means that a person is more likely to reduce the amount of food they eat throughout the day, and in turn, lose weight.

Moments of confinement can have an effect on food availability and accessibility, which can in turn have an effect on diet quality. As we saw in the earlier stages of the pandemic, as governments doubled down on restrictions and with the uncertainty that loomed ahead, many households cut back on their living expenses, which included food. This made them opt for more affordable and more often than not, less healthy and nutritious options. A cross-sectional study on eating habits and lifestyle of UAE residents during the lockdown period showed that many had adopted unfavourable dietary habits including increased caloric intake and constant snacking (increased portions), reduced fruits and vegetables consumption.

And with little to no physical activity during that time, due to the closure of sports facilities, parks and overall movement restrictions, many experienced weight gain.

Whilst coronavirus poses a threat to all individuals regardless of the person’s BMI, we did notice early on that obesity was a risk factor for the virus. In fact, a meta-analysis of 75 studies across 10 countries in about 400,000 COVID-19 patients found that obesity significantly increases the risk of poor outcomes, with a 46% higher risk of hospitalization, 113% higher risk of ICU admission and 48% increase in mortality. The reason being that people with obesity are more susceptible to respiratory disorders, due to reduced lung capacity, which requires them to work harder when breathing. 

Lest we forget Barry Popkin, a Nutrition Professor at UNC-Chapel Hill’s Gillings School of Global Public Health, who surmised that metabolic changes linked to excess weight can have an impact on the immune system’s ability to fight diseases, which can also play a role with COVID-19 outcomes. Obesity can cause inflammation which contributes to the incidences of diabetes and heart disease. 

We must also look at how this could potentially affect vaccinations. There is currently no concrete evidence as to whether or not obesity poses a threat to the efficacy of the COVID-19 vaccine. However, what we have seen time and time again, is how vaccines for a handful of other diseases, such as the influenza vaccine, don’t work as well in obese people.

While the biological mechanisms linking obesity with COVID-19 are complex, it appears that weight loss may have the potential to reverse them. If there is to be a silver lining with this pandemic, it is how much of an impact it has had with patients towards weight loss and practices that promote healthy living. Google saw a 20% increase in interest across the weight loss category search after countries left initial lockdowns. And, McKinsey & Company reported that there was a 14% increase in spending for fitness, wellness and personal care in China, post the initial lockdown, while other categories seemed to be in decline.

I have found that there are no shortcuts to getting on the healthy bandwagon, one must do the work. But an effective weight loss program that combines both science and healthcare is key. Using a multi-layered approach involving a positive lifestyle change and incorporating methods backed by healthcare professionals, is ultimately needed to combat obesity. Such as my approach working with medical device company, Allurion. Allurion’s Elipse program is more than “just a gastric balloon”. It combines a high-tech balloon solution with a full package of support to help patients develop good lifestyle habits that can remain with them long after their balloon has gone. It is a groundbreaking moment for my patients, especially those who already lead a health-lifestyle but suffer from the feeling of constant hunger, as it creates a feeling of fullness by taking up space in the stomach. It gives patients the chance to take a break from dieting and the feeling of hunger associated, which is more often than not the reason for weight-gain. 

Remember, we live in trying times. The best thing one can do is to ensure that the body’s first line of defense is operating at full capacity. And with obese and over-weight people, this starts with losing the weight.

Allurion’s Elipse Program is the world’s first and only weight loss device that requires no surgery, endoscopy, or anaesthesia. It is a swallowable capsule that expands in the stomach to around the size of a grapefruit and allows patients to lose an average of 10 to 15% after approximately 16 weeks. Allurion’s Elipse Program combines its high-tech balloon solution with a full package of support to help its patients develop good lifestyle habits that can remain with them long after their balloon has gone. Patients benefit from six months of dietary support from a nutritionist to ensure lasting lifestyle changes alongside an Allurion Connected Scale and Allurion Health Tracker both connected to the Allurion App.