British Prime Minister Boris Johnson recently unveiled a Better Health campaign to combat obesity. The announcement was prompted by Johnsons bout with COVID-19, which included a stint in intensive care in April. Johnson is convinced that his reported Body Mass Index of 36 (30 is considered obese) was responsible for the severity of his infection and is now on a mission to slim down the United Kingdom.
Johnsons proposed interventions include banning junk food advertising before 9 P.M. to reduce the likelihood that children would be exposed to such ads, preventing stores from selling unhealthy snacks at entrances and checkouts, barring buy one get one free promotions on unhealthy foods, and requiring restaurants with over 250 employees to post calorie counts. Other measures include encouraging doctors to prescribe cycling (Johnsons favored mode of transportation) and facilitating access to weight-loss programs.
Critics of Johnsons anti-obesity measures rightly charge that they are incomplete because they focus on personal responsibility rather than attacking the root causes of obesitypoverty and inequality. Others have pointed out in the past that calorie counts in restaurants have negligible effects on consumer behavior.
As a researcher and educator on the history and politics of obesity, I would also caution that Johnson and lawmakers from other countries who might follow in his footsteps should tread carefully. Weight is a delicate issue, and mishandling wars on fat or obesity could impair, rather than improve, the physical and mental health of people with obesity.
This is not to say we should ignore links between obesity and COVID-19. There is mounting evidence that, obesity is the most significant risk factor in serious cases of COVID-19, possibly second only to age. Studies of populations in China, Italy, the United States, France and Britain have shown that people with obesity may double their risk of being hospitalized or dying from COVID-19, and that relationships between weight and COVID-19 are particularly pronounced among younger people and men.
Forty-two percent of American adults are classified as obese.
There are a number of explanations as to why obesity can aggravate COVID-19 infections. Scientists have found that COVID-19 often enters the body through an enzyme called ACE2, and that people with fat tissue have more ACE2 receptors and are therefore more susceptible to infection and higher viral loads.
Once infected with COVID-19, some doctors have proposed that because fat tissue compresses the diaphragm and lungs, those with obesity experience greater difficulty breathing. Another popular theory is that obesity may interfere with the proper functioning of immune cells and trigger an excessive immune response called a cytokine storm, resulting in potentially life-threatening inflammation and organ failure. Some researchers have also suggested that irregular levels of hormones associated with obesity, like glucose-regulating adiponectin and weight-regulating leptin, compromise immune responses to the virus.
As researchers continue to investigate links between obesity and COVID-19, countries and public health organizations would be well advised to devote renewed attention to obesity. In doing so, public health initiatives must learn from the mistakes of previous campaigns that stigmatized people with obesity as lazy, weak-willed and gluttons for junk food.
In 2012, both Children's Healthcare of Atlanta (Georgia largest pediatric health care system) and Blue Cross and Blue Shield of Minnesota launched controversial ad campaigns that critics have justly characterized as fat shaming. One Georgia poster featured four overweight children, with captions such as, Big bones didnt make me this way. Big meals did. Meanwhile, the Minnesota ads targeted parents. One of its commercials featured a large man at a fast food outlet carrying a tray of burgers, hot dogs, fries, onion rings and sugary beverages. As the man blithely walked toward his booth, he overheard his overweight son in competition with another boy over whose father could eat the most. He suddenly felt ashamed.
I fear that these types of misguided ads and anti-obesity campaigns might resurface in the COVID-19 era, and that the pandemic will provide added ammunition to the notion that people with obesity are social and medical scourges. Overweight children may be subjected to more bullying by peers if there are internet ads, commercials, posters and billboards stigmatizing people with obesity and their alleged diet and exercise habits.
Among adults, anonymous commentators of news stories about COVID-19 are already posting that peoples fates are the result of poor lifestyle habits, a claim reminiscent of the 1980s and early 1990s when anti-gay voices maintained that people died of AIDS because of the homosexual lifestyle. Furthermore, stigmatizing people for their weight would be inimical to the current reckoning with racial injustice, as African American women and Latino children are the most disproportionately affected by obesity in the United States.
To those who insist that blunt messaging is necessary to underscore the gravity of obesity just as sensationalistic anti-tobacco ads were needed to drive home the dangers of smoking, public health research has shown that not only is stigma ineffective, it can induce people with obesity to gain rather than shed, pounds.
Studies have found that both children and adults subjected to weight-based bullying or discrimination are more likely to seek solace in binge-eating, to develop eating disorders and to be discouraged from exercise due to anxieties about their bodies being on display. Stigmatizing people for their weight could also impair mental health and create added stress, which could result in elevated levels of the stress hormone cortisol and increased heart rate, blood pressure, and weight.
To avoid these consequences, campaigns to reduce obesity should focus on the positive aspects of maintaining healthy diet and exercise habits. And because lower-income Americans and racial minorities are more likely to live in neighborhoods with comparatively fewer supermarkets and green spaces, public policy interventions should also ensure access to affordable healthy foods and spaces that facilitate exercise and recreation. Such interventions align with the consensus among obesity experts that weight is the function of the interaction between genes and the environment.
Finally, it is imperative that anti-obesity initiatives also include an educational component in which the public and even health care providers are informed about the effects of weight bias. Rebecca M. Puhl and Chelsea A. Heuer, leaders in this area of research, point to studies revealing that health professionals sometimes regard patients with obesity as lazy, lacking in self-discipline, dishonest, unintelligent, annoying, and noncompliant with treatment, and that medical appointments with heavier patients are shorter than those with thinner patients.
Patients with obesity perceive these slights, reporting that health care providers do not take them seriously, erroneously assume that their weight is responsible for all their ailments, and condescend to them about losing weight. Hospital gowns, examination tables and medical equipment that are not designed for larger bodies exacerbate the embarrassment and indignities they experience. As a result, patients with obesity may forgo subsequent medical care, including lifesaving cancer screenings.
On the surface, at least, Boris Johnson seems to have come to appreciate the importance of approaching obesity with more compassion. In 2004, he wrote a newspaper column headlined Face It: Its All Your Own Fat Fault. Now, he reassures the British public that his anti-obesity program is not meant to be excessively bossy or nannying, adding: We want this one to be really sympathetic to people, to understand the difficulties that people face with their weight, and just to be helpful.
Go here to see the original:
Another Misguided 'War' on Obesity - Scientific American
- The kids aren't all right: COVID-19-fueled stress eating, inequities, lack of fitness expected to boost obesity, experts say - USA TODAY - October 18th, 2020
- Hispanics live longer than most Americans, but will the US obesity epidemic change things? - The Conversation US - October 18th, 2020
- Obesity in children on the rise due to remote learning, study shows - WWLTV.com - October 18th, 2020
- How the pandemic is boosting the risk of childhood obesity WHYY - WHYY - October 18th, 2020
- Risk of severe Covid-19 high for obese people, regardless of other factors - Health24 - October 18th, 2020
- The COVID-19 pandemic emphasizes the need to manage patient obesity - Medical Economics - October 18th, 2020
- Learn About the Advice From FIGO on Obesity | Figo - International Federation of Gynecology and Obstetrics - October 18th, 2020
- Bariatric Surgery Associated with 3-Year Increase in Life Expectancy for Obese Patients - Endocrinology Network - October 18th, 2020
- funded study links adolescent brain differences to increased waist circumference - National Institutes of Health - October 18th, 2020
- National Pet Obesity Awareness Day puts spotlight on keeping furry friends at a healthy weight - KING5.com - October 18th, 2020
- Studies Begin to Untangle Obesitys Role in Covid-19 - The New York Times - September 29th, 2020
- Covid-19 has killed more people than obesity in the UK this year - Full Fact - September 29th, 2020
- Relation found between AMI and obesity < Hospital < - KBR - Korea Biomedical Review - September 29th, 2020
- Long-term impact of obesity on patient-reported outcomes and patient satisfaction after lumbar spine surgery: an observational study. - Physician's... - September 29th, 2020
- Recovered Covid patients just cant stop eating - The New Indian Express - September 29th, 2020
- Wellness Expert James Hill Says Healthy Is More Than Weight Loss - Healthline - September 29th, 2020
- Weight Gain Linked to Later Life Incident VTE - MD Magazine - September 29th, 2020
- 18 Percent Of Americans Don't Have Enough To Eat, Which Makes Them...Obese? - Science 2.0 - September 29th, 2020
- Food insecurity in the US increasingly linked to obesity - Medical News Today - September 28th, 2020
- U.S. Adult Obesity Rate Hits Highest Rate Ever Recorded - Club Industry - September 28th, 2020
- Mission: Readiness ties obesity to national security - News - Times Record - September 28th, 2020
- The Intersection Of Obesity, COVID-19, Social Justice And Mental Health - Club Industry - September 28th, 2020
- Experience of Polish Patients with Obesity in Contacts with Medical Pr | PPA - Dove Medical Press - September 28th, 2020
- Cleveland Clinic Study Identifies Weight-Loss Threshold for Cardiovascular and Survival Benefits in Patients with Obesity and Diabetes - Health... - September 28th, 2020
- Coronavirus pandemic could impact cancer rates and care in the future - WKTV - September 28th, 2020
- An obese heart is a silent risk - The Hippocratic Post - September 28th, 2020
- Nonalcoholic Fatty Liver Disease and Heart Failure: Is There a Connection? - Michigan Medicine - September 28th, 2020
- Should India adopt NOVA classification of food? - The Sunday Guardian - September 28th, 2020
- Obesity and the Bitter Pill of Truth - Medscape - September 23rd, 2020
- Obesity and COVID-19: A renewed call to address a growing crisis - World Bank Group - September 23rd, 2020
- Negative pressure wound therapy does not cut infection risk in obese women after cesarean delivery - National Institutes of Health - September 23rd, 2020
- Obesity linked to hospitalisation and ICUs for Covid-19 patients - The Irish Times - September 23rd, 2020
- New Research Shows Potential Utility of Growth Standards to Monitor Healthy Weight in Puppies and May Help Identify Puppies at Risk for Obesity -... - September 23rd, 2020
- SCOTUS, Sallys economic effects and obesity - AL.com - September 23rd, 2020
- Obesity can cause and be consequence of poor sleep - Westside Eagle Observer - September 23rd, 2020
- Health Education Week 2020: Opportunities and Advancements in Obesity Medicine - Medical Economics - September 23rd, 2020
- COVID-19 Recovery Analysis: Assisted Reproductive Technology Market | Increase in Rate of Infertility and Obesity-Related Cases to Boost the Market... - September 23rd, 2020
- Stephanie Yeboah: 'Obesity is a disgusting word... it's just used to scare people' - Telegraph.co.uk - September 23rd, 2020
- Diabetes, Obesity and other five risk factors that can lead to heart failure - India TV News - September 23rd, 2020
- Research finds out a new phenomenon of obesity with the multiple burden of malnutrition in India - Eastern Eye - September 23rd, 2020
- WHO launches guide to boost children's health and well-being in Russian-speaking countries - Russian Federation - ReliefWeb - September 23rd, 2020
- For teens with severe obesity, bariatric surgery works, but is rarely used. Experts say that needs to change - The Detroit News - September 20th, 2020
- Obesity associated with a higher risk for dementia, new study finds - National Institute on Aging - September 20th, 2020
- Your Health First: Top underlying health conditions in North Dakota? Obesity and Type 2 diabetes - KX NEWS - September 20th, 2020
- US adult obesity at highest level ever recorded; Arkansas and Oklahoma rank in top five - 5newsonline.com - September 20th, 2020
- Coronavirus science | Week in review: 'Long Covid', obesity, and will the virus become seasonal? - Health24 - September 20th, 2020
- Mediterranean diet helps offset the health impacts of obesity - Earth.com - September 20th, 2020
- Obese people 70% more at risk of severe COVID-19: Assocham - The Indian Express - September 20th, 2020
- Could interaction between Covid-19 and pre-existing bacteria explain severity in the obese? - Health24 - September 20th, 2020
- Despicable to blame Government for Covid-19 death rate given obesity, says Tory peer - Evening Standard - September 20th, 2020
- If a heavyweight is morbidly obese why is he also fit to box? - Boxing News Online - September 20th, 2020
- Cancer Is on the Rise Among Young People - Discover Magazine - September 20th, 2020
- Letters to the Editor: Sept. 20 - Canon City Daily Record - September 20th, 2020
- Good nutrition can contribute to keeping COVID-19 and other diseases away - Kiowa County Press - September 20th, 2020
- Why COVID-19 is more deadly in people with obesityeven if they're young - Science Magazine - September 8th, 2020
- Higher obesity rates appear to contribute to higher bankruptcy rates in the United States - PsyPost - September 8th, 2020
- Worldwide Non-Invasive Fat Reduction Industry to 2025 - Increasing Prevalence of Obesity Presents Opportunities - ResearchAndMarkets.com - Business... - September 8th, 2020
- New evidence testosterone therapy is effective obesity treatment in men - New Atlas - September 8th, 2020
- Obesity is tied to greater risk of complications from COVID-19 - WWLTV.com - September 8th, 2020
- Pregnancy, Obesity and Nutrition Initiative (PONI): FIGO releases new Supplement - International Federation of Gynecology and Obstetrics - September 7th, 2020
- High Pleural Pressure Prevents Alveolar Overdistension and Hemodynamic Collapse in ARDS with Class III Obesity. - Physician's Weekly - September 7th, 2020
- Global Intragastric Balloon Market (2019 to 2028) - Rise in Government Initiatives Regarding Obesity Presents Opportunities - ResearchAndMarkets.com -... - September 7th, 2020
- Drugs That Fight Diabetes and Obesity May Treat Covid-19 - Bloomberg - September 6th, 2020
- COVID-19 Patients With Obesity Have Higher Viral Load, for Longer - Medscape - September 6th, 2020
- Even half a glass of alcohol increases risk of obesity, study shows - Study Finds - September 6th, 2020
- America's Obesity Epidemic Threatens Effectiveness of Any COVID Vaccine - POZ - September 6th, 2020
- 'Fat-Shaming' Drops in US but UK Public Still Apportion Blame - Medscape - September 6th, 2020
- Calls for tougher regulation to fight obesity - Newsroom - September 6th, 2020
- Consumption of alcohol even in small amounts can result in obesity and metabolic syndrome, suggests study - Firstpost - September 6th, 2020
- World's richest countries grappling with children's reading and math skills, mental well-being and obesity - UNICEF - September 6th, 2020
- Definition of Chronic disease - MedicineNet - August 31st, 2020
- America's Move to Raise A Healthier Generation of Kids ... - August 31st, 2020
- Controlled obesity status: a rarely used concept, but with particular importance in the COVID-19 pandemic and beyond - DocWire News - August 31st, 2020
- Groningen University Hospital to investigate role of obesity in patients with COVID-19 - Innovation Origins - August 31st, 2020
- Obesity and COVID-19: How weight tips the scales to severe COVID-19 illness - The Stanford Daily - August 31st, 2020
- Study finds obese people at higher risk of COVID-19 complications - Times of India - August 31st, 2020
- Childhood obesity could increase the risk of multiple sclerosis in later life - The Conversation UK - August 31st, 2020
- Peter Rhodes on an Indian romance, the risks of obesity and standing up for nice things - expressandstar.com - August 31st, 2020
- Joint Pain Injections Market: Investments by key players is driving the global market - BioSpace - August 31st, 2020
- Why your doctor will not talk to you about obesity - The Standard - August 31st, 2020