The stress and strain of the pandemic has contributed to people not adhering to a healthy eating plan, struggling to remain active and feeling isolated due to the call to stay home and stop the spread of COVID-19. This all adds up, further increasing the risk of severe illness from COVID-19 among people with obesity. But everyone has a role to play in turning the tide against obesity and its inequitable impact.
“COVID is an acute inflammatory process and obesity is a chronic inflammatory process. The interaction between these two is a … perfect storm for disaster,” said AMA member Fatima Cody Stanford, MD, MPH, MPA.
Awareness of “the risk for both morbidity and mortality associated with COVID and patients who have obesity has dramatically increased,” added Dr. Stanford, an obesity medicine physician scientist at Harvard Medical School.
Aside from consulting their primary care physicians about the suitability of a referral to an obesity medicine physician, here are other ways people with obesity can improve their health and well-being during the pandemic.
“If you get people with obesity to recognize that obesity is not their fault and that we can help them be their best selves, that's important to hear,” said Dr. Stanford. “Most of the time, especially patients who have struggled with obesity, they hate going to the doctor because the doctors might tell them that they're doing something wrong or [that there is] something flawed about themselves.”
“It is not acceptable for me not to treat their obesity,” she said, noting that “if I were to do that to someone who came in with uncontrolled type 2 diabetes, I would lose my medical license.”
“For those people who are struggling because they feel socially isolated, find ways to connect,” said Dr. Stanford. “We as humans are made to connect. We're not made to be in solitude.
“When we're in solitude, stress goes up and when stress goes up, storage of fat goes up, so find a way to connect,” she added. “Maybe there's a friend who you used to talk to all the time and maybe you're not talking anymore, but you really want to talk to that friend who was great. This might be the time to rekindle that friendship.”
Together with Arghavan Salles, MD, PhD, a bariatric surgeon, Dr. Stanford participated in the #SocialDistancingFitnessChallenge by posting videos of herself doing yoga and high-intensity interval training.
“We did this for quite a bit in the earlier days of the pandemic as people were just learning how” to practice physical distancing, said Dr. Stanford. “Our goal in doing this was to get people to recognize that even as doctors during the middle of this pandemic who are very stressed … we're still being active and we're encouraging you to do the same.”
“In the middle of this pandemic,” patients feel stuck inside and like they can’t do anything, but “technically you can. You just have to find creative ways to do it,” she said. “We have the convenience of the use of social media to connect and we can work out with an on-demand platform,” which is a streaming service through the TV or an app for access to exercise programs.
The inability to afford healthy food options leads to imbalanced diets. Over time, this can result in poor health and chronic conditions such as type 2 diabetes. The pandemic has exacerbated these problems, further minimizing healthy food options to choose from. One way to combat this is through “services that deliver organic fruits and vegetables to your doorstep for very inexpensive amounts,” said Dr. Stanford who personally uses Misfits, which offers “imperfect foods delivered to my front door for $26.” The service delivers to ZIP codes in dozens of states.
“What is great about having this box delivered is it's for those who may be reluctant to consider vegetables … you get to begin to explore,” she said. Additionally, “what helps decrease the idea of these food deserts is the fact that many of us are having groceries delivered to our doors anyway.”
People with obesity are at risk for type 2 diabetes, which leads to an increased risk for severe COVID-19 outcomes. It is important for people with obesity to get screened for prediabetes. The AMA’s Diabetes Prevention Guide supports physicians and health care organizations in defining and implementing evidence-based diabetes prevention strategies.
This comprehensive and customized approach helps clinical practices and health care organizations identify patients with prediabetes and manage the risk of developing type 2 diabetes, including referring patients at risk to a National Diabetes Prevention Program lifestyle change program based on their individual needs.