Exercising in the Fight Against COVID-19
— Weight loss may prevent obesity-related severe disease
by Harsha Banavasi, MD December 23, 2020
As we near 18 million cases of COVID-19 and more than 320,000 deaths in the U.S., wearing a mask still continues to be the best way to prevent and control the spread of the virus. However, it is also important to acknowledge that the risk of someone contracting the virus is much higher now than it was earlier this year.
Extensive research since the beginning of this pandemic has shown that patients with pre-existing comorbidities have a much higher risk of developing severe COVID-19. Severe disease is defined as infection resulting in hospitalization, admission to the intensive care unit, intubation or mechanical ventilation, or death.
While older age is the number one risk factor for developing severe disease, this risk is non-modifiable. Modifiable risk factors for severe COVID-19 include serious cardiovascular disease (heart failure, coronary artery disease, cardiomyopathies), type 2 diabetes, and obesity (BMI ≥30).
It should be noted that morbid obesity is by itself a risk factor for developing coronary artery disease, heart failure, diabetes, and many other diseases. In fact, independent of obesity-related comorbidities, patients with a BMI over 40 had a significantly higher risk of death from COVID-19 compared with patients with a BMI of 18.5 to 24, and this risk was most striking among those ages 60 and younger and men.
The U.S. has the highest prevalence of obesity compared with any other country in the world. The latest data show that all states have more than 20% of adults with obesity. Twelve states (Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia) have more than 35% of adults with obesity. The Midwest (33.9%) and South (33.3%) have the highest prevalence of obesity, followed by the Northeast (29%) and the West (27.4%).
While wearing a mask to prevent contracting COVID-19 is the best step one can take, exercising and weight loss to prevent obesity might be the next best course of action to take at this time in order to significantly reduce the risk of developing severe COVID-19. It would not be surprising to learn that the prevalence of obesity in 2020 increased due to the fact that many public parks, gyms, and fitness centers are closed in order to prevent the spread of COVID-19. Additional barriers to exercise and weight loss that are specific to the year 2020 include high rates of unemployment and resultant financial burden.
Even in those with existing obesity, exercise and weight loss helps to better control diabetes, heart failure, coronary heart disease, and chronic lung conditions such as COPD, all of which are risk factors for severe COVID-19. It is now more important than ever to focus on physical fitness and weight loss to prevent obesity.
Not sure where to start? The American Heart Association and CDC recommend 150 minutes of physical activity per week. Physical activity is defined as anything that gets your body moving and increases your heart rate. The most convenient way to fit in 150 minutes is probably to divide the schedule into 30 minutes a day, 5 days a week.
Only about one in five adults and teens get enough exercise to maintain good health and it is important to note that some physical activity is better than none. Those looking to lose weight may be able to take advantage of free online exercise programs that are specifically geared for home workouts/small group workouts and virtual exercise programs.
Harsha Banavasi, MD, is a pulmonologist in Rome, Georgia.