The Truth About COVID-19 and Weight
Update 4/17/2020: I wrote an in-depth piece about this topic for Wired, critiquing the new evidence that’s emerged since I published this blog post. Check it out here (CW: BMI numbers, analysis of weight-stigmatizing concepts)
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Recently, many news outlets have been reporting that body size is an independent risk factor for COVID-19, but they need to cut it out right now. To date, evidence indicates that the percentage of high-BMI folks with critical COVID cases is basically the same as—if not lower than—the percentage in the general population.
I won’t link to these reports because they’re stigmatizing AF, but you know the ones: the New York Post quoting a UK tabloid about how roughly 2/3 of UK ICU patients are in the “O” BMI categories, Reuters talking about why NOLA has it worse than other cities because people there are fatter, etc.
But here’s the thing: roughly 2/3 of the *general population* in the UK (and US) falls in the “O” BMI categories. The percentage of larger-bodied folks in critical care just mirrors that of the general population. (Check out this recent UK report, which has a good graphic illustration of this concept.)
And Reuters reports that 25% of the people who’ve died of COVID-19 in Louisiana were in the “o*ese” BMI category, but doesn’t bother to mention that 34.5% of the state’s overall population falls into that category, according to the Louisiana Department of Health.
So if anything, those numbers indicate that being in the “o*ese” category may actually lower people’s risk. (To hear me talk more about this, check out last week’s episode of Plus This.)
Obviously it’s early, and there’s more we may learn about risk factors once more real science starts getting published—but we do have a fair amount of real science out of China already, and high BMI on its own just isn’t a risk factor (though ONE study found that it may be when combined with heart disease).
And by the way, any COVID-CVD-BMI link doesn’t mean higher weight causes poor outcomes in COVID-19 among CVD patients; it may just mean higher-weight people are sicker to begin with because of weight stigma and weight cycling, both of which are independent heart risk factors.
But to date, there’s no convincing evidence to suggest that high weight is a risk factor in and of itself, and certainly none to even hint that losing weight is a form of prevention or cure. (Do a Pubmed search for "COVID-19" + “o*esity,” read the full-text studies and references closely, and see for yourself. Or read the ones I’ve collected here.)
We just have larger-bodied people getting critically ill at the same or lower rates than we’d expect given the distribution of body sizes in the population, and fatphobic journalists and health professionals trying to spin a story about how being fat is bad.
Bottom line: don’t buy it. This is just diet culture trying to make fatphobic meaning out of nothing. Right now the best thing you can do—at ANY size—is stay home, wash your hands, and try not to fall prey to weight stigma ❤️