The Problem With COVID-19 Weight-Loss Advice

We still don’t have solid evidence to say that high BMI is a risk factor for COVID-19, for all the reasons I outlined in my WIRED piece a few weeks ago. But here’s the thing: even if high BMI were the risk factor it’s made out to be, it’s nearly impossible to change.

Trying to lose weight doesn’t work long-term for the vast majority of people, and it actively causes harm via weight stigma, weight cycling, and disordered eating. 

(I go into a LOT of detail about the science behind this in my book, Anti-Diet. You can also find a good quick introduction in this study.)

For example, a 2015 study of more than 176,000 people in the United Kingdom found that those in the “o*ese” BMI category have less than a 1 percent annual probability of moving into the “normal” category (CW for BMI categories and numbers in this and all studies mentioned below).

That same study found that even when the bar for weight loss is dramatically lowered, to just a few percent of your starting weight, people in the “o*ese” category have at most a 4 percent chance of losing that weight and keeping it off for 5 years or more. 

This squares with a recent systematic review of weight-loss studies (and numerous other reviews over the past six decades), showing that people who embark on weight-loss programs generally regain all the weight they lost (and often more) within 5 years. 

It’s important to keep all of this in mind as more and more media outlets jump on the “shrink your body / change your eating to reduce COVID-19 risk” bandwagon. To date there’s zero evidence that weight loss or certain ways of eating have any effect on this virus, and in general we know that weight-loss attempts often do more harm than good.

The things that can help prevent COVID-19, no matter your size, are the things we all still need to be doing (despite some states’ assertions to the contrary): Staying home as much as possible, washing your hands frequently, physical distancing and wearing masks when out in public, avoiding crowds, etc.  

Try to focus on all of that—and on calling your representatives to demand public-health measures that actually protect people—and do your best to let diet culture’s distractions pass you by. 

And this should go without saying, but sadly it isn’t said enough: regardless of whether or not weight is within our control, larger-bodied people deserve the same respect, acceptance, and access to compassionate and evidence-based care that everyone else does. Because human rights are human rights, no matter your size.