Covid-19 and obesity: A potent mix

The UAE ranks 26th on the Global Obesity Observatory’s list of nations with high percentage of obese people — behind the US positioned at 14 but ahead of the UK ranked 29. As of 2016, the country had 28.44 per cent obese men and 42.46 obese women. A more recent 2019 study of 33,000 Emirati men in the UAE, conducted by Prof. Ashraf Hassan Humaidan Al Zaabi from Zayed Military Hospital in Abu Dhabi, found even more startling statistics — 58 per cent of the surveyed were overweight or obese at age 18, rising sharply to 71 per cent at the age of 29. Sixty-two per cent of men exhibited at least one cardio-metabolic risk factor, while one in four had more than one cardio-metabolic risk factor.

And the problem is not just confined to adults in the UAE. Lina Shibib, Clinical Nutritionist at Medcare Hospital Al Safa, says that schoolchildren and youth in the UAE, aged 10-18, are likely to be 1.8 times more obese than those in the US. This is as per statistics from the first United States National Health and Nutrition Examination Survey (NHANES-1). “The UAE youth’s frequency of being more obese is twice to thrice greater than the published international standards,” she adds.

Shibib observes that causes of obesity are common in almost every country, but the UAE has an especially potent mix of unique factors that lead to higher levels. Among these are changes in cultural and social environments, lack of physical activities, improper and unhealthy diet or nutrition. This is further aggravated by behavioural problems such as binge-eating disorder, Cushing ailment, and polycystic ovary syndrome in women.

A double whammy

Add Covid-19 to the mix and things get more complicated. The World Obesity Federation (WOF) observes that the two pandemics — Covid-19 and obesity — are currently on a “collision course”, putting those suffering from both at a far higher risk.

“Systematic reviews and meta-analyses overwhelmingly show that obesity is associated both with a higher risk for intensive care unit (ICU) admission and poorer outcomes for Covid-19,” a WOF report claims, pointing to data from the UK, which found that of the 10,465 patients critically ill with Covid-19, 73.7 per cent were overweight or obese.

Similarly, data from Italy suggests that 99 per cent of deaths have been in patients with pre-existing conditions, including those that are commonly seen in people with obesity. “Patients with a body mass index (BMI) between 30 and 34 are twice as likely to be admitted to ICU compared to individuals with a BMI under 30,” asserts the WOF study.

Shibib echoes the sentiment. “People who are overweight may triple the risk of hospitalisation due to a Covid-19 infection. In addition, impaired immune function due to obesity is a big contributor to Covid complications,” she says, noting that the US Centres for Disease Control and Prevention (CDC) has observed that obesity significantly decreases lung capacity and makes ventilation more difficult. A CDC study of Covid-19 cases from March to December 2020, found that 28.3 per cent of all Covid patients were overweight, and 50.8 per cent had obesity. “This suggests that risks of hospitalisation, intensive care unit admission, invasive mechanical ventilation, and death are higher with increasing body mass index (BMI),” explains Shibib.

Home alone and nothing to do

WOF notes that home quarantining measures have exacerbated factors that lead to obesity. People tend to eat more often, and in larger quantities, when they are locked up at home with limited alternatives. They also tend to prefer processed and canned food with longer shelf life, instead of fresh and healthy produce.

“Obesity is serious because it is associated with poorer mental health outcomes, depression, anxiety, and reduced quality of life,” says Shibib, pointing out that it is one of the leading causes of death in the United States and worldwide.

Among the most common health conditions caused by being overweight are high blood pressure (hypertension), high LDL cholesterol, low HDL cholesterol, high levels of triglycerides, Type 2 diabetes, coronary heart disease, stroke, gall bladder disease, osteoarthritis, sleep apnoea and breathing problems. The list even includes some types of cancers.

The fightback

The UAE government has been actively implementing plans and initiatives to tackle obesity. In line with the UAE National Agenda 2021, the Ministry of Health has been organising workshops under the National Programme to Combat Obesity.

The aim was to reduce the rate of obesity among children within the age group of 5-17 years by 12 per cent. In January 2020, the Ministry of Health and Prevention launched Mutabah, the UAE’s first online system to collect data on obesity and excess weight among school students.

But this is one area where change, like charity, begins at home. The pandemic has highlighted the importance of staying fit, but it is up to the individual to take those crucial steps towards a healthier lifestyle. As the adage goes: Making excuses burns exactly zero calories.