Overweight people should be vaccinated first, say experts

shirtless overweight man clutching belly

Experts say overweight people should be prioritised for COVID-19 vaccinations and tests.

The World Obesity Federation has released a report stating that countries with high levels of overweight people, such as the UK and the US, have the highest rates of death from the disease.

“Death rates are 10 times higher in those where more than half the adults had a body mass index (BMI) of more than 25kg/m2 – the point at which normal weight tips into overweight,” reports The Guardian.

BMI, effectively one’s weight compared to height, is a blunt instrument for measuring obesity, as it does not consider where fat is stored on the body, and The New York Times points out that it makes “no distinction between bone density, muscle mass and body fat”.

“While unreliable, a BMI can serve a purpose; it can be used to screen for weight categories that may lead to health problems… but it is not diagnostic of the person’s body fat or health.”

However, it is reliable enough that officials in many US states use it to prioritise overweight people for COVID vaccinations.

The report showed that being overweight is a “highly significant predictor” of developing complications from contracting COVID-19 including hospitalisation, intensive care, and mechanical ventilation, as well as being a “predictor of death” from the disease.

“An overweight population is an unhealthy population, and a pandemic waiting to happen,” the report said.

In the UK, 73.7 per cent of 10,465 patients who were made critically ill by COVID-19 were overweight or obese.

The UK has the third highest death rate in the world (184 deaths per 100,000 population) and the fourth highest obesity rate with 63.7 per cent of adults overweight. The US has 152.49 deaths per 100,000 and 67.9 per cent of the population living with obesity. 

Vietnam has the world’s lowest COVID-19 death rate (0.04 deaths per 100,000), and the second lowest rate of obesity (18.3 per cent of adults). 

Being overweight might be also a risk factor for bad outcomes in people under 60 years old. Those with a BMI of between 30 and 34 are twice as likely to be admitted to intensive care as those with a BMI under 30.

“Reducing one major risk factor, overweight, would have resulted in far less stress on health services and reduced the need to protect those services from being overwhelmed,” the report stated.

Read more: Obesity link to Alzheimer’s

The report’s author, Dr Tim Lobstein, says an overweight population is “the next pandemic waiting to happen”.

“Governments have been negligent and ignored the economic value of a healthy population at their peril. For the last decade they have failed to tackle obesity, despite setting themselves targets at United Nations meetings. COVID-19 is only the latest infection exacerbated by weight issues, but the warning signs were there.”

The report analysed virus mortality data from Johns Hopkins University and the World Health Organization (WHO) and calculated that 2.2 million of the pandemic’s 2.5 million global deaths were in countries with high levels of obesity. 

It highlights that there is “not a single example internationally” of a country with low levels of obesity – less than 40 per cent of the population overweight – and high death rates. 

Read more: The skinny gene offering hope on obesity

WHO director-general Dr Tedros Adhanom Ghebreyesus said the correlation between obesity and mortality rates from COVID-19 was “clear and compelling”. 

“Investment in public health and coordinated, international action to tackle the root causes of obesity is one of the best ways for countries to build resilience in health systems post-pandemic: we urge all countries to seize this moment.”

The US Centers for Disease Control and Prevention (CDC) says the obesity rate in the US is 42 per cent, Forbes reports.

The (CDC) had previously warned obesity may triple the risk of hospitalisation due to COVID-19 infection.

“As BMI increases, the risk of death from COVID-19 increases,” it stated.

Read more: Obesity and dementia

USA Today reports that researchers at the University of North Carolina-Chapel Hill found people with a BMI above30 had a 113 per cent higher risk for hospitalisation, a 74 per cent higher risk for ICU admission and a 48 per cent higher risk of death, according to a study published in August 2020 in Obesity Reviews.

Christina Marriott, chief executive of the UK’s Royal Society of Public Health, told the BMJ that the “root cause” of obesity is poverty and inequity.

“Children in the most deprived areas are now more than twice as likely to be obese than those in the least deprived areas, and the gap is widening,” says Ms Marriott. “When the government asks individuals to change their behaviour, we see some benefit for the better off, while the worse off – whose environment and circumstances can make lifestyle change far harder to achieve – are typically left ever further behind.”

Should overweight or obese people be prioritised for the COVID-19 vaccination?

Read more: Middle-aged weight gain

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Written by Will Brodie

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