Patty Nece has never been to a retail storea whole year.
Although most of Virginia ‘s stores reopened by July and grocery stores remained open during the pandemic, the 62-year-old has not dared to step inside since last March due to her being at risk for severe COVID-19 due to her obesity.
Because of her illness, she is entitled to the vaccine and has an appointment for her first dose on Wednesday. While she looks forward to a vaccination, she’s also disappointed that some Americans have criticized people with obesity for whom the vaccine is a priority.
“It shows a misunderstanding … weight is not always in your control,” said Nece, who is also the chair of the Coalition of Obesity Action. “As with many illnesses, it comes down to personal responsibility, but that’s not the end. The mantra of eating less and exercising more – which I’ve heard all my life – is not the answer. “
In one case, a newscaster was broadcast for WTTG-TV in Washington, DCa tweet that criticizesHealth officials for prioritizing obesity patients for the vaccine.
“I am annoyed that obese people of all ages are given priority access to vaccines before all major workers,” Blake McCoy said in the since-deleted tweet. “Vaccinate all major workers. Then obese. “
The local broadcaster told the New York Daily News that McCoy was “suspended pending further investigation” after deleting the offensive tweet and posting an apology on Twitter. However, health experts say this is another example of how weight biases permeate the healthcare system and American society.
Obesity and COVID-19
Around 40% of American adults are obese, according to 2018 data from the Centers for Disease Control and Prevention. Studies have shown that people with obesity are more likely to have worse results with COVID-19 than those with a lower body mass index (BMI).
Researchers at the University of North Carolina at Chapel Hill found people with a BMI aboveAccording to a study published in Obesity Reviews in August 2020, 30 had a 113% higher risk of hospitalization, a 74% higher risk of ICU admission, and a 48% higher risk of death.
At first, health experts believed that people with obesity were at higher risk for severe COVID-19 because the disease is also linked to numerous underlying risk factors, including high blood pressure, heart disease, type 2 diabetes, and chronic kidney and liver disease.
However, after controlling these factors, the researchers found that people with obesity were still at higher risk for COVID-19, said Dr. Rekha Kumar, Medical Director of the American Board of Obesity Medicine and Associate Professor of Clinical Medicine at Weill Cornell Medicine. This may be due in part to the excess adipose tissue causing more inflammation, she said.
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“People’s bodies develop such a severe inflammatory response (to COVID-19) and that response is already there at the onset of obesity,” said Kumar. “So if you add another stimulus, they get even sicker.”
Some patients may also have obesity-hypoventilation syndrome, a breathing disorder that, according to the National Heart, Lung and Blood Institute, causes someone to have too much carbon dioxide and too little oxygen in their blood.
“It’s not about supporting the weight,” said Dr. Ethan Lazarus, President-elect of the Obesity Medicine Association. “Your lungs are constrained so they can’t expand to get the oxygen they need.” This puts them at further risk for COVID-19 complications.
Obese patients also have impaired immune systems, according to health experts, which not only makes them more prone to infectious diseases, but also makes it harder to fight them off.
Obesity can alter the metabolic state of immune cells and how they function, said Dr. Nancie MacIver, Associate Professor at Duke University School of Medicine. The excessive inflammation can be an indication that the immune system is disturbed.
Obesity and the COVID vaccine
The altered immune systems of obese patients has caused experts to worry about their response to the COVID-19 vaccine, especially since previous studies have shown that they may not respond as well to influenza vaccines.
Researchers at UNC Chapel Hill found that in vaccinated individuals, nearly 10% of obese patients were infected with the flu, compared with around 5% of participants with a lower BMI. This is the result of a study published in the International Journal of Obesity in 2017.
However, health experts say obesity patients should not be discouraged and urge them to get the COVID-19 vaccine when it is available to them.
“People should understand the difference between ineffective and decreased effectiveness,” said Kumar. “Even if a vaccine is less effective, it’s still better than someone who gets seriously ill in an intensive care unit.”
Nece fears that others like her, an obese patient, could delay care during the pandemic due to decades of weight bias in healthcare.
Obesity Awareness Week and Weight Bias
Weight bias in the medical setting manifests itself in a variety of ways, from ill-fitting clothes and weighing patients in public, to misdiagnosing a life-threatening illness due to a doctor’s inability to look past a person Obesity.
After years of weight class lectures and poor experience in the doctor’s office, many patients internalize these prejudices and avoid treatment or preventive care altogether, said James Zervios, vice president of marketing and communications for the Coalition of Obesity Action.
Nece delayed her mammogram for 15 years to avoid the stress and embarrassment of seeing a doctor.
“You get tired of dealing with this,” she said. “You get tired of the shame and guilt piled on you and it doesn’t help.”
During Obesity Care Week, which ends on Saturday, proponents like Zervios and Nece want to spread awareness that obesity is not just a behavioral disease and can be influenced by genetics, hormones, and even medication.
They also urge those suffering from obesity to seek help from health care providers despite weight bias, especially during the pandemic.
“We encourage people to remember that they are worth the care they deserve and don’t take and deal with that kind of bias,” Zervios said. “Everyone deserves to be treated with dignity and respect.”
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
U.S. TODAY health and patient safety coverage is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide any editorial contributions.