People who are above a healthy weight are at an increased risk of death or suffering serious complications from Covid-19, a Public Health England review of international and UK evidence has concluded.
The Public Health England report found the likelihood of death increases by 40% for someone with a BMI between 30 and 35 (obese) and by 90% for those with a BMI over 40 (severely obese), when compared to those with a BMI of between 18.5 and 25 (healthy weight).
Risk of being hospitalised with Covid-19 rose progressively with increasing BMI above the healthy weight range, and for receiving advanced levels of treatment such as mechanical ventilation, as well as death.
Although the proportion of people in the general population with a BMI over 30 or 40 is 28.9% and 2.9%, respectively, in England, Wales and Northern Ireland, the proportion of patients with these BMIs in intensive care is higher – 31.3% and 7.9%, respectively, according to the report.
PHE said ‘plausible’ explanations for the increased risk included the impact of having more adipose tissue – or fat – including on respiratory function, the cardiovascular system, and immune and inflammatory responses.
There may also be an interaction with weight-related comorbidities, including type 2 diabetes, cardiovascular and respiratory diseases, which are also associated with more severe Covid-19.
Stigma experienced by people living with obesity, may also delay interaction with healthcare and may also contribute to increased risk of severe complications arising from Covid-19, the report added.
There was also ‘some evidence to suggest’ that reports indicating Covid-19 is a greater health risk for older adults and black, Asian and minority (BAME) groups could be linked to weight.
Two-thirds (63%) of adults in England are overweight or obese, with an even higher percentage among certain BAME communities and those aged 55 to 74.
The report also noted that the conclusions are currently ‘tentative’ and that ‘more research is needed to build the evidence base’.
However, it said the evidence ‘consistently suggests that people with Covid-19 who are living with overweight or obesity… are at an increased risk of serious Covid-19 complications and death’.
This comes as the Government published its latest obesity strategy to help individuals adopt a healthier lifestyle to protect themselves against Covid-19.
PHE chief nutritionist Dr Alison Tedstone said: ‘It can be hard to lose weight and even harder to sustain it, which is why people cannot easily do it on their own.
‘Losing weight can bring huge benefits for health – and may also help protect against the health risks of Covid-19. The case for action on obesity has never been stronger.’