Obesity and Covid-19

Obesity and Covid-19

When Epidemics Collide

The Covid-19 epidemic is upon us.  Every day brings new stories of people who have contracted the illness and those who have recovered, or sadly, perished from it.  Civic leaders and medical professionals are scrambling to develop methods and means to fight the spread of the virus and to protect us from exposure.  The impact of this pandemic is wide and deep, and has made significant changes across all aspects of our society. 

The virus is highly transmittable, and although some people contract the virus asymptomatically, others suffer extreme complications, including death.  

Health professionals say that as with other respiratory viral infections, the most vulnerable among us for serious and potentially life-threatening complications are the elderly and people with lung or heart disease or compromised health defenses.  As coronavirus attacks the lungs and breathing mechanisms of the body, anybody with a pre-existing respiratory ailment would be vulnerable to the virus and likely to suffer more extreme complications if infected.  

The obesity epidemic is also upon us.  The Center for Disease Control and Prevention (the CDC) estimates that 42% of all adults in the USA are obese.  People with obesity often have comorbidities, including diminished lung capacity, inflammation, and diabetes.

What do you call the collision of two epidemics?  I’m not sure there is a name for it but I am certain the outcome isn’t good – and leads us to this question: 

Do obese Covid-19 patients have a higher rate of extreme complications, or even death, than the non-obese?   

The data seems to indicate they do. 

Obesity is a Major Complication 

Data shows that obese Covid-19 patients have an increased risk of developing pneumonia and the need for invasive mechanical ventilation.  

Obesity has been found to be the second strongest independent predictor of hospitalization (due to Covid-19 illness), after old age.

“Obesity is commonly associated with metabolic syndrome, which increases your risks for diabetes, hypertension, heart and blood vessel disease, and ultimately kidney disease.” Says Dr. David Nazarian, a Beverly Hills-based physician.  “So, in a nutshell, a person who is obese can check off five of the risk factors that the CDC has placed as risks for more severe COVID-19 infections.”

The CDC has pinpointed “severe obesity” – those with a Body Mass Index (BMI) of 40 or more — as being one of the groups most “at risk for complications” when it comes to coronavirus. 

“I suspect this [obesity] is America’s COVID Achilles heel and may cause higher morbidity and mortality rates than other regions [countries],” noted Dr. Jennifer Lighter, hospital epidemiologist at New York University’s Langone Health. 

Now some experts believe obesity may explain why otherwise healthy young people are needing hospitalization and are dying from Covid-19.

Researchers have found that obesity is especially prevalent in the hospitalization of young people who contract the pathogen. An April 17 article published in the Morbidity and Mortality Weekly Report underscored that of 180 patients hospitalized from March 1 to March 30, the most prevalent underlying condition was obesity – a condition that afflicted more than half.

People under 60 years of age are generally considered at lower risk of developing severe COVID-19.    Nonetheless, “In individuals less than 60 years old, they [obese people] were two to three times more likely to be admitted to the hospital or ICU, and for the morbidly obese, fatality is three times the rate than for non-obese COVID-infected individuals” noted Dr. Lighter.

Size can be an Issue in Treatment

According to the World Obesity Federation, “Persons with obesity who become ill and require intensive care present challenges in patient management as it is more difficult to intubate patients with obesity.” The Federation also adds, “It can be more challenging to obtain diagnostic imaging as there are weight limits on imaging machines, patients are more difficult to position and transport by nursing staff and, like pregnant patients in ICUs, they may not do well when prone. In general, health systems are already not well set up to manage patients with obesity.”

Dr Brunilda Nazario, lead medical director at WebMD, points out that obese patients are “difficult to intubate, and may need specialized equipment that may not be widely available.  “Unfortunately, the vast majority of our health care system is not well equipped to manage the critical care of a patient with obesity,” 

People suffering obesity often avoiding seeking medical care to avoid judgement of others or out of embarrassment or shame. However, it is the obese that should take extra precautions to prevent contracting the coronavirus, and they must seek appropriate medical care when needed.

“The stigma that people with obesity face is unjustified, this is a medical condition and should be viewed and addressed as one, especially within the health care system,” Dr. Nazario said. “Because the rates of obesity continue to climb in the U.S., and we don’t know when the pandemic will end, we need to address this simultaneously.”

Living in the World of Covid-19

Fortunately, the vast majority of us will not contract the virus – or if we do, it will be asymptomatic, or with minimal complications… a bad cold, a mild flu.  We will however, be dealing with one form or another of disruption to our daily routines due to Covid-19.

The WLS lifestyle

It is almost impossible to overstate or fully grasp the impact that the coronavirus made to our daily lives.  This disease has compelled monumental changes to virtually every aspect of our society – religious, entertainment, political, economic, educational, medical and social. 

The typical WLS lifestyle frequently depends upon a system of planning and implementing daily routines such as food prep, structured meal times, scheduled exercise periods, and group support meetings.  As these routines are an integral reason that obesity was overcome, their absence or disruption will increase the likelihood that the WLS patient will experience a disruption in lifestyle, resulting in setbacks.

Diet and Nutrition

While quarantine and sheltering-in-place have created a hardship for everybody, there are specific hardships that hit the WLS community differently than the general population.  WLS patients must manage their nutrition in a specific manner which has a greater dependency on access to fresh food – both vegetables and proteins. This becomes difficult when sheltered in place.  The result may be that the WLS patient is forced to turn to less nutritious sources of food such as canned or frozen, chemically infused and processed ‘foods’, that have:

  • more salt, sugar, and trans fats
  • more simple, less complex carbs
  • chemical additives
  • higher calories
  • less protein

WLS patients must find a way to maintain access to fresh foods – through delivery services, online ordering/drive up pick up, or other of the creative ways that grocers are finding to keep the flow of fresh foods safely accessible to the public.  

Most WLS Patients take vitamin and mineral supplements.  These nutrients are vitally important to the wellbeing of the WLS patient and must not be missed.  Being sheltered in place makes a trip to the store to resupply vitamins difficult.  Thankfully most of the vitamin manufacturers serving the WLS community provide online ordering and shipping of their products.  

Support

It is said within the WLS community that “They operate on your stomach, not your head,” in reference to the significant role that our mental and emotional states play in both the onset of obesity and the effort to defeat it.  Group support sessions are one of the most popular and utilized forms of therapy that help the WLS patient deal with the mental and emotional side of fighting obesity.  In-person group meetings in the era of social isolation are not possible.  The loss of a regular support group benefit will increase the likelihood that the WLS patient will experience a disruption in lifestyle, resulting in setbacks and may realize regain.  

Support is so very important to the long-term success of the WLS patient.  If local support groups are not available because of quarantine or rules against group meetings, there are many online options available that can provide this valuable service.  These groups meet via Facebook, Goggle Hangout or Zoom.  Most have a ‘mission’ or focus, such as being targeted at people who have had a specific procedure such as the sleeve, or gastric bypass… that are from certain hospital systems or regions of the country… that focus on addiction… that focus on mental health… etc.  Look at many, find one or more you like and join! 

Exercise

The two main calorie factors affecting weight loss and weight control are managing the calories taken in from food and drink – and the calories burned up through exercise and activity.  We have discussed the challenges of eating well as we deal with Covid-19, well it is just as important to find a way to keep exercise and movement in our daily activities, even when gyms are closed and social distancing makes taking classes and group exercise impossible.   Fortunately there are many options for getting exercise even while sheltered-in-place.  Websites and YouTube videos of Zumba, yoga, aerobic, weight lifting, Tai Chi, stretching and virtually any other form of exercise expression are readily available.  Find one that fits your likes and needs and join it with the same regularity and enthusiasm that you have attended your local gym classes.  The web is also a great place to find options for exercising at home or in your own yard.  Continuing to get exercise is probably the easiest Covid-19 challenge to overcome.  

Thriving During Covid-19

Living during the Covid-19 pandemic certainly adds many challenges to the WLS lifestyle that many have utilized to master the symptoms of obesity and reclaim control over their lives.  The common fear is that these challenges might cause us to revert to other lifestyles – like the lifestyle that exacerbated the symptoms of obesity in the first place.  

Don’t fall for it.  

The more things change, the more they stay the same.  The secret to a WLS lifestyle hasn’t changed.  Covid-19 or not… it is this: 

Eat your protein first

Get daily exercise (body and mind)

Drink water and stay hydrated

Avoid sugar and simple carbs

And…

You know the list.  It hasn’t changed, in… well, in forever.  Times change.  Circumstances morph.  Conditions evolve.  Situations develop.  Just realize that the same WLS lifestyle we have been following and has lead us toward wellness, can be followed in any time, circumstance, condition or situation.  You can find a way to make it work.  Trust the plan.

The WLSFA and Weight Loss Surgery

It is clear that the presence of obesity creates a greater risk in an individual for contracting and suffering significant complications from (including death) the coronavirus.  Weight Loss Surgery (WLS) is a tool that the obese can use to overcome the symptoms of their disease and decrease their risk of greater complications from Covid-19, should they become infected. 

WLS is a useful, but not universally available tool for fighting obesity.  It aids the patient in establishing new lifestyle practices and overcoming the symptoms of their obesity.

WLS is not universally available due to its high cost, and the fact that it is not typically covered by most health insurance policies.  Therefore there are thousands of people who would benefit from WLS, if they had the means of paying for the procedure.   In addition to overcoming obesity, they would also become more protected against contracting and suffering complications from Covid-19 as well as a whole host of other illnesses, ailments and diseases. 

The WLSFA works to provide WLS grants to people who are referred to the surgery by their surgeon, but who do not have the means to pay for it, nor insurance that covers it.  In these times of Covid-19, WLS may not only help save the life of the WLS patient, but also avoid Covid-19 complications. 

It seems that “Saving Lives one Surgery at a Time”, can have a ripple effect of positive benefits.

Sources:

Obesity and Impaired Metabolic Health in Patients with Covid-19 | Nature Reviews Endocrinology | 4/29/2020 | https://www.nature.com/articles/s41574-020-0364-6

Obesity May Impact Mortality in Covid-19 Patients | George Washington University | April 27, 2020 | 

https://medicalxpress.com/news/2020-040obesity-impact-mortality-covid-patients-html

Obesity and Covid-19: Theories and Blame Fill scientific Void | TCTMD.com | April 28, 2020 | 

https://www.tctmd.com/news/obesity-and-covid-19-theories-and-blame-fill-scientific-void

Are America’s High Obesity Levels Leading to More Coronavirus Deaths? | Fox News | April 28, 2020 |

https://www.foxnews.com/health/is-americas-high-obesity-levels-leading-to-more-coronavirus-deaths

WLSFA Introduces Tour of Hope Fundraiser with Bill Streetman

Weight Loss Surgery Patient Mr. Bill Streetman launches his “Tour of Hope” fundraising bicycle ride across Michigan and Ohio. The best part is YOU are invited along! The WLSFA is asking all of our supporters to join Bill in person as a rider or online as a donor to support Bill on this once in a life time adventure. Bill’s Tour of Hope will raise awareness for the WLSFA and our mission to help people get the medical treatment they need and to improve the lives of people effected by obesity.
In Bill’s Words:
Fifty-four years of life had taught me that I didn’t have the ability to manage my eating. Try as I did (and I tried all the diets plans out there), I simply didn’t have the ability to manage my food intake. Some people are born with the innate ability to self-manage this aspect of their life. I didn’t. I needed a tool to help ME on my Journey to Fitness. Gastric bypass was that tool for me. I am so very grateful for the ‘tool’ of my gastric bypass. My RNY was the tool I needed to help me overcome the disease of obesity. For years, without weight loss surgery, I had tried and failed to lose weight and maintain a healthy lifestyle. Now with the tool of gastric bypass, I have been able to achieve my goal of losing weight and leading a healthy lifestyle. I was fortunate to have the resources to pay for the surgery that gave me this tool. I know there are many people out there who would benefit, as I have, from weight loss surgerys, but don’t have insurance or the financial means of paying for the procedure. I want to help those people.
A special message from Bill to other men dealing with the disease of morbid obesity:
At first glance living a healthy lifestyle may look a lot like living in a deprived or unrewarded state. It would appear that there are foods you can’t eat, limits to how much you can eat, things you must deny yourself. It feels like a life where you have to say NO a lot, and give up things you enjoy. The act of seeking medical advice can seem like an admittance of defeat to some men. Opening up to a doctor is embarrassing, talking about your weaknesses, failures, faults and such are not comfortable for most people, men particularly. It leaves a man open to hostile critique, ridicule, and judgement. I tell men all the time that living a healthy lifestyle is just the opposite from being limited or restricted. That a healthy lifestyle is actually very self-empowering.

 

  • I decide what level of health and fitness I want – and I accept the corresponding lifestyle (‘Best Weight’)
  • I make the choices about what, where, and when I eat.
  • By my own authority I deem that the next [time range] will be mine to spend in an uninterrupted workout.

 

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Bill Streetman Weight Loss Surgery Patient 
Contact Bill Today!

This is my challenge to me and to you, support my fundraiser and help me save lives and raise awareness for the Weight Loss Surgery Foundation of America, because together we are “Saving Lives One Grant at a Time”

Please make a donation now to support the Tour of Hope

 ABOUT THE ‘TOUR OF HOPE

It has been a desire of mine to ride my bicycle from my home in Ohio to my family lake house in Michigan… about 425 miles. In the past I was so overweight and obese that this type of adventure wasn’t possible. After losing 200 pounds from my 400 pound frame, I am now able to undertake vigorous activities such as long-distance bike riding. Therefore, I have decided that my long-held wish to ride my bike from my Westerville, Ohio home to my Gaylord, Michigan lake house has now become my goal – soon my plan, and on July 29th through August 5th will become my reality.

I am so very grateful that I had the resources to pay for my RNY gastric bypass, a tool that I have successfully used to lose over 200 pounds and maintain a healthy lifestyle for the last five and a half years. As a means of sharing my gratitude, I am dedicating my ride to the WLSFA.org and will be asking for financial donations. The ride will be live-streamed on the Internet and documented on all my social media. I will secure sponsors and ask them to promote the ride and fundraiser through their social media. The ride will be promoted to local press and press along the route.

Who Wants to Ride With Me?

Anybody and everybody – WLS or non-WLS – is welcome to join me for all or any part of the ride.   All I ask is that you promote the ride on your social media and help raise awareness of the obesity epidemic and the WLSFA.

Who wants to be a Sponsor?

If you are interested in becoming a sponsor of the Tour of Hope, please contact me at bill@whs-newlife.com

Tour of Hope Map

Red circles are the stops we will make! South to North


Agenda/itinerary for the Westerville, Ohio to Gaylord, Michigan bike ride. Eight days, 426 miles.

Fri July 29 Day 1 – Westerville, OH to Bucyrus, OH. 53 miles. Motel? Still looking for a campground, etc.

Sat July 30 Day 2 – Bucyrus, OH to Van Buren, OH. 50 miles. Camp at Van Buren State Park.

Sun July 31 Day 3 – Van Buren, OH to Petersburg, MI. 59 miles. Camp at Totem Pole Pk Petersburg Junc.

Mon Aug 1 Day 4 – Petersburg, MI to Pinckney, MI. 46 miles. Camp at Pinckney Sate Park.

Tue Aug 2 Day 5 – Pinckney, MI to Ovid, MI. 58 miles. Camp at Sleepy Hollow State Park.

Wed Aug 3 Day 6 – Ovid, MI to Mt Pleasant, MI. 56 miles. Motel? Still looking for a campground, etc.

Thu Aug 4 Day 7 – Mt Pleasant, MI to Houghton Lk, MI. 53 miles. Camp at Houghton Lake Campground.

Fri Aug 5 Day 8 – Houghton Lake, MI to Gaylord, MI. 51 miles. Lake House/Motel in Gaylord.

Sat Aug 6 and Sun Aug 7 – spend the weekend at the lake house.

Let me know if you are interested in some or all of the ride/weekend in Gaylord.

 

Meet Sandi Henderson

Meet Sandi Henderson, member of the Board of Directors for the Weight Loss Surgery Foundation of America (WLSFA), co-author of a successful WLS cookbook, and co-founder of WLS Success Matters and Banded Living. Sandi is also a member of the WLSFA Board Executive Committee. Her commitment to the WLS lifestyle… her example of what it means to “Eat well and Exercise” every day, has made her a leader within the community. If you can’t find Sandi, try the local pool where she “gets her swim on” most days – or her kitchen, where she can be found involved in food prep. Fifteen years after her WLS, Sandi is still living the lifestyle and enjoying the rewards of her hard work. Let’s learn more about Sandi!

 

Question: Where you were born and raised?

Sandi: I was born and raised in Brooklyn New York. I moved to Southern California at age 18. I met my husband of 51 years (on April 4) in California and we married after less than 3 weeks of knowing each other. I have lived in Brooklyn NY, Madison CT, Westchester OH, Culver City CA, (SoCal) Topanga Canyon California (SoCal), Morro Bay California (Central Coast), Nipomo CA (Central Coast) and now reside in Oxnard CA at the beach. I will be 71 years young this September 15th.

Question: That is quite a list of places you’ve lived. Tell us about your family.

Sandi: I am married, have one adult daughter and 3 grandkids.

Question: What is your work experience?

Sandi: I have been in sales for most of my life – owned my own computer equipment company for 22 years and now am co-founder of a Bariatric Education and Coaching Company.

Question: What are your hobbies and interests? What do you like to do in your spare time?

Sandi: I love the beach, swimming, snorkeling, scuba diving, deep sea fishing, hiking, biking, lifting weights, reading – and occasionally binge watching Netflix or Amazon shows!

Question: You’ve lived in many places across the country, what are your favorite places to visit?

Sandi: Hawaii is our favorite place to travel, although we loved French Polynesia we return to HI annually. I have been to every island and Kauai is by far my favorite destination. The north shore in particular. I enjoy traveling to warm places surrounded by salt water infested with beautiful sea creatures.

Question: Hawaii sounds great… let’s go! How about education, what did you study?

Sandi: I am a few credits short of my Bachelor’s degree in English and a few French fries short of a Happy Meal.

Question: I bet you don’t eat too many French Fries OR Happy Meals! So tell us about your weight history:

Sandi: I was fat since I was a bit over 2 years old. Pleasantly chubby. At 10 I had to have my appendix removed and the surgeon put me on my first diet… I yoyo’d for years, losing 100 lbs. and then gaining it back and more.

Question: So how old were you when you had WLS surgery? What procedure did you have, who is the surgeon and where did you have it?

Sandi: I had lap band surgery on May 28, 2004 in Ventura CA. Dr. Helmuth Billy was my surgeon. I was 55 ½ when I had surgery. I am maintaining a 250 lb. weight loss and went from a size 28 to a size 12.

Question: Have you experienced any regain over the years?

Sandi: My weight fluctuates typically around 10 lbs. When I have gained more it is due to a problem of some sort which I discuss with my doctor and we get handled. I can lose 10 lbs. in 10 days eating real food when I am strict about weighing and measuring and journaling every single tidbit and planning out each and every meal.

Question: Let’s talk about food… what were your favorite foods before WLS – and what are your favorite foods now?

Sandi: My favorite foods then were anything I could get from the plate into my mouth. Now I like to think I am a bit more discriminating. I have co-authored a cookbook that includes recipes for weight loss surgery meals of all types from Asian to good old comfort food, through chicken soup, burgers, Italian, Greek, Indian, Thai…you name it, we’ve redesigned it to be weight loss surgery friendly.

Question: You’ve certainly put a lot of energy into your meal plans – and it shows. How about the other half of the equation – exercise. Did you exercise before WLS? What do you like to do for exercise now?

Sandi: Favorite exercise – then – was swimming which I did very infrequently and now – my favorite exercise is still swimming which I do 3x weekly and in a warm ocean any chance I get.

Question: What were your thoughts that led you to WLS?

Sandi: A blood pressure crisis in my PCP’s office. I was there for hours after taking a “pill” sublingually to reduce my blood pressure.

Question: So you had a real health scare. Sounds like it was a wakeup call. So after that you looked into WLS, and decided on the Lap Band. What were your thoughts and feelings as a pre-op?

Sandi: I was scared spitless!

Question: Scared spitless! But you went through with the surgery. What were the first days/weeks/months after surgery like?

Sandi: Amazing. Once I decided this was what I wanted I followed the rules to the letter and the weight just kept falling off.

Question: So what advice do you have for newbies?

Sandi: Be ready to change your habits PERMANENTLY…Unless you make the changes you will NOT keep the weight off. Also be ready for the emotional changes and have a good support system- both family and other weight loss surgery patients who are long term successful.

Question: So with your long-term weight loss success, how has WLS changed your life?

Sandi: I have one now. Before surgery my world was getting smaller and smaller. I barely made it to work and home each day. I was not happy. I now can go for hours, and days on end enjoying all that life has to offer from the great outdoors to the depths of the oceans to a bike ride with my husband, time with my daughter and grandkids to helping others reclaim their lives by volunteering and teaching and coaching.

Question: You must have experienced several NSV’s along the way… what is your favorite NSV?

Sandi: Going to Alaska for the 2nd time and instead of having to buy 2 seats on a helicopter to a glacier (one for each cheek), I only needed one and I could get in and out of the helicopter with ease and hiked the glacier instead of standing in one place fearful that if I fell on the ice nobody would be able to help me up. I cried the entire trip – with JOY.

Question: Such a great NSV. I think we can all understand the tears of joy. Congratulations and thanks for sharing. Now you are on the board of the WLSFA. Tell us your feelings about the work of the WLSFA and your role?

Sandi: I have been a board member of the WLSFA for several years and I adore the ability to be able to pay it forward both to those in need of surgery who cannot afford it on their own and to the WLS community as a whole by providing education and celebration at our annual fundraiser.

How to Contact Sandi: By Email sandih@wlsfa.org

Find more on Sandi at www.wlsfa.org and on her Facebook page: https://www.facebook.com/sandi.lapbandedliving