Patty Nece has not been in a retail store for an entire year.
Although most companies in Virginia reopened in July and supermarkets remained open during the pandemic, the 62-year-old woman has not dared to enter one since last March, as her obesity puts her at risk of contracting serious COVID-19.
Because of her illness, she is eligible for the vaccine and has an appointment for her first dose on Wednesday. Although she is looking forward to being vaccinated, she is also disappointed that some Americans have criticized people with obesity who are given priority to receive the vaccine.
“This shows a misunderstanding … the weight is not always under your control,” said Nece, who is also president of the Obesity Action Coalition. “Like many diseases, there is personal responsibility involved, but this is not the end. The mantra of eating less and moving more – which I have heard all my life – is not the answer. “
In one case, a WTTG-TV news anchor in Washington, DC, sent a tweet criticizing health officials for prioritizing obese patients for the vaccine.
“I am annoyed that obese people of all ages have priority access to the vaccine before all essential workers,” Blake McCoy said in the deleted tweet. “Vaccinate all essential workers. So obese. “
The local station told the New York Daily News that McCoy was “suspended, pending further review” after deleting the offending tweet and post an apology on Twitter, but health experts say it is another example of how weight bias permeates the health care system and American society.
Obesity and COVID-19
Approximately 40% of American adults are obese, according to data from the 2018 Center for Disease Control and Prevention. Studies have shown that people with obesity are more likely to have worse results with COVID-19 than others with body mass index ( Lower BMI).
Researchers at the University of North Carolina at Chapel Hill found that people with a BMI over 30 had a 113% higher risk of hospitalization, a 74% higher risk of ICU admission and a 48% higher risk of death, according to a study published in August 2020 on obesity assessments.
At first, health experts believed that people with obesity had a higher risk of severe COVID-19 because the disease is also associated with several underlying risk factors, including hypertension, heart disease, type 2 diabetes and chronic kidney and liver disease.
But after controlling for these factors, the researchers found that people with obesity were still at increased risk of contracting 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 partly due to the excess fat tissue that produces more inflammation, she said.
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“People’s bodies are developing a severe inflammatory response (to COVID-19), and that response already exists at the baseline in obesity,” said Kumar. “So when you add another stimulus, they get even more sick.”
Some patients may also suffer from obesity hypoventilation syndrome, a respiratory disorder that causes someone to have too much carbon dioxide and too little oxygen in their blood, according to the National Heart, Lung and Blood Institute.
“It’s not about carrying the weight,” said Dr. Ethan Lazarus, president-elect of the Obesity Medicine Association. “Their lungs are restricted, so they are not able to expand to get the oxygen they need.” This puts them at a higher risk of COVID-19 complications.
Obese patients also have a weakened immune system, health experts say, which not only makes them more prone to infectious diseases, but also makes it harder to fight them.
Obesity can alter the metabolic state of immune cells and how they work, said Dr. Nancie MacIver, an associate professor at Duke University School of Medicine. Excessive inflammation can be an indication that the immune system is dysfunctional.
Obesity and the COVID vaccine
The altered immune system of patients with obesity has led experts to worry about their response to the COVID-19 vaccine, especially since previous studies have suggested that they may not respond as well to influenza vaccines.
Researchers at UNC Chapel Hill found that, among vaccinated individuals, almost 10% of obese patients were infected with the flu, compared with about 5% of participants with a lower BMI, according to a 2017 study published in the International Journal of Obesity.
But health experts say that patients with obesity should not be discouraged and urge us to get the COVID-19 vaccine when it becomes available.
“People must understand the difference between ineffective effectiveness and reduced effectiveness,” said Kumar. “Even if a vaccine works less, it is still better than someone being seriously ill in an ICU.”
Nece worries, as a patient with obesity, other people like her may delay care during the pandemic due to decades of heavy bias in the healthcare system.
Awareness Week on Obesity and Weight Prejudice
Prejudice of weight in the medical environment manifests itself in a myriad of ways, from ill-fitting gowns and weighing patients in public to the incorrect diagnosis of a life-threatening illness due to the doctor’s inability to look beyond one’s overweight. people.
After years of weight classes and bad experiences in doctors’ offices, many patients internalize this prejudice and avoid treatment or preventive care altogether, said James Zervios, vice president of marketing and communication for the Obesity Action Coalition.
Nece delayed his mammogram by 15 years to avoid the stress and embarrassment of a doctor’s appointment.
“You get tired of dealing with it,” she said. “You get tired of the shame and guilt that pile up on you and it doesn’t help.”
But during Obesity Care Week, which ends on Saturday, advocates 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 drugs.
They also urge those who suffer from obesity to seek help from health professionals, despite weight prejudice, especially during the pandemic.
“We encourage people to remember that they deserve the care they deserve and don’t accept that kind of prejudice and deal with it,” said Zervios. “Everyone deserves to be treated with dignity and respect.”
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
USA TODAY’s health and patient safety coverage is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Health. The Masimo Foundation does not provide editorial contributions.
This article was originally published in USA TODAY: COVID vaccine: CDC, states that prioritize people with obesity. Here’s why.