Take it off before it takes you

A chart on Kuwait released by World Obesity Federation as part of a global report detailing the correlation between obesity and mortality rates as a consequence of the COVID-19 pandemic to mark World Obesity Day.

To mark the World Obesity Day, the World Obesity Federation has released a new, global report detailing the correlation between obesity and mortality rates as a consequence of the pandemic. The report’s author, Dr Tim Lobstein — Senior Policy Advisor to the World Obesity Federation, shows that death rates are often ten times higher in countries where more than 50% of the population is overweight, resulting in 2.2 million of the 2.5 million COVID-19 global deaths recorded in countries with high levels of obesity. However, in the Gulf region, together with New Zealand and Australia, the position appears to run against this trend where overweight prevalence among adults is high (over 60%), but reported deaths from COVID-19 are relatively low, at below 10 per 100,000. These figures are clearly affected by national responses to the COVID-19 pandemic and will change as the pandemic unfolds and as vaccination programmes are extended.

The World Health Organization (WHO) Director-General Dr Tedros Adhanom says that the report must act as a wake-up call to governments globally. Governments need to act now as failure to tackle obesity is ‘clearly responsible’ for hundreds of thousands of avoidable deaths.

Age has been the predominant focus of analysis of risks of hospitalisation and death to date, but this report shows for the first time that overweight populations come a close second. The author shows that any excess body weight is likely to impact the severity of COVID-19 in a patient.

“As we continue to confront the COVID-19 pandemic, this new report sheds light on the dangers of a different global epidemic, obesity. In addition to putting people in greater danger of developing debilitating health conditions, obesity also significantly increases the risk of hospitalisation and death due to COVID-19,” said Michael R. Bloomberg, WHO Ambassador for Noncommunicable Diseases and Injuries.

The report also reveals the dramatic economic costs of preventing health services from being overrun through lockdowns could have been significantly mitigated if governments had tackled population weight issues before the pandemic. Of the $28 trillion IMF projected global cost in lost economic output worldwide up to 2025, at least $6 trillion will be directly attributable to the issue of populations living with excess weight.

The report is being made widely available to professionals and citizens through the World Obesity Day website which contains a wealth of additional resources and information.

On World Obesity Day, a landmark global study from the World Obesity Federation reveals for the first time a driving factor between countries’ disparate death rates, demonstrating the dramatic impact of overweight and obese populations on global COVID-19 death rates. Through systematic analysis of the latest mortality data from Johns Hopkins University and WHO Global Health Observatory data on obesity, the report shows that 2.2 million of the 2.5 million global deaths were in countries with high levels of obesity. There has been much speculation about the difference in death rates between Asian and Western countries and low-income and high-income countries. Still, this report uncovers for the first time a common denominator in keeping death rates low.

The report’s author, Dr Tim Lobstein — Senior Policy Advisor to the World Obesity Federation, visiting Professor at the University of Sydney, and former advisor to the WHO and PHE — shows that death rates are ten times higher in countries where more than 50% of the population are overweight. The increase in national death rates where countries exceed the threshold of 50% of population overweight was dramatic. Strikingly, the report finds that there is not a single example internationally of a country with low levels of population overweight (less than 40% of the population) having high death rates (more than 10 per 100,000 population), while no country with high death rates (100+ per 100,000) had less than

50% of their population overweight.

For example:

Vietnam has the lowest death rate in the world and the second-lowest levels of population overweight (0.04 per 100,000 deaths from COVID-19 and 18.3% adults overweight WHO data); The UK has the third-highest death rate in the world and the fourth-highest obesity rate (184 deaths per 100,000 and 63.7 adults overweight WHO data), Followed by the United States of America (152.49 deaths per 100,000 and 67.9% living with obesity).

Obesity is recognised as both a disease in its own right and a condition that increases the likelihood of developing a wide range of non-communicable diseases. Less well-known is the fact that obesity also increases the likelihood that infectious diseases will lead to serious consequences. This is most clearly apparent in the global spread of the SARS-CoV-2 virus and the resulting pandemic of COVID-19. Through detailed analyses of the latest peer reviewed data, we demonstrate how overweight is a highly significant predictor of developing complications from COVID-19, including the need for hospitalisation, for intensive care and for mechanical ventilation. Overweight is also a predictor of death from COVID-19. The report shows that in countries where less than half the adult population is classified as overweight, the likelihood of death from COVID-19 is a small fraction – around one tenth – of the level seen in countries where more than half the population is classified as overweight. Of the 2.5 million COVID-19 deaths reported by the end of February 2021, 2.2 million were in countries where more than half thepopulation is classified as overweight.

“These results underscore the importance of fighting obesity around the world, including in lowerand middle-income countries where rates are rising fastest. We’ve seen the positive impact healthy food policies have in dozens of countries, and together we can make even more progress saving and improving lives,” said Bloomberg.

In addition, the report also shows that overweight populations are much more susceptible to respiratory diseases generally – and demonstrates that outcomes were also significantly worse for people living with obesity during the MERS and H1N1 epidemics – making the case for investment in obesity prevention and management strategies to prepare for future pandemics. WOF is also calling on governments to move people living with obesity up the priority queue for vaccinations.

“This report must act as a wake-up call to governments globally,” said Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization. “The correlation between obesity and mortality rates from COVID-19 is clear and compelling.” “Investment in public health and co-ordinated, 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.”

At a high level policy event (Obesity — Re-setting the Global Agenda) with WHO’s Director-General Dr Tedros Adhanom, WHO and UNICEF will confirm their commitment to build a coalition with the World Obesity Federation and its network.

Johanna Ralston, CEO of the World Obesity Federation, said: ‘Old age is unavoidable, but the conditions that contribute to overweight and obesity can be highly avoidable if governments step up and we all join forces to reduce the impact of this disease. The failure to address the root causes of obesity over many decades is clearly responsible for hundreds of thousands of preventable deaths. The most important thing as we emerge from this pandemic will be promising families who have lost loved ones and suffered severe economic pain “never again”.’ Dr Tim Lobstein, report

■ COVID-19 death rate is ten times higher in countries where 50%+ of the population is overweight; 2.2 million of the 2.5 million COVID-19 global deaths were in countries with high levels of obesity

■ World Health Organization (WHO) Director-General Dr Tedros Adhanom says report must act as a wake-up call to governments globally; Governments need to act now as failure to tackle obesity is ‘clearly responsible’ for hundreds of thousands of avoidable deaths globally

■ Michael R. Bloomberg, WHO Ambassador for Noncommunicable Diseases and Injuries, says “These results underscore the importance of fighting obesity around the world, including in lower- and middle-income countries where rates are rising fastest”

■ World Obesity Federation (WOF) calls for urgent vaccine prioritisation of those living with obesity

author, said: ‘We now know that an overweight population is the next pandemic waiting to happen. Look at countries like Japan and South Korea where they have very low levels of COVID-19 deaths as well as very low levels of adult obesity. They have prioritised public health across a range of measures, including population weight, and it has paid off in the pandemic. 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. We have seen it in the past with MERS, H1N1 and other respiratory diseases.’