COVID concentrates minds on obesity, sends some to surgery

Obesity is a major risk factor for those dying from the coronavirus.

So strong is that fear among the very overweight that bariatric surgeries have seen a significant jump in demand. Bariatric surgery is a procedure performed on the stomach or intestines that causes weight loss.

What’s odd about this is that obesity is tied to many other serious ailments. They include heart disease, diabetes and, as some studies suggest, cancers of the breast, esophagus, pancreas and colon.

Yet it took COVID to scare so many into asking for a kind of surgery that often involves removing part of the stomach. And that requires a hospital stay at a time when hospitals are struggling with waves of coronavirus patients who could pass on the deadly disease.

That said, seriously obese Americans who want bariatric surgery now have good reason. A large international study based in Lille, France, showed that for virus patients admitted into intensive care units, obesity was the third-highest risk factor for COVID-19 pneumonia — after advanced age and being male. And the need for invasive mechanical ventilation increases with the level of overweight.

Ted Threadgill underwent bariatric surgery after he had experienced coronavirus as an obese patient. He suffered weeks of double pneumonia, a 104 temperature and a breathing crisis. That traumatic experience, he told the Houston Chronicle, was “the ultimate sign I’m not bulletproof.”

Another incentive for obese Americans to lose weight speaks to the tragedy of our times: As waves of very sick patients overwhelm ICUs, doctors may have to decide who can be saved, and that may not include them.

Bariatric surgery has become a lot safer than it used to be. Twenty years ago, the risk from complications was 1 in 100. It’s now 1 in 1,000. But obtaining it is not a simple process of calling a surgeon and reserving an operating room.

To qualify at the University of California, San Francisco Bariatric Surgery Center, you must weigh less than 450 pounds. (That’s the maximum weight that hospital radiology equipment can support.) For some, that may mean months of losing weight prior to surgery.

You must have quit smoking at least six weeks before and must commit to changing diet, exercise and lifestyle thereafter. And, of course, your insurance must cover the procedure. Once you reach the stage of discussing what to expect with a surgeon, there is another four- to sixweek wait for the actual operation.

But it works, and the loss of weight greatly raises the odds of surviving the coronavirus. A study out of the Cleveland Clinic found that patients who had bariatric surgery in the past, even if they are still considered obese, have a 25% lower risk of needing hospitalization or admission into an ICU.

Doctors performing bariatric surgery say good data on the rising number of requests is hard to come by for reasons unique to this age of COVID. Elective procedures were, or still are, being curtailed in many states to preserve beds for coronavirus patients. As a result, some of the recent surge in requests for this medical intervention may reflect pent-up demand. And because bariatric surgery requires a great deal of preparation before the operation, many candidates are still in the preliminary phases.

A geared-up interest in losing excess weight could be a small, good outcome of this disaster. But some bariatric surgeons don’t want to go there. As Jason Balette, a doctor at Memorial Hermann The Woodlands Medical Center who operated on Threadgill, told the Chronicle, “anytime is a good opportunity to talk about obesity and the different approaches to weight loss.”

He’s right.