Obesity and the Covid-19 outbreak

Summary

Obesity is a physical condition in which a person is very overweight, with a lot of body fat.[1]

The prevalence of obesity in the UK has long been an issue for the government and the National Health Service (NHS). Almost two-thirds of adults in England are living with excess weight for their height, with similar figures in Scotland, Wales and Northern Ireland.[2]

A range of factors, including obesity, have been identified as increasing a person’s risk of becoming seriously ill after contracting Covid-19.[3]

Public Health England’s (PHE) July 2020 research report into Excess Weight and COVID-19 looked at available evidence up to July. It found that excess weight is associated with increased risk of being hospitalised with Covid-19, being subject to advanced treatment e.g. mechanical ventilation, and death from Covid-19. PHE report that the risks appear to increase at higher BMI (body mass index) levels,[4] even after adjusting for other factors like socio-economic status. BMI is more strongly correlated with testing positive for COVID-19 among BAME[5] ethnic groups than among White ethnic groups.

PHE say:

The current evidence does not suggest that having excess weight increases people’s chances of contracting Covid-19. However, the data does show that obese people are significantly more likely to become seriously ill and be admitted to intensive care with Covid-19 compared to those with a healthy BMI.

One study found that for people with a BMI of 35 to 40, risk of death from Covid-19 increases by 40% and with a BMI over 40 by 90%, compared to those not living with obesity.[6] Other data found that in intensive care units, 7.9% of critically ill patients with Covid-19 had a BMI over 40 compared with 2.9% of the general population.

PHE emphasises that these findings should be interpreted with some caution. Most of the research reports that PHE describe look at data on hospitalised patients with proven Covid-19 infection. As such, there may be differences among other groups, such as those who were not hospitalised. As with many questions around the pandemic, our knowledge is not complete.

Before the pandemic, the Government was working on a range of measures to reduce obesity, these are discussed in the Commons Library Briefing, Obesity (CBP 9049, 9 Nov 2020). In light of the pandemic, the Government has made a number of announcements outlining additional work on obesity; these are linked below.

The Government has said:

‘Tackling obesity: empowering adults and children to live healthier lives’ [the Government’s July 2020 obesity strategy] demonstrates an overarching campaign to reduce obesity, takes forward actions from previous chapters of the childhood obesity plan and sets out measures to get the nation fit and healthy, protect against COVID-19 and protect the National Health Service.[7]

A number of other bodies have reported on the association between obesity and negative Covid-19 outcomes; these are also linked below.

House of Commons Library

Obesity, Commons Library Briefing, CBP 9049, 9 November 2020

Obesity statistics, Commons Library Briefing, CBP 3336, 6 August 2019

Health inequalities: Income deprivation and north/south divides, Commons Library Insight, 22 January 2019

Social prescribing, Commons Library Briefing, CBP 8997, 2 September 2020

Coronavirus: health and social care key issues and sources, Commons Library Briefing, CBP 8887, 30 June 2020

The House of Commons Library coronavirus research hub contains a range of other coronavirus research briefings.

House of Lords Library

Tackling childhood obesity: What is the strategy?, House of Lords Library, 26 August 2020

Press releases and guidance statements

DHSC, ‘New obesity strategy unveiled as country urged to lose weight to beat coronavirus (COVID-19) and protect the NHS’, 27 July 2020

National Institute for Health and Care Excellence (NICE), ‘NICE’s support for rebuilding capacity in non-COVID health services’, 15 September 2020

European Association for the Study of Obesity (EASO), ‘Position statement on the global COVID-19 pandemic’, May 2020

EASO, ‘Obesity and COVID-19: The two sides of the coin’, October 2020

Reports

PHE, ‘Barriers and facilitators to supporting children most at risk of developing excess weight:  A scoping review of qualitative evidence from the UK and Europe’, 24 September 2020

PHE, ‘Supporting weight management services during the COVID-19 pandemic’, 7 September 2020

Local Government Association, ‘Social care and obesity’, August 2020

Obesity Action Scotland/Royal College of Physicians and Surgeons of Glasgow, ‘Obesity and COVID-19’, July/August 2020

Public Health Wales, ‘International horizon scanning and learning to inform Wales’ COVID-19 public health response and recovery’, 6 August 2020

Public Health Agency [Northern Ireland], ‘Health intelligence: COVID-19 evidence and guidance overview- obesity, physical activity and nutrition’, 29 July 2020

PHE, ‘Excess weight and COVID-19: Insights from new evidence’, 24 July 2020

PHE, ‘COVID-19: The secondary harms excess weight and COVID-19’, 20 July 2020

PHE, Weight management services during COVID-19: phase 1 insights, 20 September 2020

Research

A wide range of research has been published since the beginning of the pandemic on the links between obesity and Covid-19, including:

Moussa et al, ‘Impact of COVID-19 on obesity management services in the UK (The COMS-UK study)’, Obesity Surgery, 2020

Rubino et al, ‘Bariatric and metabolic surgery during and after the COVID-19 pandemic: DSS recommendations for management of surgical candidates and postoperative patients and prioritisation of access to surgery’, The Lancet Diabetes & Endocrinology, May 2020

News Articles

British Medical Journal, ‘Covid-19: England’s obesity strategy will fail without tackling social factors, warn doctors’, July 2020

[1]             Obesity, NHS, (accessed on 5 Oct 2020)

[2]             Public Health England, Excess Weight and COVID-19, Insights from new evidence, 24 Jul 2020

[3]             NHS, Who’s at higher risk from coronavirus, (accessed on 9 November 2020)

[4]             Body mass index (BMI) is a measure that uses a person’s height and weight to determine whether their weight is healthy. The BMI calculation divides an adult’s weight in kilograms by their height in metres squared. An NHS webpage provides further information: NHS, What is the body mass index (BMI), (accessed 9 Nov 2020)

[5]             Black, Asian and Minority Ethnic

[6]             BMI below 18.5 is in the underweight range, between 18.5-24.9 is in the healthy range, between 25 and 29.9 is in the overweight range and between 30 and 29.9 is in the obese range. See NHS, What is the body mass index (BMI), (accessed 9 Nov 2020)

[7]             PQ 95734 9 November 2020