What to Know About Obesity and COVID-19

Obesity has been deemed a risk factor for a more severe case of coronavirus disease 2019 (COVID-19). Defined as weight that is higher than what is considered a healthy weight for a given height and a body mass index (BMI) of over 30 for adults, obesity affects more than 650 million people worldwide.

Obesity is linked to impaired immune function and has been shown to worsen outcomes from COVID-19. For example, people with obesity have a greater risk for hospitalization, intensive care unit (ICU) admission, ventilation difficulties due to decreased lung capacity, and even death.

Obesity and COVID-19

 

South_agency / Getty Images

Obesity and COVID-19 Risk

Over the course of the pandemic, the Centers for Disease Control and Prevention (CDC) included obesity and severe obesity (BMI of 40 or above) among 12 conditions that it deemed had enough evidence to put people at an increased risk for a more severe case of COVID-19.

The CDC also states that people who are overweight (BMI of 25 to 30) are also more likely to get severely ill from COVID-19. While it's too soon to know exactly why people with obesity fare worse with COVID-19 than those at a healthy weight, it is believed that chronic inflammation may play a role. 

A recent study by the American Heart Association (AHA) examined data from 88 hospitals in the United States that were part of the AHA's COVID-19 Cardiovascular Disease Registry. They found that people with obesity were more likely to be hospitalized, more likely to be put on a ventilator, and had a higher risk of death compared with people with a BMI under 30.

The data revealed that these negative outcomes increased in tandem with higher BMIs. For instance, people with severe obesity were at a little more than double the risk of being put on a ventilator and faced a 26% higher risk of death compared to people who did not have obesity.

A report from the CDC found that overweight is also a risk factor for invasive mechanical ventilation.

Obesity, COVID-19, and Racial Disparities

COVID-19 has put a spotlight on racial health disparities. People of color are impacted by obesity at high rates in the United States. Non-Hispanic Black adults in the U.S. have the highest prevalence of self-reported obesity at 39.8%, followed by Hispanic adults at 33.8%, and non-Hispanic white adults at 29.9%. At the same time that high rates of obesity exist for these populations, they are also found to experience higher rates of worse COVID-19 outcomes.

Complications of Obesity and COVID-19

Both COVID-19 and obesity pathophysiology are associated with coagulation disturbances, so individuals with obesity are at higher risk of developing blood clots in the eventuality of a COVID-19 infection. This can lead to pulmonary embolism, stroke, or heart disease.

It is well known that people with obesity often also have other comorbidities such as type 2 diabetes and heart disease. An impaired cell-mediated immune response forms part of the type 2 diabetes pathophysiology, putting these individuals at higher risk of acquiring infections.

An obesity state also promotes vitamin D deficiency. This has an effect on the modulation of both the innate and the adaptive immune responses.

In a paper published in Nature Reviews Endocrinology, the authors wrote that "the COVID-19 pandemic could have serious consequences for the obesity epidemic." They suggested that as obesity leads to potentially worse COVID-19 outcomes, the new coronavirus pandemic might also be contributing to higher obesity rates.

This is due to a number of factors like mandated lockdowns and shelter-in-place orders that have led people to be more sedentary in general.

Additionally, economic problems and the fear of getting infected may drive people to eat emotionally, be less inclined to pursue exercise, and embrace other unhealthy lifestyle behaviors to cope with the stress of the pandemic.

Financial challenges may also prompt consumption of lower-cost, less healthy foods.

Some individuals who have COVID-19 end up experiencing symptoms months after they've had the virus. These so-called "long-haulers" are still being studied. A 2020 study indicated that people who have obesity or who are overweight, along with women, the elderly, individuals with asthma, and those who had a wider range of symptoms than others in the first week of being sick, were more likely to become long-haulers.

Obesity Treatments and COVID-19

While there are several FDA-approved drugs for treating obesity, there isn't any clear information on whether these medications impact COVID-19 treatment, recovery, or symptom exacerbation or reduction.

That being said, there are natural remedies and lifestyle modifications that can play a role in one's experience with COVID-19. Research has shown that COVID-19 is associated with clinically significant weight loss and a risk of malnutrition. It's recommended that healthcare providers monitor a person's nutrition and ability to sustain a healthy weight while being treated for COVID-19.

A lot of the techniques one uses to achieve a healthy weight can be beneficial while dealing with the coronavirus. A review published in 2020 showed that consistent exercise and physical activity might actually reduce the risk of acute respiratory disease syndrome (ARDS), which is a top cause of death in people with COVID-19. The study found that exercise can prevent or reduce the severity of ARDS, which affects between 3% and 17% of all people who have COVID-19.

Beyond fitness, healthy nutrition can be key to combating the virus and boosting a person's immune response. Anti-inflammatory diets can be key to fending off some of the inflammation caused by obesity and the virus.

Additionally, getting enough sleep and instituting regular, healthy behavioral patterns—all important in helping to achieving a healthy weight—can improve one's immune system, which is key to COVID-19 prevention and treatment.

Frequently Asked Questions

  • Should I get a COVID-19 vaccine if I have obesity?

    Yes. While there were earlier questions about the efficacy of COVID-19 vaccines for people who have obesity, the current consensus among medical professionals is that the vaccines are as effective for people with obesity as they are for people who have other underlying conditions.

    Obesity seems to affect vaccination efficacy. Flu vaccinations have been found to be less effective at preventing illness among people who have obesity, for example. However, data released by the U.S. Food and Drug Administration (FDA) and Pfizer showed that the COVID-19 vaccines were about equally effective across age groups, sexes, racial and ethnic groups, as well as people with underlying conditions like high blood pressure, diabetes, and obesity.

  • Are certain vaccines safer than others for people with obesity?

    At the moment, there is no research to indicate any of the vaccines on the market are less safe than others for people with obesity. Address any concerns about your health or illness prevention with your medical provider.

  • How high is my risk of being exposed to COVID-19 if I seek care for obesity?

    This varies greatly depending on the infection rates in your area and COVID-19 prevention methods being used. While you should be conscious of exposure risk, don't let fear prevent you from seeking care altogether.

    If you regularly seek treatment or consultation for obesity from a medical provider, ask them about ways you can safely keep up these appointments. This could involve telehealth, physically distanced in-person meetings, or appointments booked at special times of day. Keep in mind that most medical facilities adhere to the most stringent public health safety practices.

How to Stay Safe

The same COVID-19 preventive rules and recommendations that apply for the population at large apply for people with obesity.

You should always wear a mask when in public spaces, wash your hands thoroughly and regularly, and maintain social distancing when you are around others. That means maintaining a distance of at least 6 feet away from those who are not part of your immediate household.

Other tips for staying safe from COVID-19 include:

  • Avoid touching your eyes, nose, and mouth.
  • Cough or sneeze into your elbow or a tissue that you immediately discard.
  • Clean and disinfect frequently touched surfaces daily.
  • Stay home as much as possible, especially if you are sick.

A Word From Verywell

It can be alarming to read headlines about how conditions like obesity can potentially lead to more serious COVID-19 outcomes. The best things you can do to prevent COVID-19 are continuing your obesity treatment plan, including weight loss and prescription medications, and following the CDC guidelines on how to avoid getting infected by the coronavirus.

If you're really worried or unsure about how to manage obesity or protect yourself and others from COVID-19 at this time, be sure to bring your concerns to your healthcare provider's attention.

Was this page helpful?
14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. World Health Organization. Obesity and overweight. Updated April 1, 2020.

  2. Centers for Disease Control and Prevention. Obesity, race/ethnicity, and COVID-19. Updated March 9, 2021.

  3. Centers for Disease Control and Prevention. People with certain medical conditions. Updated February 22, 2021.

  4. Hendren NS, de Lemos JA, Ayers C, et al. Association of body mass index and age with morbidity and mortality in patients hospitalized with COVID-19Circulation. 2021;143(2):135-44. doi: 10.1161/CIRCULATIONAHA.120.051936

  5. Kompaniyets L, Goodman AB, Belay B, et al. Body mass index and risk for covid-19–related hospitalization, intensive care unit admission, invasive mechanical ventilation, and death — United States, March–December 2020MMWR Morb Mortal Wkly Rep. 2021;70(10):355-61. doi:10.15585/mmwr.mm7010e4

  6. Centers for Disease Control and Prevention (CDC). Health equity considerations and racial and ethnic minority groups. Updated February 12, 2021.

  7. Cuschieri S, Grech S. Obesity population at risk of COVID-19 complications. Glob Health Epidemiol Genom. 2020;5:e6. doi:10.1017/gheg.2020.6

  8. Stefan N, Birkenfeld AL, Schulze MB. Global pandemics interconnected — obesity, impaired metabolic health and COVID-19. Nat Rev Endocrinol. 2021;17(3):135-49. doi: 10.1038/s41574-020-00462-1

  9. Carfì A, Bernabei R, Landi F; Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19JAMA. 2020;324(6):603-5. doi:10.1001/jama.2020.12603

  10. Filippo LD, Lorenzo RD, D’Amico M, et al. COVID-19 is associated with clinically significant weight loss and risk of malnutrition, independent of hospitalisation: A post-hoc analysis of a prospective cohort studyClin Nutr. 2021;40(4):2420-2426. doi: 10.1016/j.clnu.2020.10.043

  11. Yan Z, Spaulding HR. Extracellular superoxide dismutase, a molecular transducer of health benefits of exerciseRedox Biology. 2020;32:101508. doi:10.1016/j.redox.2020.101508

  12. Fernández-Quintela A, Milton-Laskibar I, Trepiana J, et al. Key aspects in nutritional management of covid-19 patientsJCM. 2020;9(8):2589. doi:10.3390/jcm9082589

  13. U.S. Food and Drug Administration. Vaccines and related biological products advisory committee meeting. Published December 10, 2020.

  14. Harvard Health Publishing. Flu vaccine less effective in obese individuals. Published September 2017.