Since the early days of the pandemic, conventional wisdom has been that our salvation from COVID-19 lies in a vaccine. But it’s becoming increasingly clear salvation might require something few people have been willing to do, which is take a deep, hard look at themselves, the health of this nation and the more deadly epidemic of obesity.

America’s obesity epidemic threatens the effectiveness of any COVID-19 vaccine, Sarah Varney reported Aug. 6 in a health news item for Kaiser Permanente, one of the nation’s largest not-for-profit health plans.

“Scientists know that vaccines engineered to protect the public from influenza, hepatitis B, tetanus and rabies can be less effective in obese adults than in the general population, leaving them more vulnerable to infection and illness. There is little reason to believe, obesity researchers say, that COVID-19 vaccines will be any different,” Varney reported.

The harsh reality is two epidemics are colliding. More than 107 million American adults are obese, and their ability to return safely to work, care for their families and resume daily life could be curtailed if the coronavirus vaccine delivers weak immunity for them, according to Varney’s report.

Through the pandemic, much focus has been on older adults in frail health and people with underlying health conditions, such as diabetes and heart disease, who are more vulnerable to developing severe cases of COVID-19.

But as the pandemic has dragged on, health care providers have gleaned more about COVID-19 patients and outcomes.

What doctors have learned is that obesity itself, not just underlying diseases often associated with it, is a risk factor for poor COVID-19 outcomes.

“In fact, obesity is the number-one risk factor for developing a severe case of COVID-19 in people under the age of 55,” warns Dr. Kyle Stephens, weight loss surgeon at Houston Methodist Hospital.

As intensive care units in New York, New Jersey and elsewhere filled with patients, the U.S Centers for Disease Control and Prevention warned people considered morbidly obese — a body mass index of 40 or more or about 100 pounds overweight — were among the groups at highest risk of becoming severely ill with COVID-19. About 9 percent of American adults are in that category.

But as weeks passed, a clearer picture of who was being hospitalized came into focus, prompting federal health officials to expand their warning to include people with a body mass index of 30 or more. That vastly swelled the ranks of the most vulnerable to 42.4 percent of American adults, Varney reported.

Obese patients face greater risk of respiratory failure, the need for mechanical ventilation and higher mortality, according to the Mayo Clinic.

Anyone can get infected with the new virus that causes COVID-19. And it’s still unclear why obesity puts a person at higher risk, but there are some theories, Stephens said.

“One thought is that the infection may exacerbate the breathing difficulties that overweight people often experience, even if they don’t know it,” Stephens said. “Another theory is that obesity may increase the chance of a person experiencing ‘cytokine storm’ — a life-threatening immune-related complication of COVID-19. Lastly, having more fat may help the virus stick around longer due to molecular properties of both fat cells and this particular virus.”

Severe obesity puts those with coronavirus disease at particularly high risk of death, more so than related risk factors such as diabetes or hypertension, according to a study of patient records Kaiser Permanente’s researchers published earlier this month.

The study, appearing in Annals of Internal Medicine, showed obesity is especially dangerous for men and younger patients who contract COVID-19 and that obesity stood out from racial, ethnic or socioeconomic disparities when isolated from those factors.

The good news is that obesity is preventable and reversible. The bad news is it has become so common in society no one notices anymore and in some cases people celebrate it.

“People don’t always see obesity as abnormal, since it’s quite prevalent, but it’s important to know if your weight is putting you at risk for COVID-19, as well as other health conditions,” Stephens said.

Fat-shaming is reprehensible, but there’s a grave danger in “normalizing” obesity as so many advertisers have tried to do, probably with good intentions. While such movements have discouraged holding up rail-thin models as ideal, they also have made a dangerous shift to campaigns that assert it’s fine to be overweight with such slogans as “fat pride.”

Obesity isn’t just a cosmetic concern. It’s a medical problem that increases risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers, according to the Mayo Clinic.

People struggle with obesity for many reasons, including food addiction. Dietary changes, increased physical activity and other behavior changes can help.

Ultimately, salvation from COVID-19 hinges on the individual, but reducing obesity must become a serious national health priority.

“Will we have a COVID-19 vaccine next year tailored to the obese? No way,” Raz Shaikh, an associate professor of nutrition at the University of North Carolina-Chapel Hill told Kaiser Permanente’s Varney.

“Will it still work in the obese? Our prediction is no.”

Laura Elder

 Laura Elder: 409-683-5248;

Recommended for you

(8) comments

Carlos Ponce

Excellent article, Laura! Timely in that the CDC has reported that only 6% or about 9000 of the pandemic deaths are from the virus only. The remaining 94% came from contributing conditions which led to susceptibility to being infected, obesity being on the list. Other conditions include high blood pressure, diabetes, flu, chronic lower respiratory diseases and cardiac issues.

Wayne D Holt

Another bullseye on this one, Laura. I am proud that this type of realistic and accurate narrative shows up in our hometown paper...and dumbfounded that the so-called "opinion maker" mastheads in New York and Washington never seem to get around to common sense reporting as we see here.

Keep the ball rolling. People are waking up to what is real in this battle.

Dan Freeman

Mr. Ponce infers that the deaths due to COVID-19 alone are less than 10,000. He implies that deaths from a co-morbidity and COVID are not of concern. This beggars most people’s sense of morality. If the 170,000 would have lived a week or a month or many years longer, that would be worthwhile. By allowing the virus to spread by failing to wear masks, socially distance, and keeping non-essential businesses like bars and sporting events closed, Mr. Ponce’s reasoning amounts to mass murder. Wars are fought against fascists because of their willingness to sacrifice the weakest of the living. Mr. Ponce, I hope you did not mean what you wrote.

Wayne D Holt

Hey, wait a minute, Dan! That was the exact same scorn you heaped on me in another thread. I strongly oppose having to share scorn with Carlos. It's not sanitary.

Carlos Ponce

Not my findings, Dan Freeman, those of the CDC. Are you denying science?

Virginia Stone

I have been angry since reading your editorial, it hurt because I have packed on the pounds since the pandemic began and with back to back injuries and illnesses I am not the athlete I was in 2009. I agree fat-shaming is reprehensible as is shaming people with eating disorders or chronic alcoholism among others. I found the article you used in your editorial online and it also states that some researchers are hopeful that a better vaccine can be developed to be effective for morbidly obese people and other people with illnesses that affect their immune systems, so it may not be as dire as you have indicated. I guess you didn't want to add the hopeful part to your fat-shaming editorial because it gives hope to people like me.

Wayne D Holt

Ms Stone, I read the same article and came away with a very different impression. It seemed to me the focus was on health, and with weight being a serious part of what we are told are risk factors for Covid-19. Rather than trying to personally deprive you of hope, it just indicated that any cultural message that encourages a cavalier attitude about extra weight was not helpful.

I think most of us struggle with keeping a healthy weight to one degree or another. The fact that you saw this more as fat-shaming rather than health advice just points up how conditioned we are we to feeling less than our best when we have put on weight.

Don't lose hope. There are so many stories of successful weight loss and a return to better health, even against difficult conditions. I hope you have success in getting to a weight that is appropriate for you.

Virginia Stone

Mr. Holt, I feel no shame in petty attempts to shame on the overweight since we have been shamed for decades.

Recently, big people have finally been recognized as worthy of dignity and respect and since this is a new concept for us, Mr. Holt, we may be proud but

it's okay, you or Laura Elder don't have to agree with our pride but we have earned it.

I believe any cultural message that encourages a cavalier attitude or thinking that harms a person is not helpful, just as the need by some to have plastic facial features framed by locks of hair that don't belong to them with perfect makeup applied to enhance all the cosmetic surgery they have SURVIVED along with the coveted two-inch gap between the top of their legs. Is this not an unhealthful form of thinking, but this is a trendy source of pride in certain groups, this is not helpful but has been a sick norm of for years and we know this attitude is self-destructive and just as harmful to the immune system as morbid obesity so why make fat-shaming the go-to way to judge people?

The judgment of others has become a very trendy form of expressing the distaste of other human beings but it is wrong. So judging a group of people by writing an editorial that states if you are morbidly obese and you don't lose weight by the time the COVID 19 vaccine is available it will not work on you because it wasn't made for the obese and most likely will not work for you. This is fat-shaming.

Welcome to the discussion.

Keep it Clean. Please avoid obscene, vulgar, lewd, racist or sexually-oriented language.
Don't Threaten. Threats of harming another person will not be tolerated.
Be Truthful. Don't knowingly lie about anyone or anything.
Be Nice. No racism, sexism or any sort of -ism that is degrading to another person.
Be Proactive. Use the 'Report' link on each comment to let us know of abusive posts.
Share with Us. We'd love to hear eyewitness accounts, the history behind an article.

Thank you for reading!

Please log in, or sign up for a new account and purchase a subscription to read or post comments.