Weight of the world is killing us

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While modern science and medicine offer us more opportunities to live longer and healthier lives, modern lifestyle – our diet (both quality and quantity), lack of exercise, stress and other mental challenges – is killing us. Perhaps this is a trade-off of progress; in the past, after all, few people died of cancer or heart diseases because they simply did not live long enough on average to develop what are now considered diseases of old age. Whatever the case, our lives today seem to be a never-ending race between the problems we create and the solutions we find. Thankfully, the solutions have had an edge, as evidenced by the increasing life expectancy (not everywhere; it’s actually declining slightly in the US), but that edge – and the length and quality of our lives – would be much better if we were more successful at dealing with such challenges as obesity.

World Obesity Foundation has just released its COVID-19 and Obesity: The 2021 Atlasand it makes for uncomfortable reading. Take its most staggering conclusion:

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Globally, at the end of 2020, COVID-19 mortality rates were more than ten times higher in countries where overweight prevalence exceeds 50% of adults (weighted average 66.8 deaths per 100,000 adults) compared with countries where overweight prevalence is below 50% of adults (weighted average of 4.5 deaths per 100,000 adults). [emphasis in the original]

That’s right, ten times as many COVID deaths have taken place in countries where 50 per cent or more of population are overweight or obese as in countries where less than 50 per cent are – roughly 2.2 million versus 300,000. This holds true accounting for other factors like economic development, age profile of the population, reporting quality, and so on. And it at least partly explains more than half a million deaths in the US – or, indeed, why certain minorities, such as black Americans, have suffered proportionally more than others in the current pandemic.

Australia is an outlier, since two-thirds of our population are overweight or obese, yet our death rate from COVID has been among the lowest in the world. A combination of closed borders with a high quality health system (if not always high quality political leadership) is no doubt mostly responsible for us being yet again a relatively “lucky country” (debate about economic and social costs of the response aside). But if we are lucky, it’s a veritable miracle that our Pacific neighbours, who make up most of the top 10 most obese nations in the world, have been relatively unaffected by the virus. There is certainly an argument that some of the foreign aid we send to the Pacific island states should this year come in the form of vaccines, targeting as it does those among most at risk anywhere on Earth.

We should not stigmatise obesity; it’s a complex issue with many contributing factors, at least some of which are beyond individual control, at least at this point in our scientific development. But we should not go to the other extreme of “body positivity”, preaching against all science that “you can be healthy at any weight” and thus sacrificing physical health for the sake of managing psychological well-being of those concerned. There has to be a sensible middle course, both for the good of those whose extra weight will contribute to further health problems down the line and for the good of the society as a whole, which bears many direct and indirect costs flowing from the obesity epidemic.

COVID and other pandemics, of course, come and go, but other health challenges associated with being overweight, from diabetes to cardiovascular disease, remain. It would be great if out of all the misery that Coronavirus has brought world-wide, an extra spotlight shone on the often deadly consequences of obesity (to the extent that the problem can in any way be said to be lack of awareness). Alas, as alarming, and ideally action-inducing, as the statistics above are, it’s likely they will get lost amongst all the other controversies swirling around COVID, from its epidemiology to the pros and cons or various public health responses.

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