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Opinion: It's time to talk about the effects of obesity on COVID-19


New research by Stanford University may shed some light on the reason those with excess pounds represent the overwhelming majority of COVID-19 hospitalizations and deaths.

The Stanford researchers uncovered the way the virus penetrates fat cells and triggers a deadly reaction from the body’s immune response system in a study awaiting peer review.

The Centers for Disease Control and Prevention found that 78% of those who were hospitalized, in need of a ventilator or died of COVID-19 from March to December in 2020 were obese or overweight. In fact, excess weight was the single biggest predictor of hospitalization after old age.

In a state where more than 35% of us meet the criteria for obesity calculated by body mass index, and an equal percentage are classified as overweight, it’s a conversation we need to have, and soon.

It’s not just a Michigan issue. Nearly 74% of adult Americans are overweight or obese, according to the CDC. Whether it is the excess weight alone — or, more likely, its association with other known comorbidities such as type 2 diabetes, hypertension and certain types of cancer, excess weight is not helping our relationship with COVID.

We agree getting vaccinated is a smart idea, and we cheer the efforts to use and quickly develop therapeutics to treat the afflicted and minimize sickness.

But Michigan leaders have long ignored the conversation about who is most at risk in this pandemic and failed to take real steps that could help address a public health crisis that was killing people long before COVID-19.

The trend in America for decades has been to develop pharmaceutical answers for every health affliction. But the truth is, the top killers in our country — high blood pressure, heart disease and diabetes — are best combated through therapeutic lifestyle, including changes in food and physical activity.

Coauthor Dr. Tom Rifai and his Harvard Lifestyle Medicine colleague, Dr. Beth Frates, sounded the alarm in June of 2020 with an editorial in the American Journal of Health Promotion noting, “lifestyle as medicine” could be a major protection against severe COVID-19.

They urged a national campaign for America to get its metabolic house in order.

A Kaiser Health study showed that people who regularly exercise had the best chance of beating COVID, while people who were inactive did much worse. However, over the past 18 months we have seen every health measure go in the wrong direction. Last April, the American Psychological Association reported that 42% of US adults reported an average weight gain of 29 pounds.

Proper diet and exercise requires effort and self-investment, and the fitness movement could benefit from more support from our medical professionals and public health officials. Several new “lifestyle as medicine” programs like the True Health Initiative and American College of Lifestyle Medicine offer templates for healthy lifestyle alternatives.

America’s slide toward obesity and all its related health problems has been decades in the making. COVID-19 is a sobering reminder that we all need to take better care of ourselves.

The New Year is traditionally a time when Americans make resolutions. Developing a healthier lifestyle — through physical activity and exercise, better food choices or dropping a vice — are the top resolutions people make.

This year, we encourage everyone to think carefully about the importance of it.

Bryan Rief is the executive director of the Michigan Fitness Club Association and CEO of PF Michigan Group, one of the largest Planet Fitness franchisees in the U.S. Dr. Tom Rifai is founder and CEO of Reality Meets Science, a digital health company focused on therapeutic lifestyle support, a member of the board of directors for the True Health Initiative and co-host of the True Health Revealed podcast.