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COVID-19: Shielding the Obese

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I read at the weekend the shocking news that the government is preparing contingency plans for the winter months that could include shielding those who are obese.

Several newspapers ran reports to say that any future shielding will be done in a more scientific way than last time with a greater focus placed on those most at risk. That makes a lot of sense, as long as it is done well.

Some of the main risk factors for COVID-19 that we are aware of today are age (over 50), weight/body mass index, underlying health issues and ethnicity. Those undergoing treatment for cancer, respiratory problems and who have diabetes are also known to fall into at-risk groups.

The government needs to be applauded for making these plans, but can we really expect people to shield simply because they are over a certain age and have a BMI that places them in the ‘clinically obese’ category? If what we are reading is accurate, it sounds like far too generic an approach and it would be hard to carry the public with them. We’ve seen on overcrowded beaches and pubs what happens when people don’t ‘buy-in’ to what needs to be done.

Some great work has been done in Canada recently where they have changed their approach to tackling obesity so that they now focus their effort on those people who are either close to or are already experiencing health problems associated with their weight.

We need to take the same approach here, both in response to COVID and in ’normal’ times.

If a person has a BMI of 35 but their general health markers are all within the normal range, and they are not complaining of ill health, we should not be focusing resources on them and its hard to argue that they should shielding unless they’re happy to do so. There may be exceptions for those who are over 70 or 75 where the risk is far greater, but not those in their 50’s. Conversely, someone who has a BMI of 33 and is prediabetic (raised glucose but not yet above the threshold for a diabetes diagnosis) should be a focus for treatment and shielding. Assuming the people in these two examples were above the age of 50, the person with prediabetes should be higher up the list in terms of shielding, albeit their BMI is lower.

I’m sure the government realise this but it may be that they simply don’t have enough up to date health data on people to accurately stratify them. Certainly, a lot of 55-year-olds will not have seen their GP for many years and will not have been weighed or had a blood test. In that scenario how do you discriminate between them?

One effect of COVID, and the threat of shielding, that we have seen already is an increase in demand for weight loss services. A lot of people are worried about COVID and the risk their weight poses.

This has to be a good thing. People should be reassured that there is a range of weight loss services available ranging from behavioural and dietary programmes all the way through to surgery. Weight loss surgery remains the most effective long term form of treatment for people suffering from obesity, but it will not be suitable for most people. Generally, those with higher BMI (35+) and/or with health issues will be the best candidates.

By the way, I talk of obesity like a disease because we need to start treating it in that way.

If you are worried about your weight and want to take some steps to bring it under control, you can call the Healthier Weight team on 0800 313 4618 to get some information on the surgical and non-surgical treatment options available to you, or click the button below to get a quote.

Picture of Martyn Berrett

Martyn Berrett

Martyn is the former MD of Healthier Weight. Throughout his tenure he observed many bariatric procedures and took part in several research projects so has a unique perspective on all things weight loss.

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