Science, opinions, beliefs. They are not the same. And flippin' eck there are some opinionated people out there right now don't you think?!
And then there's Boris. Now I'll be honest, I don't normally do politics and I'm not a Boris fan but when I read that Bojo believed he got Covid because he was fat, a little part of me died inside.
He's about as high profile as they get and yet no-one seems to have a suitable stopper for his mouth, preventing him from making sweeping statements, based on his own personal experience of n=1. [I'll get onto his 'advisors' in part 2].
The result being that people have become frightened about their own personal risk of dying and fatter people are again the brunt of judgement, shame and weight stigma.
So are very fat / higher weight people really at greater risk of Covid-19?
I’m not interested in beliefs or opinions...what does the science say?
Possibly, we don’t know for sure right now if fatter people are at greater risk but know this - it certainly isn’t black and white and and the situation is still changing, based on what is being learnt.
So what DO we know?
- Initially huge assumptions were made that ‘ob*s*ty’ was going to be a risk factor for Covid before there was any evidence. And we must be mindful that the data still emerging, will typically be taken at face value.
- A reasonably high % of Covid patients have a BMI > 30 but this percentage also reflects our general population. In other words the virus is affecting everyone. The main flaw with the studies quoted at the moment is they do NOT control for social circumstances.
- You see, the social determinants of health more strongly predict our health outcomes compared to body weight. Things like social class, racism, sexism, discrimination, trauma, weight bias and fat phobia. These increase Covid risk through diseases such as heart disease, diabetes, asthma and cancer. How? Because fatter people are less likely to go see their GP or get the medical care they need for fear of being judged by the health care professionals whose job it is to look after them in the first place (extremely unlikely in Bojo’s case). This may also mean that fatter people avoid getting assessed for Covid symptoms until their symptoms are already advanced.
- Fatter people are often not given the same quality of support or treatment options because their conditions are automatically blamed on their weight.
- Medics are also not likely to be adequately trained in dealing with the larger patient [this is fact] so some emergency procedures can be more challenging. Again this is unlikely for Bojo because a) he is not fat enough and b) (I'm assuming) he got the best of the best care.
Even if the 'experts' are trying to talk about fatness rather than BMI, there would have to be data that showed the actual presence of fat tissue increased the risk - and if that were the case "ob*s*ty" would be the incorrect word to use since BMI does not in any way measure body composition.
Fatter people are more likely to have dieted in their past (likely because they will have been told to or felt the need to through social pressures and conditioning) in which case their weight is likely to have yo-yo'd. It's this (weight cycling) that is likely to increase the risk of complications such as high blood pressure, heart disease and diabetes etc, not body weight or fatness itself.
What is really interesting in the literature is that living in a fatter body may actually provide some protection against Covid-19 because death rates look lower in these groups once the other factors have been accounted for. Maybe that was a factor for Bojo getting better? Maybe I should tell him it’s OK to stay fat...
Ultimately we are still looking at correlation, NOT causation. These are very different things!
And even IF a high BMI does end up being a risk factor for hospitalisation from Covid (we STILL do not know this yet!) there is still NO proven, effective way to reduce BMI in the long term.
So before anyone jumps on and says hey, just eating less and do more exercise....please don’t, you don't know shit!
It is judgmental. It's fat phobic attitudes like this that have got us where we are today.
It is not just personal responsibility for our health needed here but an overhaul of our entire social system and food environment.
Please let's all be more understanding. We need more compassion not criticism. And if someone you know does comment on your or someone else's weight, you have my full permission to remind them however you want that it's none of their business.
If you could do with some ideas to help you deal with unhelpful 'diet talk' read my piece that gives you 26 possible retorts.
Mel x
Part 2 (Boris on his Bike Bollocks) coming up........