Obesity during COVID-19 Lockdown

AUTHOR : DR. SHRUTI

COVID-19 pandemic has posed a significant global burden, around the globe. COVID-19 pandemic emerged in December 2019 when the first case came into existence, since then it has caused destruction worldwide. It is a contagious disease that spreads from one to another through both direct and indirect contact. It is known to have originated from China, specifically Wuhan. It started in China covering almost every country. It was spreading even quicker than the fire in the forest, leading to more and more hospitalizations and deaths. To slow down its spread, every country around the globe imposed lockdown, banned flights, and applied curfews where no one was allowed to go out. Only essential items like medicine and fruits, vegetables, and general stores were allowed to work that too only for a few hours a day. Along with this, COVID appropriate behavior to be followed such as- 

1. Frequent use of hand sanitizers or hand washing
2. Social Distancing (2 gaj ki doori)
3. Mask on while going out
4. Avoid going out unnecessarily

Initially, one-third of the world’s population, which is nearly 3 billion people, was locked down to break the chain of infection by physical isolation. It has been found from a pandemic that apart from its direct effect i.e. infection; it has indirectly shown a change in the behaviors at individual level such as education, isolation, unemployment, and income but also at the health system level. Apart from this, one should also focus as patients for cancer, cardiac diseases, or any other chronic disorder other than COVID-19, have faced the worst consequences even at the cost of their death due to the implementation lockdown. All the elective surgeries were postponed and only emergencies were entertained along with COVID-19 cases. It has also affected the sleep and eating patterns of people which has a direct impact on their physical well-being. There was limited access to fresh fruits and vegetables, less exercising, and more consumption of unhealthy food. Also, many studies have been conducted which showed more screen time, more hours of sleep, and an additional meal per day. These activities harm maintaining a healthy weight as they lead to increased weight followed by an increase in BMI particularly in this period. Obesity is most common in patients suffering from COVID as it is linked with the severity of the disease. Apart from isolations, factors such as age, gender, and underlying conditions need to be considered. Irrespective of COVID-19, it is associated with severe chronic diseases such as COPD (chronic obstructive pulmonary disease), CVD (cardiovascular disorders), diabetes, CKD (chronic kidney disease). Continuous isolation due to lockdown reduced physical activity which ultimately leads to obesity, followed by increasing risk of a pandemic.

Obesity can be defined as excessive accumulation of fat anywhere in the body which is a risk to the health of the human being. Worldwide the burden of obesity has shown a steady increase and a major factor contributing to it is a modern or sedentary lifestyle. This got more aggravated during the lockdown period. It has not affected adults but children also as no physical work out were allowed because schools were closed leading to zero physical activity. Obesity is increasing to a greater extent around the globe, which is of public health importance and COVID-19 risk. As per past studies done, the risk of chronic diseases such as diabetes and CVD is 2% and 10% higher respectively when associated with obesity. Weight gain is known to be the most important independent factor for chronic disorders. Treatment and management of these disorders are both directly and indirectly hampered due to this pandemic and so obesity has shown its prevalence to a great extent. There are three main risks with obesity and are as follows-

1. Risk of chronic disorders 
2. More susceptible to infections (affecting innate and adaptive immunity)
3. Long-term COVID-19 after effects on obese population.

Obesity is considered a modifiable risk factor for COVID-19. It is highly related to mortality. The adipose tissue, which is fat tissue, is rich in ACE2 (angiotensin-converting enzyme 2) receptors that help in accumulation of the COVID virus. It leads to a greater viral load followed by viremia.  It alters the immune function of the body by increasing susceptibility to infections.

Healthcare Professionals worldwide are worried about this increasing trend of obesity cases. Along with the increased cases of COVID-19, diet and lifestyle conditions imposed a great risk of obesity both on adults and children. All this increases co-morbidities and deaths because of COVID-19.

Recommended measures to control or reduce the increasing trend of COVID-19 are as follows-

• Consume a well-balanced diet- Dietary intake of whole grains, fruits, vegetables, lentils, and nuts. Cut on junk foods, carbonated drinks, refined sugars.
• Promote access and availability of healthy food.
• Consume 3-4 liters of water per day.
• Yoga and meditation to get good mental peace by de-stressing yourself.
• Perform indoor activities like Zumba/Aerobics to stay physically active.
• Encourage mild physical activity with COVID-appropriate behavior or with physical limitations.
• Target social determinants of health also such as overcrowded places, sedentary lifestyle, low level of education, poverty, etc.
• Awareness about obesity to the general public.
• Ensure the health of patients with chronic diseases by providing treatment on time.
• mHealth (mobile health) plays an important role to reduce in-person visits that further helps in breaking the chain of infection.

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