When Should I Worry About...

Obesity & COVID-19: Can Your Weight Alone Put You at Higher Risk?

July 1, 2020 - Katie McCallum

Anyone can get infected with the new coronavirus that causes COVID-19. But, as we continue to learn more about this new disease, it's becoming increasingly clear that some people are more vulnerable to severe illness than others — including those who are very overweight.

"People may not realize this, but obesity in and of itself is a risk factor for being hospitalized or placed in the ICU as a result of COVID-19," says Dr. Kyle Stephens, weight loss surgeon at Houston Methodist. "And this is particularly concerning since we also know that about 42% of adults in the U.S. are considered obese."

Given that this new virus is going to be among us for some time, here are three things Dr. Stephens wants everyone to know about obesity and COVID-19.

A person's weight alone can increase his or her risk

By now, you've likely heard that older adults and people with underlying health conditions, such as diabetes or heart disease, are more vulnerable to developing a severe case of COVID-19.

But, even if you feel healthy, just being heavily overweight can increase your risk of severe illness as well.

"In fact, obesity is the number one risk factor for developing a severe case of COVID-19 in people under the age of 55," warns Dr. Stephens. "People don't always see obesity as abnormal, since it's quite prevalent, but it's important to know if your weight is putting you at risk for COVID-19, as well as other health conditions."

A person is considered obese if he or she has more body fat than what's considered healthy for his or her height. A quick measurement called body mass index (BMI) is used as a screening tool for obesity.

"Having a BMI of 30 or higher increases a person's risk of developing a severe case of COVID-19 by 27%," Dr. Stephens says. "And a BMI of 40 or higher doubles a person's risk."

And while a vaccine for COVID-19 is still being developed, what’s concerning is that even once we do have one, it will likely be less effective for people who are obese.

“What we know historically from the influenza, tetanus and hepatitis B vaccines is that people who are obese seem to benefit less from vaccination than people who are at a healthy weight,” warns Dr. Stephens. “The reason for this is still somewhat unclear, but it’s thought that the chronic state of inflammation brought on by obesity interferes with the immune system’s ability to learn from a vaccine.”

A severe case can be much harder to recover from

It's still unclear why obesity puts a person at higher risk, but there are some theories.

"One thought is that the infection may exacerbate the breathing difficulties that overweight people often experience, even if they don't know it. Another theory is that obesity may increase the chance of a person experiencing "cytokine storm" — a life-threatening immune-related complication of COVID-19. Lastly, having more fat may help the virus stick around longer due to molecular properties of both fat cells and this particular virus," explain Dr. Stephens.

Whatever the reason for a person's increased risk, it's important to keep in mind that the sicker you get, the longer it will take you to recover.

"Aside from the immediate risk to your life, a severe illness likely also means a longer recovery, and may even result in longterm damage to your lungs," explains Dr. Stephens. "If your illness becomes so severe that you end up in an ICU and/or on a ventilator, your recovery could possibly take months."

There are steps an obese person can take to protect his or her health

Everyone should be taking precautions to stay healthy, but those at higher risk for severe illness should be even more cautious and even more vigilant.

Dr. Stephens recommends obese people consider the following tips to stay healthy during the COVID-19 pandemic:

  • Be extra cautious. Everyone should be social distancing, wearing cloth masks and practicing excellent hand hygiene, but those who are obese should consider being even more vigilant about these preventive measures than someone who is otherwise healthy. If you do interact with other people, make sure they're being as safe as you.

  • Ensure your other underlying health conditions are well-managed. People who are obese and have other preexisting health issues, such as heart disease, high blood pressure and diabetes, should be sure to take all medications needed to manage their overall health. Having more than one chronic health issue can increase a person's risk even further.

  • Support your immune system. The immune system is complex, and many factors contribute to a healthy immune response. However, eating healthy, exercising regularly and getting quality sleep are easy ways to help naturally boost your immune system.


And while there's no quick way to lose weight, Dr. Stephens adds that it's never too late to start — even if we're in the middle of a pandemic.

"Being at home more may actually make it easier to eat healthy, whole foods, limit portion sizes and avoid saturated fats and simple carbs," says Dr. Stephens. "In addition, don't be afraid to get outside and go for a walk. As long as you're social distancing, even just a 15-minute walk is a great way to safely start your weight-loss journey during this pandemic."

Next Steps:


Concerned you may have COVID-19?

  • If you're experiencing COVID-19 symptoms, you can speak to a Virtual Urgent Care provider 24/7. The provider will be able to help you determine if testing is needed and advise you on what to do next.
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Categories: When Should I Worry About...