- If you are obese, you may be eligible for an early COVID-19 vaccine in several countries.
- Evidence shows that it can be a big risk for worse viral infection and complications.
- Weight stigma can sometimes make it difficult for people with obesity to access care.
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As the U.S. continues to vaccinate Americans against COVID-19, people with underlying health conditions are being pushed to the front of the queue.
In 15 states, obesity is currently one of the qualifying conditions.
This is because a body mass index (BMI) above 30, the cut-off point for obesity, is considered a risk factor for serious coronavirus complications, according to the Centers for Disease Control & Prevention.
Unlike other chronic conditions such as diabetes or cancer, obesity has a social stigma that can cause poorer care, even from health care providers, according to Dr. W. Scott Butsch, director of obesity medicine at the Cleveland Clinic. The stigma can also cause people to delay medical treatment.
In some cases, people with obesity may not even realize they can get an early vaccination. They may know that their weight is a health risk, but do not know their exact BMI.
“A lot of people come to my clinic and are surprised when we discuss the number,” Butsch said.
Although BMI is an imperfect measure of health, more than 40% of American adults are obese. That’s an estimated 78 million people, so it’s worth checking your BMI to see if you qualify.
How to know if your BMI gives access to a vaccine
Your BMI is determined by body weight in relation to height, and you can calculate it on the CDC website (or if you like math, take your weight in pounds, divide it twice by your height in inches and multiply the total by 703 ).
A number between 25 and 29.9 is considered overweight, 30 and higher are considered obese and 40+ are classified as severe obesity.
Obesity is a qualifying condition for vaccination in Mississippi, Nebraska, New Jersey, New Mexico, New York, Pennsylvania, Texas, Virginia and Wyoming.
You are eligible if you have severe obesity in Montana and Missouri.
People with obesity in addition to another underlying condition, such as diabetes, qualify in Massachusetts, New Hampshire, North Dakota and South Dakota.
Other states may include obesity as a qualifying condition as vaccination of the vaccine continues. Availability changes frequently by state and even by province, so check your local guidelines.
Obesity is a known risk factor for COVID-19 complications
Obesity is linked to worse COVID-19 cases, as well as a higher risk of complications. In April, researchers found that obesity was the major chronic risk factor for hospitalization among coronavirus patients. Evidence has also found that when a person is overweight and COVID-19 at the same time, a higher BMI means they are more likely to die from complications of the virus.
Obesity is also more prevalent among black and Hispanic Americans, who according to data tend to be disproportionately affected by COVID-19.
With all the research suggesting that people with obesity are at high risk, Butsch said it is surprising that more states are not making it a priority for early access to vaccines.
“With the call to follow science, I’m very curious if there’s a small degree of hypocrisy if we do not follow the evidence to prioritize people who are obese with the distribution of the vaccine,” he said.
BMI is an imperfect measure of health
You may have a high BMI and be completely healthy. Looks like you may not even be obese.
“At the individual level, BMI may not be a perfect indication of someone’s health risk. It’s one of the different measurements we need to take to assess health risks,” Butsch said.
This is because BMI does not take into account body composition.
Someone with a high amount of muscle mass may weigh enough to be categorized as overweight or obese, even if they are metabolically healthy. The same goes for people who are particularly tall.
BMI also does not take into account where people carry their weight. Not all body fat is equal; research suggests that belly fat or visceral fat (around the organs) is linked to more health risks compared to, for example, fat around the hips and thighs.
Since BMI was first created in the 19th century and was based on what was typical of white Europeans at that time, it may not be accurate to assess the health of different demographics, including people of different races.
If you are at high risk, it’s worth checking to see if you can vaccinate now.
Weight stigma can discourage people who benefit from the vaccine from getting one. Butsch said that people with obesity are likely to have experienced bias and judgment from medical providers and that they consequently feel frustrated with the healthcare system.
Fears about weight and body image can also prevent people from watching their weight, especially if it has recently changed, so they may not even know if they have access to the vaccine.
This is all the more reason to check your BMI and sign up for a vaccine if you are in the high risk category.
“Many people with obesity know that they are at increased risk and that they are more likely to get the vaccine,” Butsch said. “A lot of people are so worried they can’t wait to get a vaccine.”