Patty Nece has not been in a store for a whole year.
Although most Virginia businesses reopened in July and grocery stores opened throughout the pandemic, the 62-year-old has not dared to step inside since March last year because her obesity put her at risk for severe COVID-19.
Due to her illness, she was able to get the vaccine and had an appointment for her first dose on Wednesday. While she is looking forward to being vaccinated, she is also disappointed that some Americans have criticized people with obesity who prefer to get the vaccine.
“It shows a misunderstanding … weight is not always within your control,” said Nece, who also chairs the Obesity Action Coalition. ‘Like many diseases, there is personal responsibility, but it is not the end. The mantra of eating less and moving more – which I have heard all my life – is not the answer. ”
In one case, a news anchor for WTTG-TV in Washington, DC, sent a tweet criticizing health officials for prioritizing obesity patients for the vaccine.
“I am irritated by obese people of all ages to have access to vaccines in front of all essential workers,” Blake McCoy in the tweet since removed. “Vaccinate all essential workers. Then obese. ”
The local station told the New York Daily News McCoy was “suspended pending further review” after the offensive tweet was deleted and apologize on Twitter, but health experts say it’s another example of how weight bias permeates the health care system and American society.
Obesity and COVID-19
About 40% of adult Americans have obesity, according to Centers for Disease Control and Prevention data from 2018. Studies have shown that people with obesity are more likely to have worse results from COVID-19 than others with a lower body mass index (BMI).
Researchers at the University of North Carolina at Chapel Hill found people with a BMI above 30 had a 113% higher risk of hospitalization, a 74% higher risk of admission to ICU and a 48% higher risk of death, according to a study published in August. 2020 in obesity assessments.
Initially, health experts believed that people with obesity were at greater risk for severe COVID-19, as the disease was also associated with numerous underlying risk factors, including hypertension, heart disease, type 2 diabetes, and chronic kidney and liver disease.
However, after examining these factors, researchers found that people with obesity still had a higher risk for COVID-19, Dr. Rekha Kumar, medical director of the American Council for Obesity Medicine and associate professor of clinical medicine at Weill Cornell Medicine, said. This may be due in part to the excess adipose tissue causing more inflammation, she said.
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“People’s bodies are increasing such a severe inflammatory response (to COVID-19), and the response already exists at a baseline in obesity,” Kumar said. “So if you add another stimulus, they get even sicker.”
Some patients may also suffer from hypoventilation syndrome from obesity, a respiratory disorder that causes someone to have too much carbon dioxide and too little oxygen in their blood, according to the National Heart, Lung and Blood Institute.
“It does not come by carrying the weight,” said dr. Ethan Lazarus, elected president of the Society for Obesity Medicine, said. “Their lungs are restricted so they can’t expand to get the oxygen they need.” This further puts them at risk for COVID-19 complications.
Patients with obesity also have a weakened immune system, according to health experts, which not only makes them more susceptible to infectious diseases, but also makes it harder to ward them off.
Obesity can alter the metabolic state of immune cells and their function, said Dr. Nancie MacIver, associate professor at Duke University School of Medicine, said. The excess inflammation may be an indication that the immune system is dysfunctional.
Obesity and the COVID vaccine
Altered immune systems by obese patients have led experts to be concerned about their response to the COVID-19 vaccine, especially since past studies have suggested that they may not respond as well to flu vaccines.
Researchers at UNC Chapel Hill found that nearly 10% of obese patients were infected with influenza, compared to about 5% of participants with lower BMI, according to a study published in the International Journal in 2017 of Obesity.
But health experts say obesity patients should not be discouraged, and urge them to get the COVID-19 vaccine when it is available.
“People need to understand the difference between inefficient and diminished efficiency,” Kumar said. “Even if a vaccine works less, it’s still better than someone critically ill in an ICU.”
Nece is concerned that others like her may be a patient with obesity during the pandemic due to decades of weight bias in the healthcare system.
Week for Obesity Awareness and Weight Bias
Weight bias in the medical environment manifests itself in a myriad of ways, from bad gowns and weighing patients in public, to a misdiagnosis of a life-threatening illness due to a doctor’s inability to get past someone’s weight look.
James Zervios, vice president of marketing and communications at the Obesity Action Coalition, after years of weightlifting and bad experiences, has integrated into the doctor’s offices and prejudiced to avoid treatment or preventative care.
Nece delayed her mammogram by 15 years to avoid the stress and embarrassment of a doctor’s visit.
“You get tired of going,” she said. “You get tired of the shame and guilt that is placed on you and it does not help.”
Advocates like Zervios and Nece want to make people aware during obesity care week, which ends on Saturday, that obesity is not just a behavioral disease and can be influenced by genetics, hormones and even medication.
They also appeal to those suffering from obesity to seek help from healthcare providers despite weight bias, especially during the pandemic.
“We encourage people to remember that they are worth what they deserve, and that they do not consider the prejudice,” Zervios said. “Everyone deserves to be treated with dignity and respect.”
Follow Adrianna Rodriguez on Twitter: @AdriannaUSAT.
Health and Patient Safety Coverage in USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.
This article originally appeared on USA TODAY: COVID vaccine: CDC, states prioritize people with obesity. Here’s why.