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Experts are calling on the food industry to make systemic changes to help ease the obesity pandemic during the COVID-19 pandemic. Getty Images
  • Researchers say the COVID-19 pandemic and the obesity epidemic overlap, and they’re calling on the food industry to help people eat healthier diets.
  • One expert said there are three D’s that produce barriers to change in the American diet: denial, dollars, and discrimination.
  • Experts say people should try to avoid the impulse to fill up on low-quality foods during the COVID-19 pandemic and instead shift to healthier diets.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date.

The COVID-19 pandemic is being exacerbated by the obesity epidemic, and food industries around the world are to blame.

That’s what researchers from Queen Mary University of London are saying in an editorial published this week in The British Medical Journal.

Obesity is a risk factor for high blood pressure, type 2 diabetes, heart disease, stroke, and cancer. It’s also an independent risk factor for severe illness and death from COVID-19.

The researchers said that 65 to 70 percent of adults in the United Kingdom and United States are overweight or have obesity.

“Clear evidence has emerged that the two pandemics interact,” said Monique Tan, PhD, a co-author of the study and researcher at Queen Mary University of London. “One immediately, COVID-19, and the other a longer-term crisis with obesity.”

The authors are calling for the food industries around the world to immediately stop promoting unhealthy foods and drinks, and for governments to begin forcing the reformulation of such products. They say taxation attempts aren’t enough.

“This is a major opportunity for governments and the food industry to prevent unnecessary suffering and death worldwide,” Dr. Tan told Healthline. “Doing nothing and failing to create much needed change should not be an option.”

Researchers said top-down change is critical because the obesity epidemic isn’t the fault of individuals.

“It’s the result of living in a food environment where it is very difficult not to overconsume calories, putting us at a much higher risk of type 2 diabetes, strokes, heart disease, cancer, and now COVID-19,” Tan said.

“We urgently need governments worldwide to seize the opportunity to help people to eat more healthily,” she added.

Tan said this means “enforcing measures to restrict the promotion, marketing, and advertising of unhealthy foods and ensuring their reformulation to contain far less sugar, saturated fat, and salt.

“This would reduce susceptibility to this vicious virus and many other chronic diseases,” she explained.

The novel coronavirus has changed many aspects of everyday life, but experts don’t foresee it creating a lasting change on a personal health level without systemic change.

Dr. Stacy Brethauer, a general surgeon specializing in bariatric surgery at The Ohio State University Wexner Medical Center, summarizes the intersecting issues creating barriers to reducing the obesity rate with three D’s: denial, dollars, and discrimination.

Denial

Brethauer told Healthline that even though people with obesity are at higher risk for severe symptoms and mortality if they develop COVID-19, he doesn’t believe that risk alone will change behavior.

“Unfortunately, there’s a lot of denial when it comes to obesity, and many people with obesity don’t confront this problem as they would other medical conditions,” he said.

“People who are obese often don’t realize it or consider themselves only overweight,” he explained.

“Even patients with obesity who know these risks often don’t seek effective treatment, so I can’t imagine that the additional risk associated with COVID-19 will have an impact on this behavior either,” Brethauer said.

However, denial isn’t simply self-created. It’s also systemic.

“This really goes back to the idea that people with obesity think they have to treat it themselves by repeatedly dieting or doing things that clearly don’t work long term,” said Brethauer.

He added that many physicians still deny obesity is a chronic disease, even though the American Medical Association declared it to be one in 2013.

Those doctors don’t have appropriate conversations with their patients about obesity or don’t refer them for medical therapy or surgery to treat it.

As such, Brethauer explained, more people will die prematurely due to obesity or obesity-related cardiovascular disease than will die of COVID-19.

Dollars

“Dollars” relates to the barriers that insurance companies put in place to make obesity treatment affordable.

“Whether it’s behavioral therapy, medication, or surgery, there are many insurance plans that have exclusions for obesity treatment,” said Brethauer.

“Also, the dollars necessary to raise awareness at the national level and change policy are not there, and therefore the problem is not addressed on the appropriate scale,” he said.

Akua Woolbright, PhD, national nutrition director for Whole Cities Foundation, the nonprofit arm of Whole Foods, has made it the focus of her career to show people how to harness the healing power of food to combat and reduce chronic illnesses.

Dr. Woolbright said obesity, food deserts, and food swamps play active roles in the COVID-19 pandemic.

The U.S. Department of Agriculture Economic Research Service classifies urban census tracts as food deserts if at least 33 percent of the population reside more than 1 mile from a supermarket or large grocery store. In rural areas, the distance is more than 10 miles.

“Individuals who live in food deserts, especially those who lack reliable transportation or other ways to access fresh produce and other healthy foods, often rely on fast food restaurants, convenience stores, or other neighborhood retailers,” she said.

“Foods purchased from these types of locations tend to be high in calories, fat, sugar, and salt, and low in important nutrients, and consuming empty calories with little nutritive value can lead to obesity and chronic diseases,” Woolbright told Healthline.

Food swamps, on the other hand, are areas where access to fast, nutritionally deficient, and convenience foods outpaces access to healthy food options.

“Many Americans are living in ZIP codes that would simultaneously be categorized as both a food desert and a food swamp,” she said.

“While much of the focus has been on the prevalence of obesity in food deserts, according to recent research, individuals who live in food swamps are at an even greater risk,” Woolbright added.

Discrimination

“There’s still a lot of discrimination in society, the workplace, and in healthcare toward patients with obesity,” said Brethauer.

“As long as obesity is thought of as a personal weakness or failure of willpower instead of a chronic disease, we will not change the course of this disease,” he said.

Brethauer noted that obesity often prevents people from advancing socially and professionally. It can also discourage people from pursuing treatment or demanding appropriate therapy from their physicians.

“To get the necessary research funding, educational programs, and policy changes implemented, leadership at every level must recognize obesity as a problem that costs our society a great deal and cannot be ignored any longer,” he said.

Woolbright noted there are a number of systemic barriers to positive health outcomes, such as lack of access to quality housing, disposable income, medical care, and walkable communities.

However, she said many people she encounters at work are successfully overcoming these barriers.

“When I first started teaching community healthy eating classes, I was cautioned that many residents do not have access to the resources needed to adopt and maintain major lifestyle changes,” Woolbright said.

“However, I have found that people are getting creative about ways to access fresh, healthy foods,” she added.

“They are scouting out farmers markets and farm stands, starting community gardens, growing food in their backyards, canning, participating in their local community-supported agriculture, and organizing ride shares to major grocery stores.

“As we learn about the role that pre-existing conditions like obesity and chronic diseases play in the severity and recovery of COVID-19 cases, many people are becoming motivated to get and stay healthy,” said Woolbright.

“They’re interested in learning about ways they can fortify their immune systems and improve their health outcomes,” she told Healthline.

“For those who do contract the virus, the goal becomes to beat it and rebound quickly. Having a strong immune system is one important part of the healing process.”

Experts say that while policy and regulation changes are needed to tackle the obesity epidemic, we will most likely continue to be inundated with foods that lack nutritional value.

And with the stress and lifestyle disruptions associated with the current COVID-19 pandemic, most experts express concern that obesity rates may increase.

“The long-term effects of COVID-19 are largely unknown at this time,” said Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California.

“In my opinion, there will be lingering effects that will negatively impact obesity rates,” he told Healthline.

“Many people are out of work with severe disruptions in many industries. Therefore, the primary concern is not on improving one’s health, but on just being able to provide for the family,” Ali said.

“Unfortunately, fast, fried, and caloric-dense foods are easier to obtain and typically cheaper to buy than healthy alternatives,” he added.

Ali noted that people tend to turn to food for comfort during difficult times, but it’s unfortunately unhealthy food. In addition, alternatives to cheap, fast food can be hard to find.

And with gyms and some outdoor activities being unavailable or severely curtailed, there are fewer exercise options.

Ali explains the ongoing shift toward more sedentary lifestyles is a major barrier to reducing obesity rates, especially with COVID-19 and more people working on computers from home.

There are always individual actions we can take to improve our health outcomes.

Woolbright said it’s important to avoid the impulse to fill up on foods with low nutritional value and to instead channel those emotions into positive lifestyle practices.

“This is particularly important for individuals who are in high risk categories,” she said.

“When looking for ways to improve public health, it is important to consider that restricting unhealthy foods and/or increasing access to quality foods may not be enough,” she added.

It takes more than COVID-19 or any one policy or regulation change to tackle this parallel pandemic.

“Some research has shown that changes in access are most effective in influencing behavioral modifications when accompanied with ongoing nutrition education and support,” Woolbright said.