The World Health Organisation has urged politicians to act urgently on obesity after a new study found a “dramatic” correlation between Covid death rates and excess weight.
The research by former Public Health England and WHO adviser Dr Tim Loebstein reveals that coronavirus deaths are 10 times higher in countries where more than half the population is overweight.
Published to mark World Obesity Day on March 5, the study shows that 2.2m of the 2.5m (90%) Covid-19 deaths are in nations with high levels of obesity.
The World Obesity Federation, which commissioned the study, said that the “dramatic” correlation showed “hundreds of thousands” of deaths could have been avoided with better public health policies.
The UK has the third highest death rate in the world and the fourth highest obesity rate (184 deaths per 100,000 and 63.7% of adults living with obesity according to WHO data), followed by the United States of America (152.49 deaths per 100,000 and 67.9% living with obesity).
By contrast, Vietnam has the lowest death rate in the world and the second lowest proportion of its population overweight (0.04 per 100,000 deaths from Covid and 18.3% adults overweight, according to WHO data).
Not a single nation with low levels of obesity had more than 10 deaths per 100,000 people, while no country with death rates above 100 per 100,000 had less than 50% of their population overweight, the report said.
The new analysis also shows that overweight populations are much more susceptible to respiratory diseases generally, with outcomes significantly worse for people living with obesity during the MERS and H1N1 epidemics.
WHO director general Dr Tedros Adhanom Ghebreyesus said the evidence was now “clear and compelling” and the report “must act as a wake-up call to governments globally”.
Writing for HuffPost UK, former Labour deputy leader Tom Watson said that the “landmark” report showed that Boris Johnson had to devise long-term programmes to tackle deprivation, strengthen regulation of the food industry and boost public health policies.
Watson said that for too long politicians had treated the issue as a matter of personal responsibility versus “the Nanny state”.
“The root causes of obesity are complex: just telling people to eat less and move more won’t cut it. The drivers are often deprivation, affordability of food, genetic and mental health factors, lack of healthy food choices and lack of nutrition education,” he said.
“With a food industry intent on marketing and selling as much lousy fat and high sugar products as they can get away with, it’s up to governments to use the levers that only they have to address the root causes.”
Age has been the predominant focus of analysis of risks of hospitalisation and death to date, but the Lobstein report shows for the first time that overweight populations come a close second.
Professor Lobstein said: “We now know that an overweight population is the next pandemic waiting to happen.
“Look at countries like Japan and South Korea where they have very low levels of Covid-19 deaths as well as very low levels of adult obesity. They have prioritised public health across a range of measures, including population weight, and it has paid off in the pandemic.”
Around one in three UK adults is clinically obese with a BMI (body mass index) over 30, one of the highest rates in the western world.
Boris Johnson has declared that he was “too fat” and “way overweight” when he was admitted to intensive care last April as he battled Covid-19 and was put on oxygen. He has since launched a new obesity strategy but critics say it still fails to go far enough.
The study by Lobstein analyses the latest mortality data from Johns Hopkins University and WHO Global Health Observatory data on obesity.
Following speculation about the difference in death rates between Asian and western countries, as well as low income and high-income countries, the report suggests that healthy weight is a common denominator in keeping death rates low – and that any excess body weight is likely to impact the severity of Covid-19 in a patient.
It also reveals the economic costs of preventing health services being overrun through lockdowns could have been significantly mitigated if governments had tackled population weight issues before the pandemic.
Of the $28tn (£20tn) IMF projected global cost in lost economic output worldwide up to 2025, at least $6tn (£4.3tn) will be directly attributable to the issue of populations living with excess weight.
“This report must act as a wake-up call to governments globally,” said Dr Ghebreyesus.
“The correlation between obesity and mortality rates from Covid-19 is clear and compelling. Investment in public health and co-ordinated, international action to tackle the root causes of obesity is one of the best ways for countries to build resilience in health systems post-pandemic: we urge all countries to seize this moment.”
Johanna Ralston, CEO of the World Obesity Federation, said: “Old age is unavoidable, but the conditions that contribute to overweight and obesity can be highly avoidable if governments step up and we all join forces to reduce the impact of this disease.
“The failure to address the root causes of obesity over many decades is clearly responsible for hundreds of thousands – perhaps millions – of preventable deaths.”