While the U.S. Centers for Disease Control and Prevention (CDC) advises that people of any age can contract COVID-19, obesity has emerged among the major risk factors for severe cases. With more than 40 percent of Americans classified as obese, experts caution that this is a growing concern.  

“During this pandemic, we’ve learned some interesting facts,” said Karl Strom, M.D., medical director of the Center for Advanced Bariatric Surgery at Mountainside Medical Center. “We’ve found that obesity, diabetes and hypertension are significant factors in how patients are affected by COVID-19, which means those who have one of these three co-morbidities may have poorer outcomes or more intense hospitalizations. However, there are success stories of patients who have contracted the virus and because they previously lost more than 100 pounds, they were able to stay at home and be treated as outpatients, adding another benefit to weight loss.”

What does it mean to be obese?

Obesity occurs when a person has a higher level of body fat. A tool to determine whether a person is obese is measuring body mass index, or BMI. Calculated from height and weight, if a person has a BMI of 30 or higher, he or she is considered obese. A BMI of 40 or higher indicates extreme or severe obesity.

“If someone has a BMI of 40, this typically means they are about 100 pounds over their ideal body weight, which makes them a candidate for weight loss surgery,” said Dr. Strom. “It’s not only the obesity, it’s the other diseases that result from obesity that are concerning.”

According to the U.S. National Institute for Diabetes and Digestive and Kidney Diseases, health risks associated with obesity include type 2 diabetes, high blood pressure, heart disease, stroke, sleep apnea, fatty liver disease, osteoarthritis, gallbladder disease and more. “All of these diseases have a connection to obesity,” said Dr. Strom. “And if we could eliminate obesity altogether, these conditions could go away.”

In fact, the CDC suggests losing just five to 10 percent of body weight can greatly benefit a person’s health by improving blood pressure, blood cholesterol and blood sugars. “On average, patients who come to see me are between 40 and 50 years old,” said Dr. Strom. “Imagine being on 10 to 12 medications per day and then learning from your doctor one day that you no longer need to take those medications simply because you are losing weight. That is phenomenal!”

What are weight loss options?

While the healthy combination of diet and exercise are always recommended for weight loss and management, surgical weight loss options are available for those who have struggled with long-term weight gain.

“Losing weight is hard, and there isn’t an easy solution,” said Dr. Strom. “When you have bariatric or weight loss surgery, it’s a commitment. Not only do you and your doctor choose the right procedure for you, but you’ll work with a dietitian to change your eating habits, learn exercises that are right for you and attend support groups to help answer any questions you might have along your weight loss journey.”

Surgical weight loss options include:

• Laparoscopic sleeve gastrectomy – The most common procedure performed today, this surgery divides and removes a portion of the stomach that contains hormones attributed to feelings of hunger. A very long, narrow column, which resembles the shape of a banana, is then created, which allows you to feel full while eating less food. “Compared to gastric bypass, patients who undergo this procedure do not experience malabsorption of nutrients or severe vitamin deficiencies,” said Dr. Strom. “If compliant with diet, exercise and support groups, I’ve seen patients lose 60 to 70 percent excess body fat in the first year following the procedure.”
• Laparoscopic adjustable gastric band – In this surgery, an adjustable collar or band is placed around the upper portion of the stomach. As food is digested, the collar or band acts like a funnel, allowing food to trickle through slowly. “As weight loss occurs, the funnel opening gets a little bigger, which allows food to travel faster and slow weight loss down,” said Dr. Strom. “In my office, I am able to make adjustments to tighten the band, which are usually done in the first year about every six weeks.” With this surgery, there is slower weight loss without the occurrence of vitamin deficiencies.”
• Roux-en-Y gastric bypass – For this procedure, which is a major surgery, the size of the stomach is decreased and a new digestive route is created between the stomach and small intestine. “In gastric bypass, a person achieves weight loss through a combination of a smaller stomach and malabsorption of nutrients,” said Dr. Strom. “The downside of malabsorption is that you can develop vitamin deficiencies, and there is the possibility of complications and side effects.”

Next Steps and Additional Resources

While anyone can be affected by obesity, the good news is there is hope. “One of the most rewarding things for me as a bariatric surgeon is to see how weight loss surgery changes lives and has many commenting, ‘I wish I had done it sooner,’” said Dr. Strom.