Let’s cut to the chase.
Telling people to “lose weight” to survive COVID-19 is in really bad taste and stupid as well, because it:
1) Won’t work if “you will die early from heart disease, cancer, or diabetes after a life of low physical functioning and ugliness” hasn’t already;
2) Is barely actionable on pandemic timescale. “You have a month to live before you die of COVID” is not actionable for most people who are substantially overweight;
3) There is no evidence that weight loss will even achieve improved resistance to infection or complications, even if being lean is associated with lower risk for complications;
A – Is a lean person who used to be fat at the same lower risk as a person who has always been lean?
B – If there is an immunity benefit to weight loss, how long does it take being lean to see that benefit?
C – How substantial is that benefit?
We know the answer to none of these. Yet that doesn’t stop many people from making recommendations.
4) The reasons for the obesity epidemic are structural, not individual. Exhorting individual people to lose weight is not going to cause a population-level decline in obesity. In other words, the methods are not in line with the stated goals.
The popular, individualistic approach to lifestyle by diet gurus is not based in genuine concern with fixing the problem but is based instead on the goal of perpetuating the dieting industry, promoting diet agendas, and getting attention (cf. Aseem Malhotra).
5) Even modest weight loss has been shown to impair immunity in the short-term:
This study found that only a 10-kilogram loss resulted in a substantial decline in immunity.
It could be, in other words, that weight loss efforts in the midst of a pandemic could have counterproductive effects and actually increase the risk of death from the disease; just because a STATE might be protective does not mean that the TRANSITION STATE to that state is so.
Most of the people pushing the obesity-COVID19 narrative are cranks, who have never been science-based, with books and agendas to sell. They are not serious-minded people who have been working with policymakers and researchers. In fact, they systematically denounce and revile us.
These people–Noakes, Malhotra, Saladino, Ornish, and others–are using COVID-19 as an opportunity to increase business, their ideological agenda, and get attention. By fearmongering people during a pandemic.
Think about that for a second.
Some of them, if nuclear bombs were dropped in their respective countries and half the population wiped out, would either ignore this and continue tweeting about processed food, or find some way to tie nuclear fallout into tweets denouncing processed food.
These people are obsessive, maniacal, shameless, and stupid. Yes, being leaner and healthier is associated with lower risk of severe complications from COVID. The discussion ends there.
Obesity is a serious problem, and fixing it could drastically improve the health of so many. This is *the* reason I became interested in nutrition.
But the time to fix obesity is not during an infectious disease pandemic, and anyone who thinks so needs to seriously ponder the integrity of their judgment.
There is no doubt that obesity is an important risk factor. But again we have to ask what the solution is.
And we know it: “buy my book.”
It’s never: “we need to formulate and implement policies that can improve people’s health on a population level.” This is going to be the only way that we make a dent in obesity.
The rest is marketing.
A question and an answer.
Q. Is it possible that converting to a super clean diet would decrease systemic inflammation enough to cause a positive immune response? I’m just a landscaper so be gentle on me
A. This is hard to say because the immune system cuts both ways in COVID-19. At the beginning, having a robust immune response might make the disease better, while at the end, having a robust immune response is what is causing death. Correspondingly, the pharmaceutical testing strategy has been focused on enhancing both: helping the immune system clear or stop the virus, as well as dampening the immune system at the end. Take-home: we don’t understand the best way to intervene in the relationship between the immune system and COVID-19 super well. Suffice to say: being healthier might make you more resilient. But rapid or unhealthy weight loss might make things worse. Or it could be the exact opposite. We simply don’t know.