Coronavirus Chronicles — Things Are Different, and Not in a Good Way

Previous to the pandemic, most people went grocery shopping in person — whether at a chain supermarket, neighborhood store, or the farmers’ market. In most cases, this activity involved some amount of action. Walking from the parking lot (or even from home) to the building, walking around inside the building, walking from table to table in an outdoor setting — all these endeavors help to burn a few calories, and while they are eating-related, they don’t necessarily need to involve actual eating.

But now, a lot of Americans have had to join the online shopping crowd, and don’t much care for it. Many times, the food items they want are not available, and the choices that are available will not be delivered for day or weeks. The frustration causes emotional distress, and one reliable way to assuage that is to eat whatever is available at the moment, and plenty of it.

The sense of deprivation leads to irrational and self-defeating acts. A person might make a plan: “When my cookies arrive, I will open the box and divide them into ten small baggies, and ration them out to last for days.” She or he might even go so far as to actually carry out that allotment into separate little packages — and then devour all the cookies before midnight.

As always, money matters

Another problem with ordering groceries electronically is that the stores don’t accept payment from the Supplemental Nutrition Assistance Program (SNAP, aka “food stamps”) although a few states have some kind of pilot program in the works. But by and large, the most economically disadvantaged households are barred from this form of shopping.

Even for families that can pay their bills, online shopping costs about 10% more than going to the store. So the general level of food insecurity rises, and people react unreasonably, by following an instinct to eat whatever is available for fear that tomorrow there will not be anything to eat.

Health statistics

Obesity is a known risk factor for cardiovascular disease, and has been tentatively associated with cerebrovascular disease. The connection with hypertension is also there, and with diabetes. COPD (chronic obstructive pulmonary disease) is also complicated by obesity.

As it turns out, all these conditions are also associated with the severity of COVID-19 if a person falls ill with the virus, and decrease the odds of the patient’s eventual ability to recover. (Studies suggest that obese people are in general more vulnerable to infections diseases, and even that influenza vaccines do not afford them the same protection as others achieve.)

It begins to look as if obesity is an important predictor of severity. Obese people who catch the virus are more likely to need hospitalization and more likely to die. In contravention of the general truth that older people are more vulnerable to the virus, “young adults with obesity appear to be at particular risk” says The New York Times writer Roni Caryn Rabin about new and ongoing studies.

The dreaded multifactorialism comes into play, according to Dr. Matthew Hutter of Massachusetts General Hospital, who says:

Conventional wisdom has traditionally explained excess weight as a simple caloric imbalance that can be addressed by eating less and exercising more. Prominent medical groups have reconsidered their approach, however, and now recognize obesity as a medical disorder caused by a complex web of underlying factors, which in turn predisposes people to other serious medical problems.

Although the obesity rate for American adults is 42%, in New York City that number is only 22%, suggesting that New York’s terrible virus total would be quite a lot worse if not for the relative fitness of its inhabitants. Once hospitalized, the obese patient is more difficult to intubate, and imaging technologies do not work as well.

Studies in both France and the southern United States show that obese patients are almost twice as likely to require mechanical ventilation, which may not even be available. If a machine is available, an obese patient might have reason to fear being denied a ventilator by the triage process, because scarce machines can be put to better use helping patients with a higher likelihood of recovery.

Your responses and feedback are welcome!

Source: “The Real Reason It’s So Hard to Order Groceries Online Right Now,”, 04/23/20
Source: “Meta-Analyses Reveal Who Should Be More Cautious of COVID-19,”, 04/12/20
Source: “Obesity Linked to Severe Coronavirus Disease, Especially for Younger Patients,”, 04/16/20
Image by Cityswift/(CC BY 2.0)

2 Responses

  1. As schools build their remote teaching capacity, they should make physical education a priority, with home lesson plans for physical activity and/or streaming exercise classes. Because staying at home during the Pandemic May Contribute to Obesity.

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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