Coronavirus Chronicles — The Tale of Two Bullies

Childhood obesity was swaggering around, bragging about the threat it represents to humanity, when along came COVID-19 and said, “Hold my beer.” But rather than become rivals of each other, the two joined forces, the better to cause maximum damage. Of course, each aggressor has other allies.

Via social media, medical student and Ph.D. candidate Robert Rosencrans voiced his commentary on a study not of COVID-19, but of the flu known as H1N1, which behaves similarly in some ways. Rosencrans wrote,

Much rhetoric around obesity as a critical pre-existing condition for Covid-19. A key lesson from H1N1 epidemic: meta analyses (n=25,189) showed an odds ratio of 1.8 for fatality amongst obese people.

Until they controlled for one key variable.

Smaller bodied people systematically received earlier antiviral treatment than larger bodied people. Controlling for this difference eliminates impact of obesity on H1N1 fatality. Obesity kills, but the critical mediator is not biology, it’s bias.

The modifiable variable here is not peoples’ sizes. It’s provider behavior.

Food for thought. And proof once more that some problems, whether we like it or not, are multifactorial in ways that point accusatory fingers.

The enemy within

Among mental health professionals, it is generally accepted that eating disorders (along with many other self-harming behaviors) constitute an attempt by the patient to exert some modicum of control over life’s exhausting changes. The strongly-opinioned writer known as Róisín S. says,

We cannot rely on getting rid of an eating disorder whilst coping with the same circumstances that enabled the illness to develop in the first place. We must also build a treatment model that centres the patient and their complex experiences.

That first sentence embodies the most formidable challenge in the field of child obesity prevention. A child’s circumstances are the home and the parents. If that is where the illness developed, the prognosis cannot be hopeful unless the parents are ready and willing to do some work.

Any treatment program that is not 100% parent-backed will definitely face a struggle. Short of removing morbidly obese children from their homes — and that comes with its own set of traumas — very little can be done by even the most benevolently-intentioned therapist or state.

Of course, parents are not always 100% to blame. For the most part, they are not at cause. At the moment, most families have limited choice in the areas of cohabiting, shopping, eating, learning, entertainment, transportation, and physical exercise. You name it, and it is a problem for someone.

Journalist Agnieszka de Sousa gives a perfect example of how COVID-19 promotes obesity:

When Britain went into lockdown, market stalls closed and shoppers were told to limit outings for essentials at stretched supermarkets. Lynn, a 38-year-old mother of four who relies on state support, could no longer scour her neighborhood in east London for the best bargains on apples or milk. With her options limited, she’s put on almost 30 pounds (14 kilograms) since March.

It’s no secret that the cheapest food in the western world is often the stuff that’s worst for you: fast meals and ultra-processed food, usually loaded with salt, fat and sugar. For the poorest, it’s typically what they can afford, and that’s only grown more acute during the coronavirus pandemic.

The virus and the food insecurity landscape conspire to cultivate eating disorders, some of which lead to obesity, and the virus has a special fondness for obese victims. What is more, this dire situation transpires in the United Kingdom, a place highly conscious of its dedication to reversing the obesity trend.

Your responses and feedback are welcome!

Source: “Eating Disorder Treatment is Broken, and Only Abolition Can Fix It,” Medium.com, 08/30/20
Source: “Weight gain is new problem of poor in rich nations as Covid puts healthy diet out of reach,” ThePrint.in, 09/09/20
Image by Átomo Cartún/(CC BY-SA 2.0)

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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:

Presentations

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.

Food & Health Resources