Coronavirus Chronicles — Odious Obesity in League With Calamitous COVID-19

Yes, once again we imagine two contemporary plagues as a couple of evildoers who have discovered that working together is of great mutual benefit. We have been tracking the ways in which COVID-19 and obesity do little favors for each other that pay big dividends to both of them.

In tune with the theme of criminal conspiracy, a recent study on pediatric obesity and food insecurity calls these evildoers “a double whammy” right up there in its title. The report summary says,

The COVID-19 pandemic exerts disproportionate burden on low-income children and families, magnifying their vulnerability to both food insecurity and pediatric obesity.

This matters to politicians, advocates, voters, and hungry kids, because federal efforts like the Supplemental Nutrition Assistance Program (SNAP) are a big part of the battle for good nutrition and food security. It matters to the clinician who, when assessing patients, needs to implement an ethical and tactful method of screening for food insecurity. Just like temperature, pulse rate, and blood pressure, some call hunger one of the vital signs.

In some quarters, asking parents whether they are able to succeed in feeding their children is considered disturbingly intrusive. The American Academy of Pediatrics handbook on the subject devotes a chapter to “Tips from Practitioners on How to Address Food Insecurity in a Sensitive Manner.” Privacy, of course, is paramount. It is even advised that the children be in a different room or distracted when parents are interviewed on this volatile topic.

Another rule is, don’t make assumptions. In many practices, it will not be a physician asking for information, so it is important that staff members are well-versed in tactful yet effective questioning. The food insecurity assessment can do four important things:

  1. Help overcome the stigma of food insecurity.
  2. Tailor clinical care to real patient needs.
  3. Identify a vulnerable target population.
  4. Connect food insecure individuals to resources.

The terrible twosome owns a different agenda. COVID-19 and obesity each seek opportunities to soften up potential victims for the other. They have been having their way too long. To make sure that people are sufficiently nourished is a public good, because here is the thing about household food insecurity: As its severity increases, total healthcare costs rise. In many cases, those costs are borne by the taxpayers, so there is an important consideration for the country’s financial stability.

Food insecurity can mask underlying health conditions, cause misdiagnosis, and affect medication adherence. It can also contribute to increased emergency room use, and prolong hospital stays — and now we’re talking about real money.

Even worse, many of the people affected, and that means mainly children, don’t get healthcare at all because of the affordability factor. To ignore these basic needs is to help obesity gain ground, because sick patients are unlikely to run around the local track, or even do situps on the living-room floor. What they are likely to do is remain immobile and eat an even less healthy diet than usual. To brush these basic needs under the rug is to help the virus, because it thrives on obese bodies. Much of our trouble is avoidable.

Your responses and feedback are welcome!

Source: “Food Insecurity and Pediatric Obesity: a Double Whammy in the Era of COVID-19,”, 10/16/20
Source: “Addressing Food Insecurity: A Toolkit for Pediatricians,”, February 2017
Source: “Food insecurity screening,”, undated
Image by Miss T. Moore and M./CC BY-ND 2.0

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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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