Society for Endocrinology



left-36868700SFE statement regarding issues specific to obesity management during the COVID -19 pandemicThe worldwide spread of the novel coronavirus, COVID-19, has developed into an ongoing pandemic with the continued loss of life. This presents significant challenges to society including those of us working in healthcare and will especially impact individuals with some chronic conditions. Obesity is a risk factor for COVID-19 disease severity, including intensive care admission and mortality.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/obr.13128","ISSN":"1467-7881","abstract":"The linkage of individuals with obesity and COVID-19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID-19, 75 studies were used to conduct a series of meta-analyses on the relationship of individuals with obesity–COVID-19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID-19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID-19 positive, '46.0% higher (OR = 1.46; 95% CI, 1.30–1.65; p ' 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74–2.60; p ' 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46–2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22–1.80; p ' 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID-19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID-19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.","author":[{"dropping-particle":"","family":"Popkin","given":"Barry M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Du","given":"Shufa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Green","given":"William D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Beck","given":"Melinda A.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Algaith","given":"Taghred","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Herbst","given":"Christopher H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alsukait","given":"Reem F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alluhidan","given":"Mohammed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alazemi","given":"Nahar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shekar","given":"Meera","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Obesity Reviews","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2020","11","26"]]},"publisher":"Blackwell Publishing Ltd","title":"Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships","type":"article-journal","volume":"21"},"uris":[""]}],"mendeley":{"formattedCitation":"[1]","plainTextFormattedCitation":"[1]","previouslyFormattedCitation":"[1]"},"properties":{"noteIndex":0},"schema":""}[1] The epidemiological evidence is clear and biological mechanisms linking obesity and COVID-19 have been proposed.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1161/CIRCULATIONAHA.120.047659","ISSN":"15244539","PMID":"32320270","author":[{"dropping-particle":"","family":"Sattar","given":"Naveed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McInnes","given":"Iain B.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McMurray","given":"John J.V.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Circulation","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2020","7","7"]]},"page":"4-6","publisher":"Lippincott Williams and Wilkins","title":"Obesity Is a Risk Factor for Severe COVID-19 Infection: Multiple Potential Mechanisms","type":"article","volume":"142"},"uris":[""]}],"mendeley":{"formattedCitation":"[2]","plainTextFormattedCitation":"[2]","previouslyFormattedCitation":"[2]"},"properties":{"noteIndex":0},"schema":""}[2] Overweight and obesity affect 63% of adult population and 20% of year 6 children have obesity in the UK.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"URL":"","accessed":{"date-parts":[["2019","5","16"]]},"author":[{"dropping-particle":"","family":"NHS Digital","given":"part of the Government Statistical Service","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["0"]]},"title":"Statistics on Obesity, Physical Activity and Diet, England, 2019","type":"webpage"},"uris":[""]}],"mendeley":{"formattedCitation":"[3]","plainTextFormattedCitation":"[3]","previouslyFormattedCitation":"[3]"},"properties":{"noteIndex":0},"schema":""}[3] National strategies aimed at reducing COVID-19 infection rates have for some people promoted weight gain. Public Health England (PHE), and key stakeholders including patient groups, have produced a detailed report highlighting the impact of the pandemic on people with obesity and the provision of obesity services.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"URL":"","accessed":{"date-parts":[["2020","10","21"]]},"id":"ITEM-1","issued":{"date-parts":[["0"]]},"title":"Excess weight and COVID-19: insights from new evidence - GOV.UK","type":"webpage"},"uris":[""]}],"mendeley":{"formattedCitation":"[4]","plainTextFormattedCitation":"[4]","previouslyFormattedCitation":"[4]"},"properties":{"noteIndex":0},"schema":""}[4] Services aimed at supporting people with the most clinically severe obesity include Tier 3 (multidisciplinary team delivered services) and Tier 4 (bariatric surgery). These services are often based within the NHS and the redeployment of staff as well as the reduction in elective clinical activity to meet the demand for COVID-19 may have particularly affected these services. The provision of current obesity services is insufficient, and the impact of COVID-19 has further exacerbated this problem. The government has made announcements aimed at reduced new onset obesity as well as pledging to increase the services available to treat people living with obesity who are seeking weight loss. These announcements are welcomed though any increase in services may take some time to deliver.Services that have been able to adapt throughout COVID-19 have typically been delivered virtually either through digital platforms or on the telephone. Whilst digitally delivered services have been accepted by many the PHE report and our own experiences have highlighted that there is a risk of exacerbating health inequalities with over reliance on digital platforms. This may disadvantage certain patient groups including those for whom English is not a first language.COVID-19 is ongoing and there are continuing restrictions on society and on the provision of care within the NHS as a result. It is especially important therefore that we work to maintain services as much as possible and adapt to provide treatment to our patients. Examples of good practise have been highlighted within the PHE report.Is obesity a risk factor for contracting COVID-19?Meta-analysis of 20 studies has recently shown that the odds of people with obesity being COVID-19 positive were 46% higher than those without obesity.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/obr.13128","ISSN":"1467-7881","abstract":"The linkage of individuals with obesity and COVID-19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID-19, 75 studies were used to conduct a series of meta-analyses on the relationship of individuals with obesity–COVID-19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID-19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID-19 positive, '46.0% higher (OR = 1.46; 95% CI, 1.30–1.65; p ' 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74–2.60; p ' 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46–2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22–1.80; p ' 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID-19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID-19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.","author":[{"dropping-particle":"","family":"Popkin","given":"Barry M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Du","given":"Shufa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Green","given":"William D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Beck","given":"Melinda A.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Algaith","given":"Taghred","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Herbst","given":"Christopher H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alsukait","given":"Reem F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alluhidan","given":"Mohammed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alazemi","given":"Nahar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shekar","given":"Meera","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Obesity Reviews","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2020","11","26"]]},"publisher":"Blackwell Publishing Ltd","title":"Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships","type":"article-journal","volume":"21"},"uris":[""]}],"mendeley":{"formattedCitation":"[1]","plainTextFormattedCitation":"[1]","previouslyFormattedCitation":"[1]"},"properties":{"noteIndex":0},"schema":""}[1]Is obesity a risk factor for severe COVID-19?Pooled data show that people with obesity have increased odds of ICU admission by 74%, of mechanical ventilation by 66% and 48% of death compared to individuals without obesity. ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/obr.13128","ISSN":"1467-7881","abstract":"The linkage of individuals with obesity and COVID-19 is controversial and lacks systematic reviews. After a systematic search of the Chinese and English language literature on COVID-19, 75 studies were used to conduct a series of meta-analyses on the relationship of individuals with obesity–COVID-19 over the full spectrum from risk to mortality. A systematic review of the mechanistic pathways for COVID-19 and individuals with obesity is presented. Pooled analysis show individuals with obesity were more at risk for COVID-19 positive, '46.0% higher (OR = 1.46; 95% CI, 1.30–1.65; p ' 0.0001); for hospitalization, 113% higher (OR = 2.13; 95% CI, 1.74–2.60; p ' 0.0001); for ICU admission, 74% higher (OR = 1.74; 95% CI, 1.46–2.08); and for mortality, 48% increase in deaths (OR = 1.48; 95% CI, 1.22–1.80; p ' 0.001). Mechanistic pathways for individuals with obesity are presented in depth for factors linked with COVID-19 risk, severity and their potential for diminished therapeutic and prophylactic treatments among these individuals. Individuals with obesity are linked with large significant increases in morbidity and mortality from COVID-19. There are many mechanisms that jointly explain this impact. A major concern is that vaccines will be less effective for the individuals with obesity.","author":[{"dropping-particle":"","family":"Popkin","given":"Barry M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Du","given":"Shufa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Green","given":"William D.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Beck","given":"Melinda A.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Algaith","given":"Taghred","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Herbst","given":"Christopher H.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alsukait","given":"Reem F.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alluhidan","given":"Mohammed","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alazemi","given":"Nahar","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shekar","given":"Meera","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Obesity Reviews","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2020","11","26"]]},"publisher":"Blackwell Publishing Ltd","title":"Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships","type":"article-journal","volume":"21"},"uris":[""]}],"mendeley":{"formattedCitation":"[1]","plainTextFormattedCitation":"[1]","previouslyFormattedCitation":"[1]"},"properties":{"noteIndex":0},"schema":""}[1] Whilst BMI is a crude assessment of an individual’s adiposity there is a dose effect with increased risk of COVID-19 severity with increasing BMI.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/obr.13095","ISSN":"1467-7881","abstract":"The disease course of COVID-19 varies from asymptomatic infection to critical condition leading to mortality. Identification of prognostic factors is important for prevention and early treatment. We aimed to examine whether obesity is a risk factor for the critical condition in COVID-19 patients by performing a meta-analysis. The review protocol was registered onto PROSPERO (CRD42020185980). A systematic search was performed in five scientific databases between 1 January and 11 May 2020. After selection, 24 retrospective cohort studies were included in the qualitative and quantitative analyses. We calculated pooled odds ratios (OR) with 95% confidence intervals (CIs) in meta-analysis. Obesity was a significant risk factor for intensive care unit (ICU) admission in a homogenous dataset (OR = 1.21, CI: 1.002-1.46; I2 = 0.0%) as well as for invasive mechanical ventilation (IMV) (OR = 2.05, CI: 1.16-3.64; I2 = 34.86%) in COVID-19. Comparing body mass index (BMI) classes with each other, we found that a higher BMI always carries a higher risk. Obesity may serve as a clinical predictor for adverse outcomes; therefore, the inclusion of BMI in prognostic scores and improvement of guidelines for the intensive care of patients with elevated BMI are highly recommended.","author":[{"dropping-particle":"","family":"F?ldi","given":"Mária","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Farkas","given":"Nelli","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kiss","given":"Szabolcs","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zádori","given":"Noémi","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Váncsa","given":"Szilárd","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Szakó","given":"Lajos","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dembrovszky","given":"Fanni","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Solymár","given":"Margit","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bartalis","given":"Eszter","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Szakács","given":"Zsolt","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hartmann","given":"Petra","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pár","given":"Gabriella","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Er?ss","given":"Bálint","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Molnár","given":"Zsolt","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hegyi","given":"Péter","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Szentesi","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Obesity Reviews","id":"ITEM-1","issue":"10","issued":{"date-parts":[["2020","10","19"]]},"publisher":"Blackwell Publishing Ltd","title":"Obesity is a risk factor for developing critical condition in COVID‐19 patients: A systematic review and meta‐analysis","type":"article-journal","volume":"21"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1136/bmj.m1966","ISSN":"17561833","PMID":"32444366","abstract":"AbstractObjective To describe outcomes of people admitted to hospital with coronavirus disease 2019 (covid-19) in the United States, and the clinical and laboratory characteristics associated with severity of illness. Design Prospective cohort study. Setting Single academic medical center in New York City and Long Island. Participants 5279 patients with laboratory confirmed severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) infection between 1 March 2020 and 8 April 2020. The final date of follow up was 5 May 2020. Main outcome measures Outcomes were admission to hospital, critical illness (intensive care, mechanical ventilation, discharge to hospice care, or death), and discharge to hospice care or death. Predictors included patient characteristics, medical history, vital signs, and laboratory results. Multivariable logistic regression was conducted to identify risk factors for adverse outcomes, and competing risk survival analysis for mortality. Results Of 11 544 people tested for SARS-Cov-2, 5566 (48.2%) were positive. After exclusions, 5279 were included. 2741 of these 5279 (51.9%) were admitted to hospital, of whom 1904 (69.5%) were discharged alive without hospice care and 665 (24.3%) were discharged to hospice care or died. Of 647 (23.6%) patients requiring mechanical ventilation, 391 (60.4%) died and 170 (26.2%) were extubated or discharged. The strongest risk for hospital admission was associated with age, with an odds ratio of >2 for all age groups older than 44 years and 37.9 (95% confidence interval 26.1 to 56.0) for ages 75 years and older. Other risks were heart failure (4.4, 2.6 to 8.0), male sex (2.8, 2.4 to 3.2), chronic kidney disease (2.6, 1.9 to 3.6), and any increase in body mass index (BMI) (eg, for BMI >40: 2.5, 1.8 to 3.4). The strongest risks for critical illness besides age were associated with heart failure (1.9, 1.4 to 2.5), BMI >40 (1.5, 1.0 to 2.2), and male sex (1.5, 1.3 to 1.8). Admission oxygen saturation of <88% (3.7, 2.8 to 4.8), troponin level >1 (4.8, 2.1 to 10.9), C reactive protein level >200 (5.1, 2.8 to 9.2), and D-dimer level >2500 (3.9, 2.6 to 6.0) were, however, more strongly associated with critical illness than age or comorbidities. Risk of critical illness decreased significantly over the study period. Similar associations were found for mortality alone. Conclusions Age and comorbidities were found to be strong predictors of hospital admission and to a lesser extent of critical illness and mortali…","author":[{"dropping-particle":"","family":"Petrilli","given":"Christopher M.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jones","given":"Simon A.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yang","given":"Jie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rajagopalan","given":"Harish","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"O'Donnell","given":"Luke","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chernyak","given":"Yelena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tobin","given":"Katie A.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cerfolio","given":"Robert J.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Francois","given":"Fritz","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Horwitz","given":"Leora I.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The BMJ","id":"ITEM-2","issued":{"date-parts":[["2020","5","22"]]},"publisher":"BMJ Publishing Group","title":"Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: Prospective cohort study","type":"article-journal","volume":"369"},"uris":[""]}],"mendeley":{"formattedCitation":"[5,6]","plainTextFormattedCitation":"[5,6]","previouslyFormattedCitation":"[5,6]"},"properties":{"noteIndex":0},"schema":""}[5,6] Is weight loss safe in the pandemic?No data suggests that weight loss would be unsafe during the pandemic. Given the health benefits of weight loss patients should be supported to achieve their weight loss goals. However, if an individual develops symptoms suggestive of COVID-19 or tests positive patients should be encouraged to suspend weight loss and ensure that their energy requirements are met.What is the impact of the pandemic on people living with obesity?The current pandemic is having a significant impact on mental health, physical activity as well as eating behaviours on people with obesity.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/cob.12386","ISSN":"1758-8103","abstract":"OBJECTIVE How the impact of the COVID-19 stay-at-home orders are influencing physical, mental, and financial health among vulnerable populations, including those with obesity is unknown. The aim of the current study was to explore the health implications of COVID-19 AMong a sample of adults with obesity. METHODS A retrospective medical chart review identified patients with obesity from an obesity medicine clinic and a bariatric surgery (MBS) practice. Patients completed an online survey from April 15, 2020 to May 31, 2020 to assess COVID-19 status and health behaviors during stay-at-home orders. Logistic regression models examined the impact of these orders on anxiety and depression by ethnic group. RESULTS A total of 123 patients (87% female, mean age 51.2?years [SD 13.0], mean BMI 40.2 [SD 6.7], 49.2% Non-Hispanic white, 28.7% Non-Hispanic black, 16.4% Hispanic, 7% other ethnicity, 33.1% completed MBS were included. Two patients tested positive for SARS-CoV-2 and 14.6% reported symptoms. 72.8% reported increased anxiety and 83.6% increased depression since stay-at-home orders were initiated. 69.6% reported more difficultly in achieving weight loss goals, less exercise time (47.9%) and intensity (55.8%), increased stockpiling of food (49.6%) and stress eating (61.2%). Hispanics were less likely to report anxiety vs non-Hispanic whites (aOR 0.16; 95% CI, 0.05-0.49; P?=?0.009). CONCLUSIONS Results here showed the COVID-19 pandemic is having a significant impact on patients with obesity regardless of infection status. These results can inform clinicians and healthcare professionals about effective strategies to minimize COVID-19 negative outcomes for this vulnerable population now and in post-COVID-19 recovery efforts. This article is protected by copyright. All rights reserved.","author":[{"dropping-particle":"","family":"Almandoz","given":"Jaime P.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Xie","given":"Luyu","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schellinger","given":"Jeffrey N.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mathew","given":"Matthew Sunil","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gazda","given":"Chellse","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ofori","given":"Ashley","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kukreja","given":"Sachin","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Messiah","given":"Sarah E.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Clinical Obesity","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2020","10"]]},"publisher":"Wiley","title":" Impact of COVID ‐19 stay‐at‐home orders on weight ‐ related behaviours among patients with obesity ","type":"article-journal","volume":"10"},"uris":[""]}],"mendeley":{"formattedCitation":"[7]","plainTextFormattedCitation":"[7]","previouslyFormattedCitation":"[7]"},"properties":{"noteIndex":0},"schema":""}[7] This is having an impact on weight gain in people with obesity.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.3390/nu12072016","ISSN":"2072-6643","abstract":"<p>Our aim is evaluating the changes in weight and dietary habits in a sample of outpatients with obesity after 1 month of enforced lockdown during the COVID-19 pandemic in Northern Italy. In this observational retrospective study, the patients of our Obesity Unit were invited to answer to a 12-question multiple-choice questionnaire relative to weight changes, working activity, exercise, dietary habits, and conditions potentially impacting on nutritional choices. A multivariate regression analysis was performed to evaluate the associations among weight/BMI changes and the analyzed variables. A total of 150 subjects (91.5%) completed the questionnaire. Mean self-reported weight gain was ≈1.5 kg (p &lt; 0.001). Lower exercise, self-reported boredom/solitude, anxiety/depression, enhanced eating, consumption of snacks, unhealthy foods, cereals, and sweets were correlated with a significantly higher weight gain. Multiple regression analyses showed that increased education (inversely, β = ?1.15; 95%CI ?2.13, ?0.17, p = 0.022), self-reported anxiety/depression (β = 1.61; 0.53, 2.69, p = 0.004), and not consuming healthy foods (β = 1.48; 0.19, 2.77, p = 0.026) were significantly associated with increased weight gain. The estimated direct effect of self-reported anxiety/depression on weight was 2.07 kg (1.07, 3.07, p &lt; 0.001). Individuals with obesity significantly gained weight 1 month after the beginning of the quarantine. The adverse mental burden linked to the COVID-19 pandemic was greatly associated with increased weight gain.</p>","author":[{"dropping-particle":"","family":"Pellegrini","given":"Marianna","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ponzo","given":"Valentina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rosato","given":"Rosalba","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Scumaci","given":"Elena","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Goitre","given":"Ilaria","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Benso","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Belcastro","given":"Sara","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Crespi","given":"Chiara","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Michieli","given":"Franco","non-dropping-particle":"De","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ghigo","given":"Ezio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Broglio","given":"Fabio","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bo","given":"Simona","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Nutrients","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2020","7","7"]]},"page":"2016","publisher":"MDPI AG","title":"Changes in Weight and Nutritional Habits in Adults with Obesity during the “Lockdown” Period Caused by the COVID-19 Virus Emergency","type":"article-journal","volume":"12"},"uris":[""]}],"mendeley":{"formattedCitation":"[8]","plainTextFormattedCitation":"[8]","previouslyFormattedCitation":"[8]"},"properties":{"noteIndex":0},"schema":""}[8] It is clear that people living with obesity should be centrally involved in service design and delivery pathways throughout and beyond the COVID-19 pandemic.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/S2213-8587(20)30236-9","author":[{"dropping-particle":"","family":"Brocq","given":"S","non-dropping-particle":"Le","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Clare","given":"K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bryant","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Roberts","given":"K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Tahrani","given":"Aa","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"group form Obesity","given":"writing UK","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Empowerment Network","given":"Obesity","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Association for the Study of Obesity","given":"Uk","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2020"]]},"title":"Obesity and COVID-19: a call for action from people living with obesity","type":"article-journal"},"uris":[""]}],"mendeley":{"formattedCitation":"[9]","plainTextFormattedCitation":"[9]","previouslyFormattedCitation":"[9]"},"properties":{"noteIndex":0},"schema":""}[9]How can pre and post-operative care support patients in the pandemic?Alongside digital delivery of 1:1 and group meetings there may be some requirement for face to face assessment though this should be minimised to reduce risk of transmission of COVID-19. Whilst most bariatric surgery within the UK has been suspended, patients who are post- surgery should continue to be managed as previously with particular attention to post-operative nutrition, complications and psychological support. Patients pre bariatric surgery who have had operations delayed or cancelled may need particular support and be vulnerable to periods of weight gain which may have to be factored in when surgical services resume. As services resume needs-based assessments will be required to prioritise surgery given the current and further anticipated increase to waiting lists. Expert consensus suggests a framework to prioritise surgical services.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/S2213-8587(20)30157-1","PMID":"32386567","author":[{"dropping-particle":"","family":"Rubino","given":"Francesco","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"V","family":"Cohen","given":"Ricardo","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mingrone","given":"Geltrude","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"le","family":"Roux","given":"Carel W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Mechanick","given":"Jeffrey I","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Arterburn","given":"David E","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vidal","given":"Josep","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alberti","given":"George","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Amiel","given":"Stephanie A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Batterham","given":"Rachel L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bornstein","given":"Stefan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Chamseddine","given":"Ghassan","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"Del","family":"Prato","given":"Stefano","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dixon","given":"John B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eckel","given":"Robert H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hopkins","given":"David","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McGowan","given":"Barbara M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pan","given":"An","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Patel","given":"Ameet","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pattou","given":"Fran?ois","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Schauer","given":"Philip R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zimmet","given":"Paul Z","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cummings","given":"David E","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"The Lancet. Diabetes & Endocrinology","id":"ITEM-1","issue":"7","issued":{"date-parts":[["2020"]]},"page":"640","publisher":"Elsevier","title":"Bariatric and metabolic surgery during and after the COVID-19 pandemic: DSS recommendations for management of surgical candidates and postoperative patients and prioritisation of access to surgery","type":"article-journal","volume":"8"},"uris":[""]}],"mendeley":{"formattedCitation":"[10]","plainTextFormattedCitation":"[10]","previouslyFormattedCitation":"[10]"},"properties":{"noteIndex":0},"schema":""}[10] Little data is available concerning COVID-19 risk post bariatric surgery though persistent type 2 diabetes mellitus seems a particular risk factor.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1002/oby.23026","ISSN":"1930-7381","abstract":"OBJECTIVES: Obesity is a major risk factor of severe forms of COVID-19 but little is known about the post bariatric surgery (BS) setting. We assessed the prevalence of likely COVID-19 and its risk factors in patients followed-up after BS. METHODS: We surveyed 738 patients who underwent BS and were followed-up at our university medical centre. A retrospective comparison of characteristics at baseline, one- year post BS and at the time of lockdown was performed between patients with a COVID-19 likely event (CL) based on a combination of reported symptoms vs. those for whom it was unlikely (CU). RESULTS: CL occurred in 62 (8.4%) patients among whom 4 (6.4%) had severe form requiring hospitalization and 1 (1.6%) died. The CL group had a higher proportion of persistent type 2 diabetes (T2D) at last follow-up (36.2% vs. 20.3%, p=0.01). BMI at the time of lockdown was lower in the CL group (30.2 ± 5.1 vs. 32.8 ± 6.5 kg/m(2) ; p<0.01) with higher percent weight loss since BS in the CL group. Severe forms of COVID-19 requiring hospitalization were associated with persistent T2D at last follow-up visit. CONCLUSIONS: In post-bariatric patients, COVID-19 likely events were associated with persistent T2D and lower BMI.","author":[{"dropping-particle":"","family":"Bel Lassen","given":"Pierre","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Poitou","given":"Christine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Genser","given":"Laurent","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marchelli","given":"Florence","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Aron‐Wisnewsky","given":"Judith","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ciangura","given":"Cécile","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jacques","given":"Flavien","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Moreau","given":"Pauline","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Oppert","given":"Jean‐Michel","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Clément","given":"Karine","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"André","given":"Sébastien","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Alili","given":"Rohia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Debédat","given":"Jean","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dugail","given":"Isabelle","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gamblin","given":"Camille","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gléau","given":"Léa","non-dropping-particle":"Le","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gourmelon","given":"Nathalie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Malespine","given":"Leslie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marques","given":"Andrea","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Marquet","given":"Florian","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Osinski","given":"Céline","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pelloux","given":"Véronique","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Petit","given":"Ghislain","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Serradas","given":"Patricia","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Steinbach","given":"Emilie","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ribeiro","given":"Agnes","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Voland","given":"Lise","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Zerah","given":"Elon","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Obesity","id":"ITEM-1","issued":{"date-parts":[["2020","9"]]},"page":"oby.23026","publisher":"Wiley","title":"COVID‐19 and its severity in bariatric surgery operated patients","type":"article-journal"},"uris":[""]}],"mendeley":{"formattedCitation":"[11]","plainTextFormattedCitation":"[11]","previouslyFormattedCitation":"[11]"},"properties":{"noteIndex":0},"schema":""}[11]How can obesity services be delivered in the pandemic?Given the impact of obesity on COVID-19 health outcomes as well as the impact of lockdowns on physical and mental health it is important that obesity services are as resilient as possible to the ongoing challenges. Whilst delivery online is likely to be beneficial recent work has highlighted that this has the potential to exclude certain groups and should be factored into service configuration.What is the advice for people with obesity in terms of shielding?NHS guidance () is that those with a BMI of > 40 kg/m2 should be particularly stringent in following social distancing advice and such people have been classified as at moderate risk. However, this may be falsely reassuring for those with more clinically severe obesity and a lower BMI as well as enhance healthy anxiety in people with a higher BMI.What electronic resources are available for people living with obesity?The type 2 diabetes know your risk website identifies people likely to be eligible for the Healthier You NHS Diabetes Prevention Programme. This world class evidence-based program is likely to be of benefit to many people with obesity. People with more clinically severe obesity should be referred to Tier 3 as previously to support weight loss targets. Increasingly Tier 3 services are adopting bespoke digital platforms to deliver elements of their service though it is hoped that in the future self-referral will be increasingly used.ReferencesADDIN Mendeley Bibliography CSL_BIBLIOGRAPHY 1 Popkin BM, Du S, Green WD, et al. Individuals with obesity and COVID‐19: A global perspective on the epidemiology and biological relationships. Obes Rev 2020;21. doi:10.1111/obr.131282 Sattar N, McInnes IB, McMurray JJV. Obesity Is a Risk Factor for Severe COVID-19 Infection: Multiple Potential Mechanisms. Circulation. 2020;142:4–6. doi:10.1161/CIRCULATIONAHA.120.0476593 NHS Digital part of the GSS. Statistics on Obesity, Physical Activity and Diet, England, 2019. (accessed 16 May 2019).4 Excess weight and COVID-19: insights from new evidence - GOV.UK. (accessed 21 Oct 2020).5 F?ldi M, Farkas N, Kiss S, et al. Obesity is a risk factor for developing critical condition in COVID‐19 patients: A systematic review and meta‐analysis. Obes Rev 2020;21. doi:10.1111/obr.130956 Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: Prospective cohort study. BMJ 2020;369. doi:10.1136/bmj.m19667 Almandoz JP, Xie L, Schellinger JN, et al. Impact of COVID ‐19 stay‐at‐home orders on weight ‐ related behaviours among patients with obesity . Clin Obes 2020;10. doi:10.1111/cob.123868 Pellegrini M, Ponzo V, Rosato R, et al. Changes in Weight and Nutritional Habits in Adults with Obesity during the “Lockdown” Period Caused by the COVID-19 Virus Emergency. Nutrients 2020;12:2016. doi:10.3390/nu120720169 Le Brocq S, Clare K, Bryant M, et al. Obesity and COVID-19: a call for action from people living with obesity. Published Online First: 2020. doi:10.1016/S2213-8587(20)30236-910 Rubino F, Cohen R V, Mingrone G, et al. Bariatric and metabolic surgery during and after the COVID-19 pandemic: DSS recommendations for management of surgical candidates and postoperative patients and prioritisation of access to surgery. Lancet Diabetes Endocrinol 2020;8:640. doi:10.1016/S2213-8587(20)30157-111 Bel Lassen P, Poitou C, Genser L, et al. COVID‐19 and its severity in bariatric surgery operated patients. Obesity 2020;:oby.23026. doi:10.1002/oby.23026 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download