Category: Wellness

I’ve talked a lot about how obesity can increase the danger from COVID-19. And while the virus affects children and adults very differently, underlying conditions like obesity raise the risk across all ages. COVID-19 may be with us for the foreseeable future, so now is a critical time to develop healthier habits and improve resilience with your kids.

If you’re already encouraging behavior like social distancing, handwashing and wearing masks while out, consider adding these tips to your family’s COVID-19 safety plan.

1. Follow the 5-2-1-0 rule.

Obesity experts have a useful system for encouraging healthy habits in children. Every day, eat 5 servings of fruits or vegetables, restrict screen time to 2 hours or less, play actively for at least 1 hour, and drink 0 sugary beverages like soda. But while we’re socially distancing, a couple of those rules can be especially tricky. Designate time for active play whenever possible. Then after they’re done any online learning for the day, make sure they spend at least an hour playing or exercising before they switch over to TV or videogames. 

2. Stick to a sleep schedule.

Without places to be every morning, it’s easy for kids to develop bad sleep habits – after all, who’s going to notice if they’re a bit tired in their online classes? But lack of sleep is associated with unhealthy weight gain in infants, children and youth. Ensure they’re getting 10 hours of sleep each night by unplugging from screens at least two hours before bedtime and adding some light exercise like yoga or calisthenics to your family’s evening routine.

3. Cook together…

Kids are more likely to try healthier options if they had a hand in making them. Now is a great opportunity to explore new recipes and encourage young ones to understand exactly what goes into their food. They may even discover a new hobby and get a fun lesson in nutrition and portion sizes while they’re at it. Take time to talk about your ingredients and the nutrients in each. Then encourage them to share the results on social media and inspire their friends to do the same.

4. … and play together.

Whenever possible, avoid just assigning exercise to your kids. Instead, find activities the whole family can do together. Nature walks and bike rides are great ways to maintain social distance while outside. When indoors, family yoga, calisthenics or even dance-offs can get everyone involved for a quick 30-minute burst of activity. “Game-ify” your routine by tracking weekly achievable goals for the whole family, then reward success in a way that makes sense for your family. A little competition can be a big incentive for stir-crazy kids.

5. Lead by example.

While you’re encouraging healthier habits in isolation, don’t forget about yourself. Share your own accomplishments, take pride in the steps you’ve taken (no matter how small) and keep momentum going through consistent encouragement. Empower your kids to hold you accountable for your habits as well and use constructive language when anyone’s struggling. As you hear so often these days, “We’re all in this together.” It’s just as true when it comes to preventing and tackling obesity.

Check-ups rescheduled. Surgeries postponed. Exercise regimens lapsed.

In a middle of a pandemic, it can be easy to lose focus on the other medical conditions so many of us live with every day. But it’s never been more important to address those conditions, because improving our underlying health can dramatically improve our outcomes if we do fall sick. Obesity is a prime example.

My last article discussed the fact that communities with high rates of co-morbidities such as obesity are experiencing higher rates of mortality from the virus. According to the U.S. Centers for Disease Control and Prevention, those with a body mass index of 40 or over are at much greater risk of severe illness from COVID-19. So what is it about obesity that raises that risk?

COVID-19’s deadliness is due in part to how our bodies fight infection: through inflammation. Normally, it’s a regular part of the healing process, and one of the ways our immune systems clear damaged tissue to begin repairs. But for some COVID-19 patients, that response goes into overdrive, and as inflammation gets out of control, it can cause serious damage throughout our body, including our lungs. People suffering from obesity already experience higher rates of inflammation, so this added intensity of the response becomes even more dangerous. Coupled with inflammation is oxygen deprivation, another symptom that frequently demands hospitalization in COVID-19 patients and is already prevalent in those suffering from obesity.

Once obese patients get to the hospital, they face greater challenges to care than patients with a lower BMI. Intubation, or the insertion of a tube into the airways to enable breathing assistance via respirator, is more difficult, as is moving patients during emergencies. This is especially true for under-resourced healthcare systems: the World Obesity Federation has warned that “Special beds and positioning/transport equipment are available in specialized surgery units, but may not be widely available elsewhere in hospitals and certainly not in all countries.”

Coronavirus is only the latest “secondary” disease to be exacerbated by obesity, and it won’t be the last. From diabetes to coronary and respiratory illnesses, these diseases take the focus while the condition that either causes them or makes them far deadlier does not get the same attention from the patient or their caregiver. How can we change this?

Recognize obesity as a disease.

Both doctors and patients need to approach obesity the way they would any other life-threatening condition, even if secondary diseases such as hypertension or diabetes have not yet been diagnosed. The worldwide rates of obesity are growing at a rate that would never be tolerated were it a more conventional disease. It’s time to start thinking about and reacting to it the same way we do other life-threatening illnesses.

Remove the stigma.

As I’ve discussed in a previous article, the stigma surrounding obesity can mean people are less likely to seek treatment and less likely to continue it if they feel shamed by their medical professionals and communities. Care must be provided in a supportive, judgement-free environment for it to be most effective.

Change the model.

One of the reasons why the treatment of obesity has been such a challenge in the modern world is the fact that our model is incentivized to treat the secondary diseases in a stop-gap manner rather than the root cause in a preventive approach. From research to medication, it is more profitable for the medical industry to manage diabetes or hypertension than it would be to solve the condition that causes them. Changing this will require a fundamental shift in the model, but the results will be worth it for patients and our healthcare system.

As the tragic reality of COVID-19 becomes ever clearer, a pattern has begun to emerge: different communities will experience very different impacts. As Reuters journalist Brad Brook reported earlier this month, nowhere has this become more terribly apparent than in New Orleans (The National Post).

With only a fraction of confirmed cases compared to New York City, New Orleans has been experiencing significantly higher mortality rates. Although differences between the Big Apple and the Big Easy range from economic realities to government policy and quality of healthcare, health authorities have revealed a variable that seems to have even greater impact on the awful toll: diabetes, high blood pressure and obesity — statistics that New Orleans rank highest for in the US. Nearly all the people who have died from COVID-19 in the Louisiana city lived with one or more of these chronic health conditions, and roughly a quarter suffered from obesity. A state healthcare policy expert put it more simply: “We’re just sicker.”

It’s the perfect storm, a combination of dietary traditions that celebrate sugary, fatty foods with healthcare systems that are frequently overstretched and under-supported even in good times. But while it may be a worst-case scenario, what New Orleans teaches us is fundamental: people living with “co-morbidities,” underlying health conditions that increase the risk of death from other illnesses, are more likely to contract disease, get sicker, experience more morbidity and mortality, and recover slower than healthier counterparts. It would follow then, that reducing co-morbidities is one of the most effective responses we can take to the pandemic.

Imagine a pot of water that’s constantly simmering but not quite boiling. Due to the constant and multisystem strain caused by obesity, that’s the reality for an individual living with such a co-morbidity: carefully managing their health on the edge of potential danger. Now an illness such as COVID-19 presents a rapid spike in heat of that that water. A healthy person can withstand the change without tipping over the edge because their boiling point is naturally lower. But in New Orleans, we’re seeing what happens when an already simmering community reaches its boiling point.

The crucial takeaways from Brook’s report are twofold. First, our priority must be to protect the most vulnerable people in our communities including those suffering from obesity. This means that self-isolation and social distancing are all the more important for people with these co-morbidities, their families and their friends.

But the second lesson is easily overlooked in the midst of a crisis. By only addressing the new illness, in this case COVID-19, without dealing with the underlying conditions, we stay near the boiling point. This means that improving our fundamental health — lowering that temperature — becomes one of the best steps we can take to protect ourselves and our loved ones in any pandemic. It’s true for this one and it will remain true for those that may follow. Just as critical as social distancing, masks or gloves are healthy habits, diet and exercise.

The good news is that it’s never too late to reduce our co-morbidities and become more resilient. Even in self-isolation, a shift to a healthier diet can show immediate positive effects. From a boosted immune system to lower blood pressure, what we choose to eat can ultimately save our (or someone else’s) life.

Being a physician is about more than just treating patients; as carers and active members of the medical community I believe that we should continue to improve on existing practices, rather than just accepting the status quo. A family physician of more than eleven years, I have committed myself to changing the way we approach primary care in Ontario through the use of best-evidence, team-based care and technology.

As the medical director of Winterberry Family Medicine, I put my passion into practice everyday. A modern, multidisciplinary clinic, our approach moves away from the traditional primary care model, relying on a dedicated team of physicians, nurse practitioners, physician’s assistants, and registered nurses to provide a range of medical services at any time. At Winterberry, we aim to provide the appropriate access to the appropriate healthcare provider using the appropriate tools. The Winterberry model, when coupled with the adoption of new healthcare technologies such as telemedicine, is providing our patients with more timely access and better overall care.

Improving approaches to primary care is not the only cause I champion. My work at Winterberry has also brought me into direct contact with many patients suffering from obesity and its affiliated diseases. Now classified by WHO as a chronic disease, obesity has been attributed to one in 10 premature deaths amongst Canadian adults aged 20 to 64, and our generation is the first in history expected to suffer a shorter and reduced quality of life in comparison to their parents.

As a physician, I find this deeply concerning; as a father, downright alarming. Healthcare providers and society alike must stop stigmatization and begin to not only recognize and treat the symptoms of obesity, but also work on prevention. Through my own practice, I have developed a strong belief that the best approach to combating this epidemic is prevention, and I work tirelessly with both new and existing patients to stop this disease dead in its tracks.

 I look to lead the charge in both team-based care and obesity. Through my work, which you can follow through my LinkedIn, I aim to shift our perspectives on care and disease management to create better pathways for our loved ones and children.

Physician, Husband, Father