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PHE recommends targeted interventions on obesity to reduce Covid deaths

Public Health England has recommended targeted interventions to tackle obesity in a bid to reduce Covid-19 deaths.

The recommendations come as a PHE evidence review concluded that excess weight leads to a significantly higher risk of hospitalisation and death from Covid-19.

Further, since problems with excess weight disproportionately affects older people and some BAME groups, PHE said this may ‘explain’ why these groups have had worse Covid-19 outcomes.

Excess weight affects two-thirds of the English population but particularly those aged 55-74 and some BAME groups.

The report said: ‘Supporting people who are living with overweight or obesity to lose weight, together with interventions to prevent weight gain across the population will plausibly reduce future population risks of Covid-19.’

And it added that ‘more targeted actions are needed to support change in groups disproportionately affected by obesity, and its causes, including people in the country’s most deprived socio-economic groups’.

PHE drew evidence from retrospective cohort studies, clinical audits of patients with Covid-19 in hospital and primary care records with links to outcomes data to reach its new conclusions.

The evidence suggested that excess weight is associated with increased risk of hospitalisation, needing intensive care and dying with the disease.

The report said: ‘The risks seem to increase progressively with increasing BMI above the healthy weight range, even after adjustment for potential confounding factors, including demographic and socio-economic factors.

‘There is also some evidence to suggest that disparities in excess weight may explain some of the observed differences in outcomes linked to Covid-19 for older adults and some BAME groups.’

According to PHE explanations for the association between Covid risk and excess weight include ‘the effects of excess adipose tissue on respiratory function, metabolic dysfunction, the cardiovascular system, enhanced inflammatory response and impaired response to infection’.

It may also be linked to ‘weight-related co-morbidities’ such as type 2 diabetes, cardiovascular and respiratory diseases, as well as stigma.

The report said that ‘it is reasonable to conclude that reducing excess weight could help reduce the risk of severe Covid-19 illness’, adding that excess weight ‘may be one of the few modifiable risk factors’.

PHE chief nutritionist Dr Alison Tedstone said: ‘The current evidence is clear that being overweight or obese puts you at greater risk of serious illness or death from Covid-19, as well as from many other life-threatening diseases.

‘It can be hard to lose weight and even harder to sustain it, which is why people cannot easily do it on their own. Losing weight can bring huge benefits for health – and may also help protect against the health risks of Covid-19. The case for action on obesity has never been stronger.’

A rapid review into Covid-19 carried out by PHE in May confirmed that BAME people have a higher mortality risk.

Meanwhile, experts have said patients with diabetes, hypertension and cardiovascular disease should be added to the list of clinically extremely vulnerable patients who should shield during a second Covid-19 spike.

A senior clinical adviser to the Government further suggested that  health checks should from the age of 25 for BAME people.

Meanwhile, NICE has published proposals for a new QOF indicator which would see GPs incentivised to refer all obese patients for weight management within three months.

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