2021-03-07 00:23

'Weight isn't always within your control': Why some states are prioritizing obesity patients for the COVID-19 vaccine MJX世界播


Patty Nece hasn’t been inside a retail store for an entire year. MJX世界播


Even though most Virginia businesses reopened by July and grocery stores remained opened throughout the pandemic, the 62-year-old hasn't dared to step inside one since last March, as her obesity puts her at risk for severe COVID-19. MJX世界播


Because of her disease, she’s eligible to get the vaccine and has an appointment for her first dose on Wednesday. While she’s looking forward to getting vaccinated, she’s also disappointed some Americans have criticized people with obesity who are prioritized to get the vaccine. MJX世界播


“It displays a misunderstanding … weight isn’t always within your control,” said Nece, who is also the chairwoman of the Obesity Action Coalition. “Like many diseases, there’s personal responsibility involved but that’s not the end. The mantra of eat less and move more – which I’ve heard my entire life – isn’t the answer.” MJX世界播


In one instance, a news anchor for WTTG-TV in Washington, D.C., sent a tweet criticizing health officials for prioritizing obesity patients for the vaccine. MJX世界播


“I’m annoyed obese people of all ages get priority vaccine access before all essential workers,” Blake McCoy said in the since-deleted tweet. “Vaccinate all essential workers. Then obese.” MJX世界播

布莱克·麦考伊(Blake McCoy)在这条后来被删除的推文中说:“我对所有年龄段的肥胖者在所有基本工作人员之前优先获得疫苗感到恼火。”“为所有必需的工人接种疫苗。然后是肥胖。“。MJX世界播

The local station told the New York Daily News McCoy was “suspended pending further review” after deleting the offensive tweet and posting an apology on Twitter, but health experts say it’s another example of how weight bias permeates the health system and American society. MJX世界播


Obesity and COVID-19 MJX世界播


Roughly 40% of adult Americans have obesity, according to Centers for Disease Control and Prevention data from 2018. Studies have shown people with obesity are more likely to have worse outcomes from COVID-19 than others with a lower body mass index (BMI). MJX世界播

根据疾病控制和预防中心(Centers For Disease Control And Prevention)2018年的数据,大约40%的美国成年人患有肥胖症。研究表明,与其他体重指数较低的人相比,肥胖患者服用新冠肺炎的结果更差。MJX世界播

Researchers at the University of North Carolina at Chapel Hill found people with a BMI above 30 had a 113% higher risk for hospitalization, a 74% higher risk for ICU admission and a 48% higher risk of death, according to a study published in August 2020 in Obesity Reviews. MJX世界播

北卡罗来纳大学教堂山分校(University Of North Carolina At Chapel Hill)的研究人员发现,BMI超过30的人住院的风险高113%,住ICU的风险高74%,死亡风险高48%。MJX世界播

At first, health experts believed people with obesity were more at risk for severe COVID-19 because the disease also is associated with numerous underlying risk factors including hypertension, heart disease, type 2 diabetes and chronic kidney and liver disease. MJX世界播


But after controlling for those factors, researchers found people with obesity were still at higher risk for COVID-19, said Dr. Rekha Kumar, medical director of the American Board of Obesity Medicine and associate professor of clinical medicine at Weill Cornell Medicine. This may be partly due to the excess fat tissue producing more inflammation, she said. MJX世界播


“People’s bodies are mounting such a severe inflammatory response (to COVID-19), and that response is already existing at a baseline in obesity,” Kumar said. “So, when you add another stimulus, they’re getting even sicker.” MJX世界播


Some patients also may suffer from obesity hypoventilation syndrome, a breathing disorder that causes someone to have too much carbon dioxide and too little oxygen in the blood, according to the National Heart, Lung and Blood Institute. MJX世界播


“It’s not from carrying the weight,” said Dr. Ethan Lazarus, president-elect of the Obesity Medicine Association. “Their lungs are restricted so they’re not able to expand to get the oxygen they need.” This puts them at further risk for COVID-19 complications. MJX世界播


Patients with obesity also have an impaired immune system, health experts say, which not only makes them more prone to infectious diseases but also makes it harder to fight them off. MJX世界播


Obesity can change the metabolic state of immune cells and how they function, said Dr. Nancie MacIver, associate professor at Duke University School of Medicine. The excess inflammation may be an indication the immune system is dysfunctional. MJX世界播

杜克大学医学院(Duke University School Of Medicine)副教授南希·麦克弗(Nancie MacIver)博士说,肥胖可以改变免疫细胞的新陈代谢状态及其功能。过度的炎症可能是免疫系统功能失调的迹象。MJX世界播

Obesity and the COVID vaccine MJX世界播


Obesity patients' altered immune system has led experts to worry about their response to the COVID-19 vaccine, especially as past studies have suggested they may not respond as well to influenza vaccines. MJX世界播


Researchers at UNC Chapel Hill found that among vaccinated individuals, nearly 10% of patients with obesity were infected with the flu compared to about 5% of participants with a lower BMI, according to a 2017 study published in the International Journal of Obesity. MJX世界播


But health experts say obesity patients shouldn’t be discouraged, and urge them to get the COVID-19 vaccine when it is available to them. MJX世界播


“People should understand the difference between not effective and reduced efficacy,” Kumar said. “Even if a vaccine works less, it’s still better than somebody becoming critically ill in an ICU.” MJX世界播


Nece worries, as a patient with obesity, others like her may delay care during the pandemic due to decades of weight bias in the health care system. MJX世界播


Obesity Awareness Week and weight bias MJX世界播


Weight bias in the medical setting manifests itself in a myriad of ways, from having ill-fitted gowns and weighing patients in public, to misdiagnosing a life-threatening illness due to a doctor’s inability to look past a person's excess weight. MJX世界播


After years of weight lecturing and bad experiences at the doctor’s offices, many patients internalize that bias and avoid treatment or preventative care altogether, said James Zervios, vice president of marketing and communications at the Obesity Action Coalition. MJX世界播

肥胖行动联盟负责营销和沟通的副总裁詹姆斯·泽维奥斯(James Zervios)说,在多年的减肥讲座和在医生办公室的糟糕经历之后,许多患者内化了这种偏见,完全避免了治疗或预防性护理。MJX世界播

Nece delayed her mammogram by 15 years to avoid the stress and embarrassment of a doctor’s visit. MJX世界播


“You get tired of dealing with it," she said. "You get tired of the shame and blame that gets heaped on you and it doesn’t help.” MJX世界播


But during Obesity Care Week, which ends Saturday, advocates like Zervios and Nece want to spread awareness that obesity is not just a behavioral disease and can be influenced by genetics, hormones and even medications. MJX世界播


They also urge those who are suffering with obesity to seek help from health care providers despite weight bias, especially during the pandemic. MJX世界播


“We encourage people to remember that they are worth the care that they deserve and don’t take that kind of bias and deal with it,” Zervios said. “Everybody deserves to be treated with dignity and respect.” MJX世界播


© 2016 世界播 www.shijiebobao.com 中国互联网举报中心 京ICP证140141号 鄂ICP备18018000号-1