Thread by @shangaur

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UK PM Boris Johnson has declared a “war on fat” after confronting the role his #obesity played in his harrowing encounter with #COVID.

In this #tweetorial, we’ll take a closer look at the studies sounding the alarm in the UK.

#medthread #MedTwitter

thetimes.co.uk/article/boris-…

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Ho et al. (pre-print) studied 428,225 subjects in the @UK_Biobank of which 340 had confirmed #COVID.

BMI had a risk ratio (RR) of 1.24 (per 1SD). Obesity itself had a RR of 2.29.

medrxiv.org/content/10.110…

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To put this in context: for every 4.5 point increase in BMI, the risk of hospitalization from #COVID increases by almost 25%!

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Docherty et al. studied 20,133 COVID-19 patients across 208 UK hospitals in @bmj_latest.

Other than age, the top 3 risk factors for mortality were:

🔹Liver disease: hazard ratio (HR)=1.51
🔹Dementia: HR=1.40
🔹Obesity: HR=1.33

bmj.com/content/369/bm…

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To put this in context: obesity raises the risk of death from #COVID by 33%!

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These are harrowing statistics! The economic impact is also substantial. 👇

@ICNARC tracks ICUs across the @NHSuk.

As of May 22, 39% of the 9,026 #COVID patients in the ICU have obesity. The average length of stay (LOS) in the ICU is 8-10 days.

icnarc.org/Our-Audit/Audi…

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The daily cost of an ICU bed in the NHS is £1,932. At an average LOS of 9 days, #COVID has already cost the @NHSuk £170 million.

(this is just a small piece of the pie, as it is only related to ICU care and not other costs)

How would reducing obesity impact this? 👇

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Reports from multiple countries point to a two-fold increased need of ICU-level care in #COVID patients with #obesity.

medscape.com/viewarticle/92…

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⬇️BMI by ~5 points would likely reduce the requirement for ICU-level care by half.

This would lead to ICU savings of £30 million or £8,500 per ICU patient with obesity.

(this is a small piece of the pie, as it does not include all the cost savings across @NHSuk of ⬇️BMI)

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So is it feasible to declare—and fund—a “war on fat”?

Yes, absolutely.

The immediate potential cost savings and health benefits are substantial.

The long-term benefits could change the public health of an entire nation.

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However, we have waged “wars on fat” and “battles of the bulge” in the past and have failed.

What makes this time different?

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First, #COVID has forced us to confront #obesity with the urgency of an acute disease rather than the complacency of a chronic condition.

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Second, at the highest levels of government and in board rooms across the world, #obesity is on the agenda for key stakeholders who can coordinate a wide-scale response.

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Third, innovation in the health and wellness space in the past decade has led to the development of technology that can support a population-wide weight loss initiative.

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Finally, and most importantly, consumers are more aware of the benefits of living life at a healthier BMI.

What we need now is a coordinated effort from patients, providers, scientists, legislators, entrepreneurs, and advocates to tackle obesity head-on.

The time is now!