Covid 19 and Obesity
Dr. Michael Bilof explains why COVID-19 affects those with obesity, why treatment might be more difficult, and how those who suffer from obesity can protect themselves from the virus.
Featuring:
Michael Bilof, MD
Dr. Bilof is a leader among his peers. His fellow bariatric surgeons in New Jersey chose him as President of the New Jersey Chapter of the American Society of Metabolic and Bariatric Surgeons (ASMBS) from 2014-2016. Transcription:
Bill Klaproth: This Garden State Bariatrics and Wellness Center Podcast on COVID-19 recorded on April 20th. We've heard that obesity puts people at high risk when it comes to the Coronavirus. So what do you need to know and what is the latest information? Well, let's learn more with Dr. Michael Bilof, a Bariatric Surgeon. He is also the Founder of Garden State Bariatrics and Wellness Center.
Introduction: This is it. Winning through Losing, a weight loss surgery podcast from Garden State Bariatrics and Wellness Center.
Host: Dr. Bilof, as always, thanks for your time. So do we know why people with obesity are in the high risk category for Covid-19?
Dr. Bilof: You know, Bill, the short answer is we do not. The thing that makes Corona particularly dangerous as most people don't really have a lot of symptoms, but even though they don't have symptoms, they can still spread the disease to other people. Which is really what's made this thing kind of scary, that someone's walking around feeling fine can still spread the disease. So, but patients who do get the more, you know, the we'll say more virulent or more aggressive form of Corona and are actually sick. It does appear that for some reason, and honestly we don't know why, but we can certainly speculate, but we don't, we don't really know why the patients who are obese have a BMI over 30, seem to be more prone to getting that more aggressive version of the Corona virus that is feeling sick end up in the hospital. And then among the patients who end up in the hospital, the obese patients are the ones most likely end up in the ICU and on a ventilator, even if they're younger. So you know, as I'm sure most people who have been following the news realize that the patients who are elderly are the most at risk for Corona. But there's a small segment of these patients under the age of 50 and some even under the age of 30 who are getting this very aggressive form of the Corona. And obesity is one of the risks for patients in that younger half of the population to get the more aggressive version. And we're not exactly sure why. My own feeling is that it's probably related to all of the other medical problems that patients who are obese get the diabetes, high blood pressure and sleep apnea, which then makes them prone to perhaps getting this more aggressive version of Corona.
Host: So what you said there is very important. If you're obese, it's not just affecting the older population, it can affect younger people too. So you have to be aware of that. And do you think this is because of the comorbidities that people that are obese are having a harder time with this because of the things such as diabetes, sleep apnea, high blood pressure, etcetera?
Dr. Bilof: Well, it's given how early it is in this, in this epidemic. I don't think we know that for sure. That's a bit of a speculation on my part. But you know, patients who are obese have a whole host of medical problems that will often prompt them to seek the services of someone like myself and get bariatric surgery. And this is just another of those things that obese patients seem to be more prone to getting this more virulent version of Corona. You know, hopefully we will have a vaccine in the next 12 or 18 months. But again, we don't know and you know, will this virus come back next year in the Fall? You know, over the winter we don't know. But we do know that obesity seems to be a risk for the more aggressive version of it. And for patients to more likely end up in the hospital in the ICU. And so, you know, if someone's out there thinking about bariatric surgery, it's another one of those things that, you know, you may want to be aware of that you're at risk for and that you may not have been aware.
Host: So that's right. Someone may not know they are in the high risk category for COVID-19 and you were mentioning bariatric weight loss surgery. Maybe someone is thinking about that. Seems like now would be a good time to really explore that, come in, have a consultation, understand the different procedures and start to put a plan together for bariatric weight loss surgery.
Dr. Bilof: Yeah, Bill. So we're, you know, obviously we're recording this in the middle of the epidemic, but you know, someone may be listening to this a little bit later on thinking, you know, is this something for me to consider? And obviously the choice of doing Bariatric surgery is very personal and depending on a person's individual situation. One thing I can say is it takes several months generally speaking to get approved and to go through the whole process. So even if someone really is eager to do this, it's going to be several months before they actually get the surgery. And then, you know, it takes several more months to actually lose the weight and kind of, you know, reduce your risk factor for COVID-19 or diabetes or high blood pressure. So if you're even thinking about it, it's another one of those, you know, when you weigh the decision, should I do the surgery, should I not do the surgery? It's another one of the things to kind of, you know, tip the scales, if you will, in one direction or the other. Again, for whatever reason, it appears that obesity is a risk factor for the more aggressive version of COVID-19.
Host: So what can we all do, and especially people that are in that high risk category, what can we do to protect ourselves from COVID-19?
Dr. Bilof: Right. So in the immediate, you know, sense. So while they're actually experiencing the quarantine and social distancing and other measures that have been recommended by the authorities you know, it's kind of a running joke that I suspect many people have heard about the quarantine 15 that patients and people are kind of gaining weight cause they're sitting around and they can't exercise, they can't go out and they're, you know, bingeing on Netflix and just you know, eating junk food. So to some extent you want to avoid doing those things and to the extent possible, get out and get some fresh air. If you have some sort of exercise machine at home to use it. And there's plenty of apps on the web that too, that allow you to exercise even without any kind of fancy equipment. And so you want to do that and, and try to eat sensibly. You certainly want to implement those measures to avoid worsening any type of obesity the actual crisis,
Host: And speaking of exercise, even getting outside every day for a walk. That helps too. Is that right?
Dr. Bilof: Absolutely. And there's no, there's really no downside to that sort of thing. I don't think I've noticed in my own neighborhood is the amount of people walking. I mean there's a park near where I live and I have noticed the amount of people walking in that park is noticeably more than would typically be the case at this time of year. So it does seem that some people are certainly out, out and about. And you know, while social distancing are trying to be active
Host: And remaining active is really important. And like you said, making sure you eat a sensible diet. Besides washing hands and social distancing, which we've also heard about. Any other things we should be doing to protect ourselves?
Dr. Bilof: Yeah, I would just echo the message that most people have been getting from the public health authorities that the best way to avoid getting sick is to implement the measures that have been recommended and most of which are kind of common sense. If you didn't want to get the flu, you would, you know, wash your hands and stay away from anyone who appeared to be ill. And obviously those are the things you should do. Again, the thing that makes COVID-19 particularly troubling is that patients who have no outward symptoms and can still transmit the disease, which is why the social distancing is so important that someone can appear quite healthy and still be infectious. Unlike the flu where, you know, unlike the flu where typically someone gets the flu, they look and feel quite ill and they often just quarantine themselves because they don't feel like going out. Patients who have COVID-19 and have the mild asymptomatic version can still transmit the disease, which is why the social distancing aspect is so important.
Host: And if you could wrap this up for us, Dr. Bilof, what's most important for us to know when it comes to obesity and the Coronavirus?
Dr. Bilof: Well, I think the main sort of take home message that I want to impart to anyone listening to this is that it's, you know, and I don't want to be alarmist, the numbers here are still small, but the, for some reason, and particularly in the younger population, that's what's most striking to me, that among patients who are under the age of 50, who otherwise really were in the lower risk for getting COVID-19, for some reason in that group of patients, if they were obese, they seem to get a more aggressive version of this infection. It's quite concerning that you know, otherwise, these younger patients for the most part were relatively immune. But if they're obese, they seem to get it more worse, version, more likely to end up in the hospital. And then among the group who ends up in the hospital, these were the patients more likely to end up in the ICU and on a ventilator. And that's, you know, that is quite concerning because normally young people think of themselves and rightly so as being somewhat immune to these diseases that affect patients who are more elderly.
Host: And that is an important point to remember. Dr. Bilof, thank you so much for your time and talking with us about obesity and COVID-19. Thanks again.
Dr. Bilof: Thank you Bill.
Host: That's Dr. Michael Bilof and for more information, please visit gsbwc.com. That's gsbwc.com. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Winning Through Losing, a weight loss surgery podcast from Garden State Bariatrics and Wellness Center. I'm Bill Klaproth. Thanks for listening.
Bill Klaproth: This Garden State Bariatrics and Wellness Center Podcast on COVID-19 recorded on April 20th. We've heard that obesity puts people at high risk when it comes to the Coronavirus. So what do you need to know and what is the latest information? Well, let's learn more with Dr. Michael Bilof, a Bariatric Surgeon. He is also the Founder of Garden State Bariatrics and Wellness Center.
Introduction: This is it. Winning through Losing, a weight loss surgery podcast from Garden State Bariatrics and Wellness Center.
Host: Dr. Bilof, as always, thanks for your time. So do we know why people with obesity are in the high risk category for Covid-19?
Dr. Bilof: You know, Bill, the short answer is we do not. The thing that makes Corona particularly dangerous as most people don't really have a lot of symptoms, but even though they don't have symptoms, they can still spread the disease to other people. Which is really what's made this thing kind of scary, that someone's walking around feeling fine can still spread the disease. So, but patients who do get the more, you know, the we'll say more virulent or more aggressive form of Corona and are actually sick. It does appear that for some reason, and honestly we don't know why, but we can certainly speculate, but we don't, we don't really know why the patients who are obese have a BMI over 30, seem to be more prone to getting that more aggressive version of the Corona virus that is feeling sick end up in the hospital. And then among the patients who end up in the hospital, the obese patients are the ones most likely end up in the ICU and on a ventilator, even if they're younger. So you know, as I'm sure most people who have been following the news realize that the patients who are elderly are the most at risk for Corona. But there's a small segment of these patients under the age of 50 and some even under the age of 30 who are getting this very aggressive form of the Corona. And obesity is one of the risks for patients in that younger half of the population to get the more aggressive version. And we're not exactly sure why. My own feeling is that it's probably related to all of the other medical problems that patients who are obese get the diabetes, high blood pressure and sleep apnea, which then makes them prone to perhaps getting this more aggressive version of Corona.
Host: So what you said there is very important. If you're obese, it's not just affecting the older population, it can affect younger people too. So you have to be aware of that. And do you think this is because of the comorbidities that people that are obese are having a harder time with this because of the things such as diabetes, sleep apnea, high blood pressure, etcetera?
Dr. Bilof: Well, it's given how early it is in this, in this epidemic. I don't think we know that for sure. That's a bit of a speculation on my part. But you know, patients who are obese have a whole host of medical problems that will often prompt them to seek the services of someone like myself and get bariatric surgery. And this is just another of those things that obese patients seem to be more prone to getting this more virulent version of Corona. You know, hopefully we will have a vaccine in the next 12 or 18 months. But again, we don't know and you know, will this virus come back next year in the Fall? You know, over the winter we don't know. But we do know that obesity seems to be a risk for the more aggressive version of it. And for patients to more likely end up in the hospital in the ICU. And so, you know, if someone's out there thinking about bariatric surgery, it's another one of those things that, you know, you may want to be aware of that you're at risk for and that you may not have been aware.
Host: So that's right. Someone may not know they are in the high risk category for COVID-19 and you were mentioning bariatric weight loss surgery. Maybe someone is thinking about that. Seems like now would be a good time to really explore that, come in, have a consultation, understand the different procedures and start to put a plan together for bariatric weight loss surgery.
Dr. Bilof: Yeah, Bill. So we're, you know, obviously we're recording this in the middle of the epidemic, but you know, someone may be listening to this a little bit later on thinking, you know, is this something for me to consider? And obviously the choice of doing Bariatric surgery is very personal and depending on a person's individual situation. One thing I can say is it takes several months generally speaking to get approved and to go through the whole process. So even if someone really is eager to do this, it's going to be several months before they actually get the surgery. And then, you know, it takes several more months to actually lose the weight and kind of, you know, reduce your risk factor for COVID-19 or diabetes or high blood pressure. So if you're even thinking about it, it's another one of those, you know, when you weigh the decision, should I do the surgery, should I not do the surgery? It's another one of the things to kind of, you know, tip the scales, if you will, in one direction or the other. Again, for whatever reason, it appears that obesity is a risk factor for the more aggressive version of COVID-19.
Host: So what can we all do, and especially people that are in that high risk category, what can we do to protect ourselves from COVID-19?
Dr. Bilof: Right. So in the immediate, you know, sense. So while they're actually experiencing the quarantine and social distancing and other measures that have been recommended by the authorities you know, it's kind of a running joke that I suspect many people have heard about the quarantine 15 that patients and people are kind of gaining weight cause they're sitting around and they can't exercise, they can't go out and they're, you know, bingeing on Netflix and just you know, eating junk food. So to some extent you want to avoid doing those things and to the extent possible, get out and get some fresh air. If you have some sort of exercise machine at home to use it. And there's plenty of apps on the web that too, that allow you to exercise even without any kind of fancy equipment. And so you want to do that and, and try to eat sensibly. You certainly want to implement those measures to avoid worsening any type of obesity the actual crisis,
Host: And speaking of exercise, even getting outside every day for a walk. That helps too. Is that right?
Dr. Bilof: Absolutely. And there's no, there's really no downside to that sort of thing. I don't think I've noticed in my own neighborhood is the amount of people walking. I mean there's a park near where I live and I have noticed the amount of people walking in that park is noticeably more than would typically be the case at this time of year. So it does seem that some people are certainly out, out and about. And you know, while social distancing are trying to be active
Host: And remaining active is really important. And like you said, making sure you eat a sensible diet. Besides washing hands and social distancing, which we've also heard about. Any other things we should be doing to protect ourselves?
Dr. Bilof: Yeah, I would just echo the message that most people have been getting from the public health authorities that the best way to avoid getting sick is to implement the measures that have been recommended and most of which are kind of common sense. If you didn't want to get the flu, you would, you know, wash your hands and stay away from anyone who appeared to be ill. And obviously those are the things you should do. Again, the thing that makes COVID-19 particularly troubling is that patients who have no outward symptoms and can still transmit the disease, which is why the social distancing is so important that someone can appear quite healthy and still be infectious. Unlike the flu where, you know, unlike the flu where typically someone gets the flu, they look and feel quite ill and they often just quarantine themselves because they don't feel like going out. Patients who have COVID-19 and have the mild asymptomatic version can still transmit the disease, which is why the social distancing aspect is so important.
Host: And if you could wrap this up for us, Dr. Bilof, what's most important for us to know when it comes to obesity and the Coronavirus?
Dr. Bilof: Well, I think the main sort of take home message that I want to impart to anyone listening to this is that it's, you know, and I don't want to be alarmist, the numbers here are still small, but the, for some reason, and particularly in the younger population, that's what's most striking to me, that among patients who are under the age of 50, who otherwise really were in the lower risk for getting COVID-19, for some reason in that group of patients, if they were obese, they seem to get a more aggressive version of this infection. It's quite concerning that you know, otherwise, these younger patients for the most part were relatively immune. But if they're obese, they seem to get it more worse, version, more likely to end up in the hospital. And then among the group who ends up in the hospital, these were the patients more likely to end up in the ICU and on a ventilator. And that's, you know, that is quite concerning because normally young people think of themselves and rightly so as being somewhat immune to these diseases that affect patients who are more elderly.
Host: And that is an important point to remember. Dr. Bilof, thank you so much for your time and talking with us about obesity and COVID-19. Thanks again.
Dr. Bilof: Thank you Bill.
Host: That's Dr. Michael Bilof and for more information, please visit gsbwc.com. That's gsbwc.com. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is Winning Through Losing, a weight loss surgery podcast from Garden State Bariatrics and Wellness Center. I'm Bill Klaproth. Thanks for listening.