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In March 2020 at the onset of Covid-19 within the US, 14 states reported that about 90 percent of patients hospitalized with Covid-19 had one or more underlying conditions. The most common health problem was hypertension (49.7%), while obesity (48.3%) ranked second. Obesity is a major risk factor for contracting Covid-19, but why?

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To comprehend the relationship between obesity and Covid-19, it’s important to understand the hormone leptin. Leptin, from the Greek word “leptoes” which means thin, is a hormone that regulates the appetite by reducing hunger and helps to regulate energy balance.

The relationship of obesity to leptin surfaced in the mid-1990s. Leptin signals the brain when we are full and to stop eating, and possibly at the same time, it increases energy expenditure. At first, it seemed a possible panacea for the treatment of obesity. Although a slight increase in leptin reduces the appetite and can be a major factor in weight loss, excessive leptin doesn’t have the same effect.

Most leptin is produced in fat cells, but some are also produced in lung tissues. In diet-induced obesity, fat cells produce leptin in large quantities. The more obese a person, the higher the levels of leptin. However, a quirk within the cells not completely understood, results in a detrimental effect from too much leptin and causes the obese to become “leptin resistant.” Therefore, they lose little if any weight. How does leptin-resistance impact the obese in this pandemic virus?

Not only does leptin regulate energy balance within the body, interactions between the nervous and endocrine systems, and metabolism (chemical reactions within cells to maintain and sustain life), it is involved in regulating cells that fight infection—our immune system. Molecules of the hormone leptin are trapped in the fat cells. These highly ineffective leptin levels can result in chronic inflammation thereby increasing susceptibility to infections and autoimmunity including Covid-19. 

Individuals with obesity also are prone to hypoventilation (inadequate oxygen levels caused by breathing at an abnormally slow rate) which results in high carbon dioxide (CO2) levels in the blood and not enough oxygen. High leptin levels in the obese cause the body to produce more blood CO2 levels during the day that cannot be attributed to other factors or conditions.

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Covid-19 has proven once again that medical issues more frequently arise in those with diet-induced obesity. Statistics show that in the US, nonwhites have higher rates of obesity. While many consider this a societal problem, it is also an individual issue. With nearly seventy percent of Americans overweight and more than half of those obese, each of us is responsible for maintaining a healthy weight. Eating healthier foods helps deter obesity and is a win-win for everyone. Educating society, especially those with obesity, to consume fewer calories and make wise choices when eating may well be a good option to combat Covid-19.

         

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