Should we promote weight loss to fight the pandemic?

Since the beginning of the pandemic, epidemiological studies have linked obesity with Covid-19, both the risks of infection, as well as those of severity and mortality. And, contrary to what has happened with other factors, this relationship has been confirmed in successive investigations, such as the following:

Given this evidence, there have been many voices, especially from the nutrition field, calling for greater priority in the promotion of healthy eating and more initiatives for weight loss programs, such as strategies to combat the pandemic.

Is it a reasonable request?

Below I will briefly present my opinion. A personal and debatable opinion, of course.

But what is not so clear is his priority in this situation. In a pandemic situation, it is especially important to quickly achieve large-scale results, since the disease evolves from infection to death very quickly, in just weeks, taking lives, disrupting our society and collapsing our health systems. And regarding interventions for healthy eating and weight loss in this context, we find ourselves in the following circumstances:

Lack of evidence of real impact: Although there are a large number of studies that find a relationship between obesity and the risks of Covid-19, they are all observational. At the moment, no trial has been carried out in which weight loss has been promoted and the reduction of infections and/or severe cases has been confirmed. And because of the difficulty of this type of trial, I doubt that a study like this will be done in a reasonable period of time.

Little effectiveness and high cost in interventions of this type: Unfortunately, history shows us that it is very difficult to achieve medium-long term success in a massive weight loss intervention. The few experiences of this type have achieved very modest results and at a high cost (example). Only some interventions with relatively small groups, many resources and follow-up reach relevant results in the short-medium term and the effects are not usually sustained over time for the majority of the participants. On the other hand, the fact that the growing obesity trend has not been reversed by any country in the world is highly significant and not very hopeful.

Limited magnitude of potential benefits: With the results of the observational studies cited at the beginning of the post, we can extrapolate what could be achieved through an intervention of this type. It is not something too rigorous, but we can do the exercise. Being very optimistic, and in the best of cases, approximately a 25% reduction in the risk of infection could be achieved, and the risk of severity by half, in cases in which weight loss is maintained. Well, these are values ​​much lower than those achieved during the trials of the first approved vaccines, which are up to 20 times better and also for the entire vaccinated population (study, study, study).

In summary, without ceasing to be a defender of policies to promote healthy eating and prevent overweight, and without forgetting that during the pandemic situation it is necessary to continue working to promote healthy habits, I believe that now it is time to prioritize other strategies, capable of to achieve results more globally, of greater magnitude and more quickly.