Lesson 2: So what about that weight gain?

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(The subject of this article has had an update (with more data and analysis) on September 28).

But this is still a good place to start ... 


On should not fall into the trap of thinking that because COVID-19 is caused by a "novel" coronavirus, that we are lost in a snowstorm of unknowing. The "we" here applying to both patients, healthcare teams, researchers, decision makers in governments and all the rest. Everyone seems intent on finding out how deep this viral snowstorm is, or will be, and how to find a way out as soon as possible. 


Logically, the first place to start when faced with this illness, if the primary goal remains to relieve

suffering and heal the sick where possible, is to see what is known that might be of use.


We'll come back to one useful example of that which informs what you are about to see here below.


Let's have a preliminary look at data from our Questionnaire that relates to the height, weight and derived data of our respondents. And this on September 18, 2020.


Of 53 "completed" questionnaires, 49 had answers for Height, Weight before illness, and Weight the day of questionnaire completion.


While this may already sound pretty boring, we didn't find it so. 


Below, an image with lots of numbers. Just calmly look it over. 

We'll be trying to focus in on several points, but will not go too deeply into this since we hope to have many more than 53 respondents with 49 sets of related answers to give us ever stronger results.


Results - with 49 responses


We could jump to separate answers by gender, or age, but let's just stop here and scan the results.


Most often, when one gets sick, especially with a prolonged illness, and commonly with infectious illnesses, one anticipates losing weight. Just a pound or kilogram or stone or so. One might think it a good result as one emerges: "Oh, you noticed?! Yes, Ii went on the 'sick as a dog' diet."


So the first tiny Eureka! moment


... comes when you learn as I did, that most people in our little study gained weight.

Not all. The range goes from losing 10 to gaining 12 kilograms. But 49% of these respondents gained weight while ill 6.37 months (25.5 wks).


You may be thinking ahead to thoughts like: "Well if they got up off the couch and stopped wtaching TV all day, interrupted only by trips to the john and the cookie jar ... maybe they wouldn't gain weight."

A thought which is actually: wrong.


Most respondents (88%) are women. Too early to really tack that down, but it suggests that most patients with "Long-term" COVID-19 are female. If the guys who are sick with this have been sneaking around reading this kind of stuff, but not taking the questionnaire, shame on you. Take the damn thing before reading any further!


Next, how does one talk politely about weight issues?

The Press doesn't do it. You've already learned that.


So put simply, how "big" or "small" are these 49 respondents?

And to whom shall be comparing them to? 

Not to Martians who tend to be small, but who did not answer our questionnaire.


Many of those who responded and left an email address to get personal feedback, have a UK email address. So let's find a UK standard.


Here's one from the ONU:

Standards for size

And right below that,

let's place the average values from our study for our 49, before they got sick. ("average" for me always transates into means and standard deviations)


Means for size


So our responders on average were : 4 cm taller, 4 kg heavier than the average Brit. (These mean values include incorparating comparisons with the different standards for males and females).


Now just a bit more detail. Let's start placing a judgement on those sizes.

Let's use that Body Mass Index (BMI) result and our standards.


The mean "before illness " BMI is (so far) 27.3 Kg/M². The interpretation at the top in the first image on this page reads:  "25.0 - 29.2  = Overweight."

And on average, that body mass snuck up just a bit further by the time weeks later, when they took the questionnaire.


You have the average values for English men and women just above on this page.

And while remaining polite, those averages for both men and women in England, place them very much in that "Overweight" category.


To be a bit more specific for our group of 49:


Females: BMI before illness, 27.5 Kg/ M²

Males: BMI before illness : 25.8 Kg/ M²  (only 6 males in these data)

So again, less ponderous than the average Brit, by gender, but still in that category of "Overweight."


So what can we say?

      • Does being a few cm taller and a little larger, make one a "bigger target" for the coronavairus? Sounds ridiculous. While having more skin surface (didn't calculate that but we could), might present a larger surface to come in contact with viral particles, it ususally comes in through nose, mouth, eyes, and not through the skin. Not unless you rub your sking on your nose, mouth, eyes.
      • And since we learn as well from exceptions to the rule, 24 respondents (49%) were in the normal BMI range given above before getting ill. Eight (8) lost weight (33%); 9 gained weight (37,5%); and 7 (29%) remained the same. One person in this group gained 12 Kg!
      • And 1 was underweight. And gained 3Kg ! An increase in BMI from 17 to 18 Kg/ M².



Age and weight have usually had obvious ties

Here are our respondents who were 48 years old and younger:


Age less than 48


Simply put, they were taller and skinnier than the average Brit before getting sick.


And those older than 48?


Age greater than 48


Well, they were slightly taller, but 8 Kg heavier than the average Brit.


Is this why they caught this thing?

Who knows? I don't. All the medical literature since just about whenever, says that you should maintain a normal weight (or BMI) if you want to stay healthy. That point will be returned to below.


We won't be adding too much data here, nor torturing the data in 5 or 6 different ways in this article to see what secrets in can whisper to us. That gets worse than a PowerPoint presentation.


But, we haven't said "the 'O' word yet.

How many of our respondents so far, before their illness started, were obese? Had a BMI > 30 Kg/M².


Answer: 13  ( divided by 49 = 26.5%)

And compared with those same standards ... Taller and bigger.


Obese vs standards - 18 sept



Let's push the topic slightly and gently ...

We know that 45% of the world's population is overweight.


What do we learn if we compare further with this set of standards:


3 Classes of obesity



Class 1 obesity : 6 respondents ( divided by 49 = 12.25%)


Class 1 obesity - 6



Class 2 obesity : 4 respondents ( divided by 49 = 8.2%)


Class 2 obesity - 4



Class 3 obesity :  3 respondents (6.12%)


Class 3 obesity - 3



OK, let's stop taking apart and putting together these data for right now.


As I said before, these are preliminary results. So watch out with the numbers at this time.

I share them now, because I think it can potentially help those who are still patiently or impatiently, piecing together why they're sick.




But let's keep the promise we made at the top of this page ...


Another quick slap in the face of science began when people in government said "This will be like a flu." Then epidemiologists and healthcare people and and especially patients learned to say: "Hey. This isn't the flu! This has nothing to do with the flu! I'm still sick and it's been a month! (or 6.5 months)."


Well parts of that are true and parts are all wrong.


COVID-19 is a respiratory virus. So's the flu.

COVID-19 can cause deaths. So can the flu.


But before continuing my comparative list, let's bring in the real pros at this. John Beigel is a good name to know in the viral illness department.


The relationship between viral infections and obesity is more complex than a simple worsening of the infuenza infectiveness and clinical picture and outcome in obese patients. Most readers will have heard that.


It is important to remember that the obese individual will carry and transmit the SARS-CoV-2 virus for a mean of 104% longer than those of normal weight. It's why quarantine duration should be doubled in an obese, infected patient.


Also, best results, meaning: less transmission of the virus, less severe illness, shorter duration are obtained within the normal range of Body Mass.

It has a "U" - shaped form of occurence of illness. At the bottom of the "U" is normal weight. On the left rising bar of the "U" is underweight (and more illness). At the right on the "U" is overweight (and more illness). So a less "big deal" with this COVID-19 illness can be anticipated if normal in size. A "bigger deal" if either underweight or overweight. Either may get one into the same pit of trouble.




But what about that weight GAIN result clearly seen here in the responses to this questionnaire?


Here is a link to an excellent piece of work on our very subject so you can download it.

Share it with those caring for you if you have this illness, and when the question comes up.


Stay with me another 180 seconds ...


The proposed mechanisms by which a viral illness (including COVID-19) could lead to weight gain and even "new onset" obesity are :


      • an increase in inflammation with specific cells (macrophages, our 'vacuum-cleaner' cells for example are one good choice) causing ...
      • a reduction in leptin in fat cells
        • leading to increased fat accumulation in those cells
        • a reduction in breakdown of these fats for energy use
        • a reduction in lipid oxidation (burning fat) and fatty acid synthesis (which would use the fat to make other things like cellular memebranes for example)
      • more uptake of glucose by fat cells, leading to an energy surplus
      • more adipocyte proliferation and differentiation (more fat cells) than before
        • normal weight gain usually involves filling cells that are already present with more fat. But not making new fat cells.
        • but now, "oh no!" - more fat cells are being made, just waiting to fill up with,... you guessed it: fat.


So ...

These wonderful physicians and scientists have provided the perfect explanation for our results.


For those who are wondering if "Long-term" COVID-19 can be associated with weight gain, and even to the point of obesity, the answer is yes


You are not thinking your way fat. You are not eating your way fat (unless you really go, excuse the expression, hog wild),... it's the virus.


It's not your "glands." It's the virus.


Know someone who should believe you when you say that, but doesn't?


Send 'em here.


And to have more wonderful articles like this appearing here, make sure and tell all those with COVID-19 that has become "Long-term" to fill out that darn Questionnaire.


They might learn something. They might even feel a bit relieved.



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