- Over 80% of people in intensive care in France because of the coronavirus are overweight or obese.
- Even if other simultaneous factors can cause complications for these patients, this rate shows the fragility of this population, more and more numerous in particular in France.
- Will this problem of our societies be placed at the center of the debates in a world of tomorrow which will have seen to what extent this can constitute a risk factor?
In an article of April 7, the newspaper Le Monde , after consulting a national register of Covid patients, warned of the very large proportion of overweight people among patients in intensive care in France, more than 80%. A figure marking the realization of what many specialists have pointed out for a long time: populations have become more fragile in terms of health.
"Finally, we consider obesity for what it is: a disease in itself and not just a risk factor for diabetes or cardiovascular disease," said Dr. Monique Romon, former president of the French Nutrition Society. For her, the risk is clear: obese or overweight people more easily risk respiratory failure proportional to the importance of their obesity and have a risk multiplied by 7 to have to be intubated because of their respiratory distress. She concludes: “For years, with the French Nutrition Society, we have been fighting for this recognition. It takes this catastrophe for us to start being heard. "
A criticism of society more than of the individual
We immediately warn, out of the question to fall into the fist of the people concerned. Monique Romon puts the points on the “i” of the pictures on this subject. Individuals in a situation of overweight or obesity, which we see primarily in resuscitation services (but not only), “are mainly people in a situation of social insecurity, and their immediate concern is not the prevention of health because they have other problems to solve, they are the ones we must support as a priority ”.
We also specify, overweight is not necessarily linked to lack of physical activity or poor nutrition. Sylvie Benkemoun, psychologist and president of GROS (Think Tank on Obesity and Overweight), reminds us that there are lots of different causes and reasons, and different factors. Not all obesities are risk factors for Covid, but we put them all in the same basket. "
The World Health Organization estimates in its April 2020 report on obesity that the two main factors to explain the exponential increase in the Body Mass Index (a weight / height ratio) in the world (at l (Worldwide, the number of obesity cases has almost tripled since 1975, says the organization) are a bad way of eating and lack of physical activity.
Health first
In France, 54% of adult men and 44% of women are overweight or obese. Similar figures - or even much higher - in the other countries hugely affected by the Covid: Italy, United Kingdom, Spain and the United States.
In addition to being a direct cause of morbidity, overweight feeds others as part of the Covid: cardiovascular disease, diabetes, etc. So many diseases associated with lack of physical form, particularly dangerous during a pandemic. At a point much worse than expected, according to Nathalie Hutter-Lardeau: “All health professionals knew of course the theoretical risks of an overweight population. But to see a 40-year-old person in obesity end up in intensive care, it's a sacred awareness. "
Be wary of any sanitary
However, some, like Sylvie Benkemoun, warned of the risk of a purely health and cliché response: "I am worried that the next world will continue to want to fight obesity even more but by reproducing the same errors, with the same single answer and which pretends to ignore the multiple psychological and social factors, beyond questions of food and physical activity. "
It is this lack of a “personalized” response that she believes explains the failure for the moment of health policies. She cites as an example bariatric surgery (operations on the stomach), an increasingly invasive response to overweight, while it does not have long-term effects in more than a third of cases.
Hide this debate that I cannot see
After the shock of the human toll of the epidemic, what lessons will we learn from it? Will this famous world after see the questioning of these health policies? Will the “great sportsmen” of confinement, very visible on social networks, one day be applauded at 8 p.m., in a society glorifying healthy food and physical activity (which is already a bit the case)? (And we don't say that because we finally validated our three sets of ten pull-ups during this confinement).
Not so sure. If the rate of overweight people in intensive care quickly made the headlines of the media the week of the announcement, the figure then almost disappeared from the debates and questions about the world of tomorrow. At the table accused of the dysfunctions of our societies facing the coronavirus, junk food and the little physical activity of sedentary people are missing. Ultraliberalism, massive deforestation, forced globalization are held to account, but the questioning of our lifestyles does not seem to be on the agenda.
The impossible questioning of the West
Difficult introspection of Western societies. For Marie-Eve Laporte, “we would risk seeing this denunciation as a mark of our personal responsibilities and find it too guilty. "This is even the whole risk for Sylvie Benkemoun, who is worried about a world that is even more stigmatizing and difficult for overweight people:" We are in an all-sanitary and all-hygienic society where we wants to act on behalf of the frail for their good. I fear that we will want to deprive people of their right to dispose of themselves. "
Here again, Monique Romon warns against unnecessarily clouding the balance sheet, and points out that a lot has already been done: "Public policy is not limited to just saying that you have to eat five fruits and vegetables a day. The second obesity plan presented in October 2019 declines a series of measures and in particular the early support of people who are overweight and obese. ” Moreover, the first pages of this plan indicate, figures to support, a stagnation of overweight in France in recent years, breaking with decades of increase, proof that the country has managed to grasp a minimum of the problem.
The second obesity plan took particular account of territorial and social disparities, and pointed to “medical management of obesity appearing to be still insufficiently structured outside the hospital sector”, making a major improvement objective for the future (the plan runs until 2022). Monique Romon recognizes this, “unfortunately the means to carry out this policy are not yet there. "
Already noticeable changes?
Is a metamorphosis of our society then possible in the world of tomorrow? Will this epidemic, which has brought medical attention to the fore, fuel this debate? "This crisis should allow us to finally identify the problems of obesity to better understand it, in order to provide appropriate responses, less in the injunction and more in the understanding," hopes Sylvie Benkemoun.
Have not our lifestyles already started to change, during confinement? “Slowing down, taking the time to cook real meals, sitting down to eat is a blessing for your health. It is possible that after all this, the population keeps good habits: eat more local, cook your own meals… ”, believes Nathalie Hutter-Lardeau.
If we have to temporize on our plates, Marie-Eve Laporte asks the question at 100,000 dollars. "If we don't take this tragedy to put these issues at the heart of the debate, when will we do it?" "
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- Obesity
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- Covid 19
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- Overweight