Introduction
Obesity is a chronic and recurrent disease associated with increased disability, comorbidities, and reduced quality of life, as well as life expectancy. Several severe diseases are caused or aggravated by obesity and early reports on Covid-19 infection have included obesity as an important risk factor for disease severity [1–5]. Recently, the Centers for Disease Control and Prevention included body mass index (BMI) over 30 kg/m2 as a risk factor.
Reporting obesity as a disease associated with Covid-19 severity is utterly important for clinical care, research and public health. However, there have been reports of increased stigma and personal responsibility, as obesity has been seen as a lifestyle choice. It is clearly important to provide a right message in which there is no blame the individual, but, at the same time, emphasize strategies to mitigate the risks. If obesity is a disease, achieving a “normal weight” would be the only way to mitigate the risks or is it possible to have a “controlled obesity state”, in which risks of several diseases are reduced?
For example, as a comparison, diabetes is also a risk factor for Covid-19 and several epidemiological studies have shown that good glycemic control is associated with reduced risk of infection. So, a simple public message for diabetes is to maintain your blood sugar under control (generally an HbA1c < 7%), but not necessarily in a non-diabetic level. Shouldn't we do the same with obesity?