Why did Boris Johnson get so sick from the coronavirus?
One of the highest-profile world leaders to suffer from COVID-19 was Boris Johnson, the prime minister of the United Kingdom. Not only did he test positive, but he also became very ill due to the novel coronavirus infection, sars cov-2.
During Mr. Johnson’s hospitalization in April of 2020, he states that he came very close to being put on a ventilator. Fortunately, while in intensive care, he only required oxygen treatment.
The prime minister came dangerously close to death due to COVID-19. After being discharged from the hospital, Mr. Johnson stated that he believed the severity of his coronavirus infection was due to his being overweight.
Now that he is recovering and has resumed his prime minister’s job, he has pledged to institute policies in the UK to lower the rate of obesity and a sedentary lifestyle.
Boris Johnson’s height is 69 inches. At 245 pounds, his body mass index (BMI) was 36 at the time of hospitalization. If he were to gain another 30 lb, his BMI would be 40, the cutoff for morbid obesity.
Experts at the centers for disease control have known for a long time that obesity is a significant risk factor for a worse outcome from COVID-19. How is it possible that the prime minister of the United Kingdom would allow himself to remain overweight during the pandemic? Why was he not engaged in an intensive weight loss program before getting sick?
Is it possible that Mr. Johnson has issues with food addiction, food cravings, and binge eating? While we can speculate on the causes of his weight condition, as a matter of protected health information between him and his healthcare providers, we may never know unless he decides to reveal more.
Can public health programs reduce the rates of obesity?
What can we do to help ourselves and others reduce our weight if we are clinically overweight and help others lose weight? Will public policies make a difference in reducing obesity in Britain and around the world? Will Boris Johnson tackle his nation’s obesity problem with sugar taxes and programs to increase the public’s physical activity?
Unfortunately, these programs may do little to impact obesity and eating behaviors in the UK and beyond. Food addiction issues are personal for each individual. To improve our relationship with food and overall health, we must work on our challenges individually to make positive progress.
For example, there are excellent programs, such as A Community Wellness Clinic in Spokane, WA, that provide excellent comprehensive care, including attention to food, mind, body, and soul. Alternatively, there are 12-step groups, such as Grey Sheeters Anonymous, that address specific food problems and mental, emotional, and spiritual issues.
In my interview with Sara Somers about her book, “Saving Sarah: A Memoir of Food Addiction,” she discusses the impact that GreySheeters Anonymous has had on her life. A central theme of the Grey Sheeters program is in following a food plan that avoids common trigger foods.
What about medical treatment for overeating?
Some medications can help with food cravings. While we no longer have the old Fen-Phen diet program from the 90s, due to the heart valve damaging dangers of fenfluramine and dexfenfluramine, there are still some effective medications.
Phentermine, one of the components of Fen-Phen, is still around. Phentermine functions similarly to amphetamine, suppressing appetite.
Even more intriguing is the use of naltrexone to treat binge eating disorder. Naltrexone is an opioid receptor blocker used to treat opioid addiction and alcohol use disorder. It also shows promise in treating other forms of drug addiction.
Naltrexone works on food addiction the same way it works for alcohol addiction. Pharmacological extinction is the process of retraining the brain by blocking the endorphin reward associated with a bad habit, such as over-drinking or overeating. Naltrexone is used as a key component of The Sinclair Method (TSM) to treat alcohol use disorder.
It is similar to the Pavlovian experiment with training dogs to salivate with the sound of a dinner bell. By removing the reinforcing reward, the behavior diminishes and eventually disappears.
Naltrexone is available in combination with the antidepressant, bupropion, as the brand name drug, Contrave. Contrave is an FDA-approved weight-loss pill.
What about therapy for weight loss and overeating?
Therapy can make a difference, especially in addressing underlying issues that may trace back to childhood. Cognitive-behavioral therapy may also be useful and is available in a variety of settings, from therapists to SMART Recovery meetings.
Additionally, there is a new class of technology, known as prescription digital therapeutics (PDT).
PDT utilizes smartphone software that has been authorized by the FDA for use in treating specific mental health conditions. Doctors are prescribing PDT for patients with various addictions.
The software uses cognitive-behavioral therapy to treat patients. In addition to helping people to identify triggers, the software facilitates monitoring by the prescriber and communication between patient and healthcare team.
You may also find apps that are not FDA authorized but use similar therapeutic techniques to help people modify eating habits. Ask your doctor for further recommendations.
Is low carb eating the best way to lose weight and keep it off?
A low carb diet consists of foods that tend to be low in carbohydrates. Carbohydrates are food molecules related to sugar. When the body digests carbohydrates, they break down into sugars.
The thinking behind low carb eating makes sense. When you eat sugars and carbs, your body responds by releasing insulin from the pancreas. Insulin is a hormone that helps deliver sugars to the body’s cells for energy. Unfortunately, insulin is also a hormone that promotes increases in fat deposits.
When a person sustains a low carb diet for some time, they may enter a state known as “ketosis.” Some experts believe that ketosis promotes weight loss because the body converts to breaking down stored fats for energy. Diets that promote ketosis are known as “ketogenic diets.”
Are ketogenic diets safe?
There is some debate on this subject. Some experts believe that sustained low carb diets are safe and can be maintained indefinitely. Others are concerned about various risks, including poor nutrition, because low carb dieters avoid healthy fruits and vegetables.
There is also concern that blood vessels can be damaged by carb binging after being on a low carb diet. While we cannot be sure about the safety of low carb diets, there are healthy alternatives.
What about eating certain foods with a low glycemic index?
You may have heard the term “glycemic index.” The glycemic index is a measurement of how a food affects blood glucose and insulin levels. Low glycemic index (GI) foods digest more slowly and are, therefore, healthier. Most fruits, vegetables, and legumes are a low glycemic index. Processed foods, such as potatoes, corn, white rice, and processed foods, such as cereals, have a high index.
The Mediterranean diet is a diet that includes plant-based foods primarily. Many of the foods recommended on this diet are in the low GI category. The Mediterranean diet is known to be a heart-healthy diet.
Another similar diet, described by Dean Ornish, MD, is based on a study demonstrating that coronary artery disease could improve with diet alone. While there is an appeal to optimizing heart health with diet alone, many consider this food plan to be strict and difficult to follow.
What about peer support?
It is not easy to get support from family when it comes to weight loss. Food control is a sensitive subject. When you try to manage your food intake, it seems like suddenly, everyone around you is an expert.
You may even have an issue with family members purposely, or unintentionally, sabotaging your efforts. “One meal is not going to make you gain weight.” Fighting the urge to eat delicious foods is made more difficult by family members who undermine your program.
As mentioned earlier, some programs integrate peer support. For example, there are 12-step programs, such as GreySheeters Anonymous (GSA), Overeaters Anonymous (OA), and others.
When it comes to commercial programs, there is WW, formerly known as Weight Watchers. While WW meetings can be helpful, it is questionable if the program has a high rate of success for most members.
Some private medical programs may include ongoing individual support or group support. When speaking to a weight loss or nutritional expert, ask if they offer a support community. In some cases, they may manage a group on Facebook, open only to current clients.
How can peer support help? When you have success, following your program for several days, it can be rewarding to share your progress with the group. Likewise, if you are facing challenges and sticking to the plan, you can discuss your issues with the group and gain additional insight and ideas for improving your program.
COVID-19 is surging, and I am overweight. What can I do right now?
If you are overweight, you didn’t gain the weight overnight, and you should not attempt to lose it too quickly either. I recommend starting by tracking your foods. Even if you find it challenging to stick to a particular food plan, you will find it easier to manage food intake if you are aware of the foods you are eating. Tracking your meals will significantly increase your awareness of your eating habits and promote overall healthy eating.
The fact is that tracking food and exercise is central to all of the best and most successful programs. Fortunately, tracking is getting to be more accessible than ever.
There are some excellent tracking apps and tools available. For example, there is the app My Fitness Pal, which has an extensive database of foods, and it can scan food package bar codes. You can get started right away by downloading the app and making it a point to enter every meal that you eat during the day.
When you track foods, be sure to check the number of servings in a package. For example, if you have a can of soup, it likely has at least two servings, even in a small can. If you do not see how many servings you are consuming, you may eat more than you think you are.
What about exercise?
In losing weight and maintaining weight loss, following a sensible food plan is the most crucial element of your program. However, exercise is also essential. Exercise can help you to lose weight, and it has additional health benefits.
The best kind of exercise includes activities that are safe with the lowest risk for injury. Walking outside is an excellent form of exercise. Swimming is also excellent. If you have access to a machine, such as an elliptical machine, you can exercise without excessive strain on your knees.
Walking and swimming are aerobic exercises that help with weight loss and heart health. You may also choose to engage in weight training or other muscle-building activities. It is essential to be careful to avoid injury. Injuries can be long-lasting, and they will hurt your weight loss program.
Where should I get started?
The first step in getting healthy and losing weight is to make an appointment with your doctor. Your doctor will be able to do a physical exam, evaluate your history for risk factors, and perform various lab tests and additional testing if it is needed.
For example, some people have difficulty losing weight because of an underactive thyroid. Your doctor will be able to check your thyroid with a blood test. They can also check your blood sugar, cholesterol, and other important health indicators.
If there are any concerns about your heart health, your doctor may order cardiac testing to ensure that your heart can handle an exercise program. These tests may include a stress test, echocardiogram, and electrocardiogram.
If your doctor does not routinely advise patients on specific weight loss plans, they may refer you to a nutrition specialist or weight loss doctor. You may also want to consider seeking a weight loss specialist and schedule a consultation.
When you see your doctor, you can also ask about some of the medications discussed in this article. While not for everyone, naltrexone and Contrave are particularly intriguing. Naltrexone may be more appropriate for people who believe that they have a food addiction and tend to go on food binges.
Because of the pandemic, you may want to consider starting with telemedicine, or telehealth, visit. An online visit with your doctor will limit your potential exposure to infection.
What about bariatric surgery?
You may have heard of various surgeries for weight loss. Are these procedures recommended? There are gastric banding and gastric bypass. Are these surgeries safe?
As with any surgery, there are significant risks. There is a risk of infection, bleeding, trauma, and more. With gastric bypass, there can be long-term nutritional problems. Even after major bariatric surgery, it is possible to regain the lost weight.
Additionally, doctors perform these procedures on people who are at high risk for surgical complications. Obesity and type 2 diabetes are conditions that increase the risk of surgical complications and even death.
Before jumping into bariatric surgery, which has a higher risk than most other weight loss methods, it is essential to weigh the risks versus benefits and evaluate all alternatives carefully. In some cases, weight loss surgery can be life-saving. Yet, there are often alternatives that you can try first.
What about hypnotism and acupuncture?
In addition to medical weight loss procedures, there are alternative non-invasive procedures that you may consider trying. Are they effective? Hypnotism and acupuncture are two alternative therapies advertised as being helpful for weight loss. Should you see a hypnotist or acupuncturist?
These alternative therapies are of questionable value and will be highly dependent on the skill of the provider. While the risk associated with these techniques is minimal, they can be costly. I recommend investigating the evidence for the success of alternative therapies before getting started.
Stay safe and lose weight.
You can lose weight, and you can keep the weight off and stay healthy. By losing weight and avoiding future weight gain, you will be increasing your overall health. Your risk for severe health conditions, such as heart disease and cancer, will be significantly reduced.
You will have less of a chance of COVID-19 severe complications if you become infected with the novel coronavirus. I recommend calling your doctor today to schedule an appointment to evaluate your weight loss needs and to formulate a plan for weight loss success.