When the Rev. Robert Biekman was diagnosed with COVID-19 last month, he couldn’t help but think what would have happened if he had still weighed more than 360 pounds — realizing how his condition four years ago would have hurt his ability to fight the virus and potentially cost him his life.
“If I was as big as I was, this thing would’ve probably taken me out,” said Biekman, 61, who after a 2017 surgery, change in diet and a commitment to run 5 miles every other day, now keeps his weight around 190 pounds or less. He recovered from the virus and now tests negative.
Obesity is a killer in Black communities, contributing to heart disease, diabetes, high blood pressure and all causes of death. It’s among the factors making heart disease the No. 1 cause of death among Black men in the U.S.
The pandemic exposed another deadly threat from obesity: A higher risk of complications or death from COVID-19.
After old age, underlying health conditions often spurred by being overweight or obese contribute the most to complications and death in COVID patients, U.S. health officials say. Obesity can triple the risk of being hospitalized with COVID and the risk of death rises with higher measures of body fat. The reasons range from poor lung function to suppressed immune systems from related health conditions, such as heart disease and diabetes.
Cook County Medical Examiner records list obesity as a contributing cause for 760 COVID deaths through January 10, or about 1 in 11 of the more than 8,500 deaths for that period.
The data also reveals a trend among younger people who have died. Those who are 40 or under account for only 2.5% of COVID deaths. However, almost 40% of the death records for that group indicate obesity was a contributing cause of death.
All demographic groups impacted
Obesity is a major health concern across all demographic groups in the U.S. About 40% of Blacks, 30% of whites and 34% of Hispanics are considered obese, U.S. health data show. Obesity is defined by a metric known as body mass index, or BMI, which calculates a score based on weight and height. A person who is 5-foot-9 and weighs 203 pounds or more would be considered obese, according to the Centers for Disease Control.
In Chicago and Cook County, it’s a problem that’s pushed health providers and Black community leaders to wage war on obesity. Blacks make up about 23% of the county population, yet account for 38% of the COVID deaths with obesity as a contributing factor, records show.
As the season of Lent approaches, the Rev. Otis Moss III, senior pastor at Trinity United Church of Christ on the South Side, urges his 7,500 members to honor the holy period with healthy living, including weekly adherence to nutritious eating.
“It’s part and parcel of our mission and our vision,” Moss said. “One of the things we worked very hard on is not only healthy choices but diet, exercise, spiritual and emotional state of health.”
During Lent in 2019, more than 40 members of Trinity United, encouraged by Moss, agreed to eat only a plant-based diet while a team of doctors monitored them. Examining blood samples, researchers found that in just five weeks of eating a plant-based diet the participants not only lost weight, they showed metabolic evidence of improved cardiovascular health.
“They lost a lot of weight, their risk factors went down, all the metabolic markers improved,” said study researcher Dr. Kim Williams Sr., chief of cardiology at Rush University Medical Center. “We made a difference.”
Dr. Terry Mason, former Cook County chief medical officer and a member of Trinity United who helped conduct the research, said the doctors hope to run an even larger study of at least 200 people in the future.
Williams and Mason, both vegans, promote the merits of eating only plant-based foods and avoiding processed and sugar-loaded items. Both have been stressing the vegan lifestyle for more than 20 years, and both men are worried about the impact diet has on the health of Black Chicagoans.
Preventative care, including exercise and healthy eating, is a better approach than “maintenance” through medicines, Williams said.
“If we were to follow that, we’d fight coronavirus better, we’d fight cardiovascular disease better and we wouldn’t have this problem in the African-American community so much,” Williams said.
Because of its impact on already stressed organs in the body of obese people, COVID-19 is just the latest bad outcome from poor eating habits, Mason said.
“Imagine it’s like pouring gasoline on top of a fire when you have COVID,” Mason said. “It creates these horrific situations in our bodies. That’s why most of these people who died from COVID, most of them have these underlying issues. If we really want to get to the core of the problem, we have to change what we eat.”
Even patients who are overweight just enough to be at the low end of being classified obese can face complications from COVID, said Dr. Holly Lofton, an obesity medicine specialist at NYU Langone Health in New York.
The more obese the patient, even procedures such as medical imaging and placement of breathing tubes can be difficult. What’s more, the more belly fat a patient carries can put pressure on the lungs, she said.
“Many people with obesity carry more fat around the midsection, which pushes up on the lungs,” Lofton said. “Patients can’t expand their lungs enough and that can very quickly lead to respiratory failure and death.”
The pandemic exposed discrimination in the U.S. health system. COVID is ravaging Black communities, disproportionately infecting and killing more people than in white neighborhoods. This is happening for a number of reasons, including a lack of access to medical care and overall poor health.
Funding sought to improve access to healthy foods
There are two major initiatives to improve health care on the city’s South and West sides, which are each seeking millions of dollars in state funding. Both efforts stress preventive health care and the West Side initiative proposes spending health care dollars to build a grocery store and boost access to healthy foods.
In a number of the city’s Black neighborhoods, convenience stores sometimes substitute for grocers but lack nutritious food options.
“There’s access to food but not food that’s beneficial to a child’s growth,” Moss said.
Both Moss and Biekman have been involved in forming the South Side initiative, illustrating the role of religious leaders.
Biekman, who is now an executive with the Metropolitan Chicago Synod of the Evangelical Lutheran Church in America, lost his weight when he was a pastor at Maple Park United Methodist Church on the South Side.
At the time, he openly talked with his congregation about the decision to address his obesity and transform his health, a discussion that inspired some of his church’s members, he said.
“With the faith community, we journey together,” he said.
Contributing: Caroline Hurley
Brett Chase’s reporting on the environment and public health is made possible by a grant from The Chicago Community Trust.