When the COVID-19 pandemic reached the Rio Grande Valley in spring, the region was already beset by prevailing endemics: diabetes and obesity.
The collision of the outbreaks, a local bariatric surgeon said, is the reason the Valley’s death rate for the virus was the highest in the state during summer.
“When you get a combination of high obesity and a viral infection like COVID-19, that is when it can be catastrophic,” said Dr. Luis Reyes, a surgeon at South Texas Health System’s Bariatric and Weight Loss Center in McAllen.
Although he said the demand at the center for weight loss surgeries are just as high as pre-pandemic times, people who are obese or diabetic are afraid of contracting the virus and are citing it as the reason they are seeking weight loss surgeries.
“Many people have expressed that they know that bring obese will be detrimental if they get sick, so they are looking for options to get healthier,” he said.
Reyes added that more people are inquiring and engaging in weight-loss programs than before.
The Valley, where one in three people are either obese or have diabetes, had a COVID-19 death rate that was twice of the state’s average at one point. The region accounts for nearly 5% of Texas’ population, but as of Tuesday, the Valley’ death toll was 2,989, which is about 18% of the state’s.
Reyes said the term “diabesity” was created to describe how a diagnosis of either disease, more often than not, is linked to the other.
“We now have knowledge that diabetes and obesity are the most important comorbidities that will determine the outcome of the disease,” Reyes said.
Being overweight or having diabetes leads to other medical problems such as hypertension, arthritis and sleep apnea — comorbidities that can lead someone to having severe symptoms of COVID-19.
“Obesity is a state of chronic inflammation,” Reyes said. “So basically, the body of people who are overweight, are in a constant swelling state and that predisposes them to decrease in their immunity and makes them more susceptible to infections and any aggression that any system of the body could have.”
People who are overweight also tend to have difficulty breathing.
“All these mechanical conditions would make it very difficult when you have a virus that is attacking your respiratory system,” Reyes said. “So by decreasing the inflammatory state of the body, we are able to improve the ability of our body to fight the disease.”
When the pandemic hit the area in March, local hospitals were not allowed to perform elective surgeries, including weight loss surgeries. However in April, obesity was found to be a leading comorbidity of COVID-19, and hospitals were allowed to perform bariatric surgeries again.
He performs about five weight loss surgeries a week — such as gastric bypasses, laparoscopic bands and gastric sleeves — which reduce the size of the stomach and change the exchange of hormonal signals between the stomach and brain.
People who are classified as obese class 2, or morbidly obese — more than 60 lbs overweight and have a BMI higher than 35 — are candidates for weight loss surgeries.
Those who are 40 pounds or less are considered to be in obesity class 1, and Reyes said for people who fall into this category, he recommends medical management, exercise and a healthy diet.
Social distancing efforts the pandemic has prompted, however, made him concerned about the public’s health.
“I knew that people were going to choose mainly the wrong food and not be active, like watching TV in order to supplement their anxiety and boredom,” Reyes said. “People have gained weight and become a little enactive because of the pandemic. But during these times we need to learn from the problems and get up and say ‘we are not going to follow these negative feelings and we are going to eat healthy, we are going to exercise and we are going to figure out how we are going to get out of this pandemic.’”