71st Session of the WHO Regional Committee for the Western Pacific (6-9 Oct 2020)

World Obesity and our members in the region, including the Australian and New Zealand Obesity Society, commend the World Health Organization (WHO) and its member states in the Western Pacific region (WPR) for their action to control the novel coronavirus.

As the pandemic evolves, we wish to draw attention to the interactions between COVID-19 severity and obesity, a disease that affects the region acutely, and one that must be considered in all COVID-19 response and recovery plans. Obesity is a chronic disease that independently increases mortality rates and is a major risk factor for the three non-communicable diseases (NCDs) responsible for the majority of premature deaths in the region - type 2 diabetes, cardiovascular disease, and cancer. Mounting evidence also now shows that obesity is a major risk factor for COVID-19 complications and mortality. Global analysis published in our journal Obesity Reviews found that people with obesity were 113% more likely to require hospital admission, 74% more likely to require ICU admission, and 48% more likely to die.

Overweight and obesity also appear to be risk factors for worse outcomes in younger populations (<60 years old), with patients with BMI between 30 and 34 being twice as likely to be admitted to ICU compared to individuals with BMI under 30 . In addition, strict measures like self-isolation and lockdown have resulted in physical activity restrictions, limited accessibility to healthy food, and increased mental health difficulties. It is thus vital that we focus during this time on improving the health and reducing the vulnerability of people living with or affected by or at risk of developing obesity, while working to reduce stigma around the disease.

World Obesity’s Global Atlas on Childhood Obesity predicts that, by 2025, the highest number of children aged 5-19 years living with obesity will be in the WPR region: 62 million, or 17% of children in the region. According to our Missing the Targets report, no country in the region is on track to meet WHO obesity targets, and all 10 of the top 10 countries with the largest proportion of adults over 20 years old living with obesity are in the WPR. In the context of COVID-19 these facts and figures have a new urgency.

COVID-19 has exposed fatal weaknesses in the most advanced health systems, where there has not been room to address seemingly less urgent problems such as the ongoing burden of ill health due to obesity and poor diets. Since the start of the pandemic, treatment and support for the chronic NCDs prevalent among people with obesity/overweight, such as diabetes and cardiovascular disease clinics, have receded, exacerbating risk of strokes and ‘heart attacks’. The social, economic, and specifically racial, determinants of health have been identified as the root cause of health disparities and poor outcomes related to COVID-19.

As you meet today, we urge governments to embed the following considerations in their national strategies for COVID-19 in the short- and long-term:

• Ensure that nutritionally adequate food is made available for all, particularly for vulnerable populations.
• Ensure patients living with NCDs have continued access to medications and treatments.
• Ensure that policies and restrictions in place to limit the spread of COVID-19 allow for people to be physically active, while maintaining adequate physical distancing.
• Increase education and awareness that obesity is a disease and not a sign of affluence.
• Recognise that obesity and other NCDs increase the risk and likely worsen the outcomes of COVID-19, and ensure that people living with these diseases have access to testing and are provided with care early.