How to lose weight for the second Covid wave, by Dr Michael Mosley

With pubs and restaurants starting to open up across the UK, and pre-lockdown life slowly returning to normal, health experts are also warning the UK to prepare for a 'second wave' of Covid-19. And according to Dr Jenny Harries, England's deputy chief medical officer, one way to protect yourself is to lose weight.

Speaking to Phillip Schofield on This Morning last week, Dr Harries said, “Obesity is actually problematic and that’s one of the things that we could do something about," before advising people to "make yourself as fit as possible, and keep practising that social distancing over the winter.”

"I do think there is a likely to be a second wave as a number of other countries have already begun to experience theirs," says Dr Michael Mosley, creator of The Fast 800 Plan. "It is most likely to happen as we move into winter, when people are bored of social distancing rules and begin to huddle up together indoors. The virus is far more likely to spread indoors than outdoors, and there is good evidence that sunshine (ultraviolet light) kills the virus fairly fast."

Dr Mosley says that anyone carrying excess weight is at a greater risk of becoming ill if they get Covid-19. "The more overweight you are, the lower your lung capacity, so if Covid-19 attacks your lungs you are more likely to end up in intensive care. Being obese also means you are likely to have a less efficient immune response, and added health complications such as high blood pressure, heart disease and type 2 diabetes, which seriously increases your risk of Covid-19 complications."

Losing weight, therefore, can swiftly boost your chances of recovery, and rapid weight loss via fasting has been shown to be a powerfully effective way of going about it, says Dr Mosley.

"I have been writing about the importance of losing weight, if you have a large waist and raised blood sugars, for years. As well as weight loss, I’ve also written about good gut health, intermittent fasting, ways of reducing stress and getting better sleep. And one of the threads linking all my work has been the way these lifestyle changes will not only shrink your waistline but also bolster your immunity."

Dr Mosley says that while being overweight doesn’t increase your risk of catching the virus if you are exposed to it, being obese does make you twice as likely to end up in intensive care with life-threatening complications if you do catch it.

Three quarters of the people who die from Covid-19 are overweight or obese, which is worrying news for the estimated two thirds of the UK population who are heavier than they should be.

5 reasons why Covid-19 is so much worse if you are overweight

You have less space to breathe

Any excess fat around the neck and airway and the extra weight on the chest hinders breathing, making very heavy people more vulnerable to complications straight away. The more overweight you are, the lower your lung capacity so, if Covid-19 attacks your lungs then you are more likely to end up in intensive care.

You’re more likely to have raised blood sugar levels or type 2 diabetes

People with type 2 diabetes or prediabetes (where your blood sugars are raised but not yet in the diabetic range) are more prone to all forms of infection. That’s because raised blood sugar unleashes destructive molecules which interfere with the body’s natural infection-control defences.

You are more likely to have metabolic syndrome

If you have a large waist you are more likely to have dangerous ‘visceral fat’ in your abdomen and this can lead to a host of conditions, which include raised blood sugar levels, elevated blood pressure and abnormal levels of cholesterol and fat in the blood which together form a toxic cluster called ‘metabolic syndrome’.

This elevates your risk of dying from Covid-19 ten-fold. That is worrying for the 1 in 3 adults over the age of 50 in the UK, Australia and the UK who have metabolic syndrome. Many of them don’t even know they have it.

You are likely to have damaged arteries

People with raised blood sugar levels also tend to have extensive damage to their blood vessels. Covid-19 attacks your blood vessels and also causes increased formation of blood clots, and if your blood vessels are already damaged through long-term raised blood sugar levels or too much fat in the blood, this can put you at risk of heart attack or stroke.

Your immune system is likely to struggle

Not only will an immune system weakened by excess weight be unable to mount a strong enough defence to stop the coronavirus replicating itself throughout your body, but it is more likely to over-react under pressure, causing ‘collateral damage’ to healthy tissue. This can lead to organ failure and even death.

So, is it safe to lose weight quickly?

"Yes, absolutely," says Dr Mosley. "There is a widespread belief that if you lose weight fast, then you will put it on even faster. But is that true? In a recent review article titled 'Myths, Presumptions and Facts about Obesity' in the prestigious medical journal, The New England Journal of Medicine, researchers put this claim firmly into the “myths” category.

"After looking at numerous studies which have compared rapid with slow and steady weight loss, they concluded that you would do better to lose it quickly rather than slowly. A recent Australian study backs up these claims. Researchers took 200 obese volunteers and put half of them on a low calorie diet (less than 800 calories a day) for 12 weeks. The other half were asked to cut their calories by 500 a day (enough to lose around a pound a week).

"They were then asked to do this for 36 weeks. There was a very high drop-out rate among the steady dieters: less than half made it to the end of the 36 weeks. Most said they gave up because they were frustrated by the slow rate of progress. By comparison, more than 80 per cent of those in the rapid weight loss programme stuck to it.

"They were then followed for three years. Although both groups put some weight back on, the amounts were similar. Katrina Purcell, a dietitian who led the study, said at the time, 'Our results show that achieving a weight loss target is more likely, and drop-out is lower, if losing weight is done quickly.' Rapid weight loss isn’t suitable for everyone and if you do decide to lose weight fast you have to make sure you have the right balance of nutrients in your diet.

"Most rapid weight loss studies are now based on 800 calories a day, which is high enough to be sustainable and give the nutrients you need, and low enough to lead to rapid weight loss and other beneficial health changes. You might worry about getting hungry but most people who fast say that within a very short time their hunger passes. Rapid weight loss encourages your body to switch over to fat burning. It also reduces insulin levels, increases growth hormone and boosts levels of a hormone called BDNF in the brain, which helps improve your mood.

"Right now, under the spectre of this frightening pandemic, losing weight isn’t about being ‘bikini body ready’ for summer. For many people, weight loss is now, quite literally, a matter of life and death."