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Comment by nradov | Hacker News Reader

I think Hidekatsu Yanai was largely correct about the mechanism of action in fat tissue back in October 2020.

https://cardiologyres.org/index.php/Cardiologyres/article/vi...

It's disappointing that public health agencies haven't put much emphasis on telling people to reduce body fat. While the vaccines are fairly effective at preventing deaths, breakthrough infections are quite common and getting down to a healthy body fat level further reduces risk.

https://www.wfae.org/health/2021-09-30/novant-says-9-of-10-c...

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Public health already emphasizes reducing body fat to a significant degree for numerous other health reasons. Simply telling people to do so has proven fairly ineffective.

I think, in the context of possibly dying of Covid-19, it could be effective though. If the messaging was there that you could greatly reduce your risk by loosing weight, at least the group of people who were both obese and seriously frightened of Covid could be engaged to make positive changes. That would save lives.

> I think, in the context of possibly dying of Covid-19, it could be effective though

Possibility of dying blind, without feet because of diabetes wasn't good enough reason to lose fat for many. COVID-19 won't be either.

Yeah but "possible condition 20 - 40 years away" is very different to "contagious disease that could get you next week". Urgency is a motivator!

Even with the onset of diabetes/serious complications from the disease, it’s still often not enough.

Losing weight is very difficult for people to sustain. There are individual success stories but those don’t outweigh the fact that, statistically, people just isn’t lose weight and keep it off sustainably.

No it isn't. People don't make rational decisions about these things. Just look at how many reject social distancing, masks, and vaccines.

"Not enough" and "too many" are both perfectly fitting with your example.

Next week and losing fat can't be in the same sentence.

1 kg of fat is roughly 7500 Cal. Healthy deficit is 500 Cal a day, which means losing 2 kg of fat per month. 50 kg overweight means two years of suffering.

People are motivated to lose fat already. There are immediate social and psychological costs aplenty to carrying it and immediate benefits to presenting as trim/fit.

Obesity is not a motivation problem.

I would believe that covid has provided all sorts of opportunities for changes in habit, though, which might help.

If COVID has proven anything, it's that political messaging is far better than all other types of messaging combined.

Either way, telling people to change their lifestyles falls on deaf ears as a group. People know, for example, that being obese in your 50s and 60s puts you at a great deal of risk, yet most people who are obese at the beginning of their 50s are still obese at the end of their 60s, provided that they are still alive.

You know why politicians don't state these obvious facts? Because they don't want to lose votes.

Most fat people probably don't like hearing wealthy skinny politicians with personal chefs and trainers telling them to lose weight. Doesn't score well with the focus group I guess.

We can't reliably get people to vaccinate, which reduces the risk of severe hospitalization or death orders of magnitude more than losing weight.

How many orders of magnitude? Can you quantify that for us? While I recommend that everyone eligible protect themselves by getting vaccinated, I don't think the current data supports the strength of your claim. Exaggerations and hyperbole aren't helpful.

Peak protection From hospitalization and death reaches over 90%.

I’m not too familiar with the added risk from being over weight, but as I understand it, it is no where near that big of a step change.

So that would be one order of magnitude, not orders (plural). We need to be precise in our communications.

Agreed. It's like if you see a bus heading towards you, would you stand still and let it hit you or step out of the way?

> Simply telling people to do so has proven fairly ineffective.

We've already normalized instituting authoritarian measures over this pandemic. Given the Rubicon we've already crossed, there's absolutely no moral reason we shouldn't be firing everyone who doesn't reduce their BMI below threshold X by Y date and confining them to their homes.

What nonsenses.

Vaccines and masks don't protect just you but also those around you. Its simple and effective measures. That's the justification for mandates.

Fat kills you and you alone. The reasons are often complex and it requires long-term changes in private lifestyle and behavior to make any change.

But obese people don't live in vacuum, they are much more likely to take away the hospital beds from others in this pandemic. Also the world has socialised medicare (par America) so the costs have relevant effect on every citizen for anti vaxxers and obese.

If the obese and overweight remain fully vaccinated w/ boosters, it's unlikely they'll end up in the hospital taking away hospital beds. The unvaccinated in general are the biggest issue.

Public health agencies have been telling people to lose weight for decades.

they can tell until the cows come home but it's very hard to actually do it cause most causes are environmental and lifestyle related that can't easily be changed - can't all of a sudden start walking to work if you live in a car dependent area and that's true for most of the USA.

Wake me up when you find a US government with the guts to mandate cuts in the amount of high fructose corn syrup allowed in staple foods, put a tax on sugary drinks etc...

until then telling people to lose weight is a waste of time.

Actually, have they put any emphasis at all in reducing body fat with regard to Covid? Look at the CDC's recommendations:

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-si...

Nothing about losing weight, eating healthy, exercising. Nothing about vitamin D either.

It's both sad and hilarious that the CDC is still recommending frequently disinfecting your doorknobs. As if that's going to make a difference in the pandemic.

Meanwhile we have very strong evidence from multiple controlled clinical studies that hypovitaminosis D is a critical risk factor.

https://vitamin-d-covid.shotwell.ca/

in california at least, we did exactly the wrong thing in this regard: we closed down all gyms for over a year, and even shut down outdoor recreational facilities, to the point that outdoor basketball rims, soccer goals, and tennis nets were removed, outdoor gym equipment chained, and outdoor trails were closed. it was beyond idiotic.

Is washing hands and sanitizing touch points (like doorknobs) ever not effective at preventing disease? Hand Washing seems to be one of the few things doctors have never wavered on since the beginning of germ theory.

It's not effective in cases where the disease is neutralized by the environment before you would wash your hands anyways. A lot of diseases can't survive outside the body for long; I think this is more true of viruses than bacteria, but I could be wrong.

E.g. HIV doesn't last long outside the body. By the time blood dries, almost all of the HIV is neutralized.

I think the research has said COVID is similar, and can really only live on a surface for minutes.

Hand washing is great for preventing disease generally. It's less effective against some diseases, but it also has virtually no downsides, so it's still a sane thing to do.

Yes, but it doesn't seem to achieve much in the context of COVID-19.

I don't think I'd classify any of those studies as "very strong evidence". Lots of studies in many different environments(some uncontrollable) measuring different things at different dosages. It doesn't exactly result in finding any particular conclusion, certainly not "Vitamin D supplementation effectively prevents, reduces harm or cures COVID".

You're arguing against a straw man. I never claimed that vitamin D cures COVID. Go back and read the studies again.

I didn't say you said that, but looking at study summaries that state things like "high-dose cholecalciferol supplementation led to SARS-CoV-2 RNA negative status" is why I mentioned "cure".

At the bottom of the page you linked, you'll find a link for "People at Increased Risk"(also found via "Specific Groups of People" link on sidebar), you'll then click on "Medical Conditions"[1], which mentions a list of medical conditions that increase risk, including obesity. Obesity section links you to the CDC's "Healthy Weight, Nutrition, and Physical Activity" page[2], which discusses exactly what you mention.

1. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precaut...

2. https://www.cdc.gov/healthyweight/index.html

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