COVID-19 Should Up Urgency of Anti-Obesity Efforts, Docs Say

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

The evidence linking obesity to adverse COVID-19 outcomes is “overwhelmingly clear” and points strongly to the need for aggressive obesity prevention and management efforts, two UK experts say.

“Recent successful interventions in weight management need to be extended and offered to many more people at risk,” write Naveed Sattar, MBChB, PhD, professor of metabolic medicine at the University of Glasgow, and Jonathan Valabhji, MBBS MD, national clinical director for obesity and diabetes at NHS England, London, UK.

“New, simpler, innovative ways to spread evidence-based dietary or activity messages should also be examined as many people with risk factors are not currently receiving advice. If ever there was a time to improve obesity prevention and management, it is now,” they stress.

Risk of Hospitalization For COVID-19 Rises With Increasing BMI

Sattar and Valabhji summarize evidence from several hundred epidemiological and genetic studies – with more than a dozen meta-analyses – linking obesity with worse COVID-19 outcomes, in their article published online August 10 in Current Obesity Reports.

The evidence suggests that the link between body mass index (BMI) and COVID-19 related mortality is stronger than for deaths from other causes, including other respiratory illnesses.  

A genetic study suggests that the risk for COVID-19 hospitalization rises by about 5%-10% per kg/m2 increase in BMI.

“The COVID-19 pandemic has shone a light on obesity in an apparent new way — ie, as a risk factor for an acute infectious condition that has killed more than 3 million people worldwide as well as contributing to many experiencing long COVID,” they write.

Telling Patients About Obesity–COVID-19 Link May Motivate Them

The COVID-19 pandemic adds urgency to anti-obesity efforts from a clinical perspective, especially as the pandemic has promoted weight gain due to less physical activity and less healthful eating in many cases, Sattar told Medscape Medical News.

“The medical professions in each country need to up their games with respect to weight management. But the issue is few have the time or expertise to discuss in clinics. What could be done is to develop a simple menu of evidence-based options that do work,” Sattar said.

These options include lifestyle changes “first and foremost,” as in the DiRECT trial, or commercial weight-loss plans, newer medications, and bariatric surgery for some.     

The once-weekly glucagon-like peptide-1 (GLP-1) receptor agonist semaglutide (Wegovy, Novo Nordisk) was approved for weight loss in the United States in June and is under regulatory review in the UK and Europe.

“We should soon have medicines that help larger weight loss. As ever, they cost more so we cannot apply to all folk who would want them, especially in health systems with finite resources…but at least positive developments are coming,” Sattar said.  

Importantly, he urged, “We need to target those at risk of obesity well before they get there. We cannot go on simply treating the end-stage diseases with more and more drugs as obesity is fueling multimorbidity, so there is much to gain by earlier evidence-based lifestyle interventions. We need to develop such clinics more widely and make evidence more accessible to all folk and make weight conversations the norm.”

Telling patients about the link between obesity and COVID-19 outcomes might be helpful, Sattar believes.

“Anything that motivates may help some folk, and as COVID-19 is an immediate risk, then some may respond better than being told about longer-term risks such as diabetes, cancer, heart disease, etc.”

Fundamental Reform of Food Environment Needed

Sattar and Valabhji also discuss recent initiatives by the UK government to target obesity, including population-level proposals to ban television and online advertisements for unhealthy foods at certain hours of the day and mandating calorie counts on restaurant menus.

The National Health Service (NHS) has recently begun offering new or expanded services for weight management for people with obesity also diagnosed diabetes or hypertension, and is aiming to double the capacity of the NHS Diabetes Prevention Programme to support 200,000 individuals annually by 2024.

Diabetes Prevention Programmes are already offered in the United States, and other countries are also considering adopting the program.

The NHS also has “excellent” online resources for patients on weight loss tips and how GPs can help patients lose weight, for example, Sattar noted.

But overall he suspects that the UK government’s initiatives thus far will only be “modestly beneficial.” “We need to do much more, like legislate food manufacturers to reformulate to better, healthier products, but this will take time, and food companies will have to be forced to invest and cut profits, which they will lobby against, but unless we fundamentally change the food environment then it’s hard to see major population shifts in obesity,” he noted.

The issue is linked to yet another global crisis, he said.

“At the time of climate change, we really need to integrate food policy with the need to cut methane and CO2, so it could be a win-win…All governments need to think holistically.”

Sattar has reported consulting for Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, MSD, Hamni, Novartis, Novo Nordisk, Pfizer, and Sanofi, and receiving grants from Boehringer Ingelheim, AstraZeneca, and Roche Diagnostics.


Hypogonadal Men With Psoriasis Benefit From Long-Term Testosterone Replacement Therapy

Psoriasis is increasingly recognised as a skin disease with far-reaching systemic effects, associated with a high prevalence of comorbid disease such as cardiometabolic dysfunction, shifting the focus from a single organ disease confined to the skin to a systemic inflammatory condition. Chronic and systemic inflammation plays a major role in the development of these diseases, and there are striking similarities between the molecular and inflammatory pathways in psoriasis and atherosclerosis. In a single-centre, cumulative, prospective registry study of 347 hypogonadal men (total testosterone ≤12.1 nmol l(-1) ), fifteen men with psoriasis could be studied. Upon testosterone administration, the skin disease improved considerably. Scores on the Psoriasis Area and Severity Index and Physician Global Assessment for Psoriasis showed significant improvement for the first 24 months. Thereafter, these improvements were sustained. Upon testosterone treatment, C-reactive protein declined significantly. There were significant improvements of obesity and of lipid profiles. Adipose tissue is now regarded as a source of inflammatory factors. These preliminary results deserve to be studied in a specifically designed study to investigate the effects of testosterone on psoriasis and its associated immunopathology.

Keywords: C-reactive protein; erectile function; metabolic syndrome; psoriasis; testosterone.

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Totally Losing It…Together!

If you and your sweetie-pie are both looking to shed some pounds and move toward a more healthy lifestyle, is it better to go it alone or to join forces in the quest for a better life? While there are certainly some challenges in tackling weight loss together, the benefits are far greater. Here are some keys to totally losing it…together!

1. Decide Why
After you’ve motivated yourselves to get started, you may notice a little decrease in your desire to press forward. This isn’t the time to cut back, but rather to push forward with even more dedication. Decide at the onset why you want to make the change toward a more healthy life. Have an honest conversation about your motivations and your goals – both right away and in the future. Having (and reviewing) these goals will prove to be great motivation as you continue to move toward a healthier lifestyle.

2. Mars and Venus
One of the biggest hurdles in a tandem weight loss journey is the results at the scale. Most experts agree that men will lose weight a bit more efficiently than women. This difference is due, in part, to the fact that men typically have a higher concentration of water in their bodies. These “water pounds” are the first to go! Ladies, don’t get discouraged if your beau is losing weight more quickly than you. Think long-term!

3. Keep Your Roles Equal
Often times, one partner will take the role of “Food Police,” while the other adopts the part of the “Exercise Monitor.” Don’t let yourselves fall into the trap of false competition. Remember that you’re not in a race. Accountability is necessary for success but don’t let the process put any strain on the bond you share with your partner. Make it a point to share the responsibility of encouragement and inspiration. Plan meals together, construct your exercise routine together, and never let any lapses become and excuse to fall off the wagon.

4. Be Supportive
This is a bit of a two-edged sword, as being supportive of your partner also involves a good bit of transparency and honesty. Do your part in being upfront about your struggles. If you’re prone to bouts of binge-eating while you’re bored, it’s important your partner is aware. If there are struggles you face when you’re away from each other, be honest about them. After your share your concerns, it will become easier for your partner to be able to support you in the right way.

5. Spur It On
Mutual accountability is about more than just support. Motivation and determination are equally important. You should be determined not only to see your own goals to fruition, but also the goals of your sweetheart! Motivate each other with notes, praise, and affection. Likewise, never punish or belittle your loved one because of a shortcoming. Commit yourselves to each other and to living a longer, happier, and more productive life together!


Dining Out & Eating Smart

As the holiday season dies down, you may find yourself frequenting your favorite restaurants a little more often than you did in weeks before. Most restaurant owners will tell you they see a significant bump in traffic after the holidays. They attribute this increase in patronage to the fact that most of us want to avoid the hassle of cooking – especially after spending so much time in the kitchen during the holiday season!

If you’ve set out to make weight loss a priority goal for 2015, give some thought to your habits when it comes to dining out. Here are four quick tips to help you make better nutrition decisions at restaurants!

Hydrate Yourself
Your beverage is typically the first thing you’ll order in a restaurant. While a cola or beer may be your go-to, they’re full of empty calories and can actually make you thirstier. Instead, order a glass of water. Filtered water is usually free, anyway. So you may save a few bucks on the check! Drink most of your glass of water before your meal arrives.

Special Order
If the chicken dish looks good but it’s served with starchy or fatty sides, ask about swapping for something a little more healthy. Likewise, if vegetables are cooked in butter or fried, ask whether the chef could prepare them in oil or just plain steamed. If you’re feeling like you might be a pain to the waiter, you can always leave a little extra tip!

Leave the Freebies
Fried chips and salsa, warm bread and butter, croissants and jam, or any other free appetizers your server may set down will likely leave you full of empty calories. In fact, a small piece of bread and butter could cost you as much as 150 calories. Likewise, you should take it easy on salad dressings and sauces. Often times, these are full of salt, fat, or flavor enhancers.

Know Yourself
If you’ve always “indulged” in the dessert cart at Vincenzo’s or if you’ve never been able to turn down that deep-fried onion blossom from your favorite steakhouse, it might be a good idea to avoid those temptations altogether – at least for the first couple months of your weight loss journey. As your cravings and habits begin to change, slowly work in these familiar places but go in with fresh eyes and a fresh attitude.


7 Steps to New Year’s Goal Success

Let’s cut straight to the chase – New Year’s Resolutions get a bit of a bad rap. From failed diets, to putting down nicotine, to the quest for more family time, the Resolution finds far more failure than victory. While it’s true that New Year’s Day is really just the same as any other day in your life, it’s possible to use the turning of a new year as a catalyst for change.

The important thing is to think of your “resolution” as a jumping-off point as opposed to the beginning of a brand new life. Being realistic about your goals, as well as implementing practices that help encourage those goals, can go a long way in helping you complete them. In this final blog entry before the clock strikes “2015,” we’ll take a look at 7 steps to helping you realize your goals for the New Year!

1. One at a Time
Many times, we will find ourselves falling short of goals simply because we’ve set too many of them. Losing 25 pounds, letting go of caffeine dependence, getting more exercise, spending more volunteer hours…these are all great goals. But if you try to start each of these at the same time, you are much less likely to see success in all of them. Instead, work your goals out one at a time. Choose the one that will take the most effort and work on that goal first. Add another goal as the year goes by, and then another when you complete that one. This brings us to our next tip –

2. Make a Plan
Imagine taking a cross-country road trip. Let’s say you’re starting in Wilmington, North Carolina and you’re heading all the way to Portland, Oregon. This certainly isn’t the sort of drive you can just wing. You’d need a map, you’d need to know how much fuel you’ll have to purchase, you’d need to know where you could stop to sleep, you’d need to know the cost of hotel rooms along the way, you’d have to get an idea of where you could stop for food. In the same way, making changes to your life is a sort of journey. Set yourself up for success by making a plan. Think about your long-term destination, and think about all the little goals you’ll have to reach along the way. Keep in mind you’ll need to fuel your journey as well as making sure you’re taking care of yourself. A good plan doesn’t only exist in your mind. In fact, you’re way more likely to succeed if you –

3. Write It Down
The physical act of writing down your plan tells your subconscious mind that you mean business. Don’t just jot them down on your computer and send them to the printer. Instead, take the time to write your goals down in your own handwriting. Commit to paper the plan you’ve made and review it regularly. While this step of the process will help you to stay on track, accountability is also a huge help in seeing goals to fruition. With that in mind, it’s important that you –

4. Talk About It
Once you’ve sorted your goals, made a plan, and committed it to paper, another great practice is to talk about your journey. Get your friends and family excited about your goals and involve them in any way you can. If your brother decides he could benefit from a little more physical exercise, commit to walking the park with him once a week. If your neighbors are excited about the community service you’re planning to do, ask them to join you in organizing a food drive. This accountability can really help along the way as you can rely on support from your loved ones. And while a support system will help you take the steps you need, it’s important to remember that your journey is about –

5. Progress, Not Perfection
While some of us can skate through our plans with nary a detour, most of us should expect a few speed bumps along the way. If you deviate from your plan, remember that it’s okay. Get yourself back on track by remembering the progress you’ve already made – even if it’s only been a day! When we “fall off the wagon,” or “back step,” the temptation is to throw hands up and walk away. But don’t fall into the trap of perfection. If you do get stuck, it’s okay. Just remember to –

6. Know When You Need Help
If you find yourself in over your head, remember that this is NOT the end. There’s no reason for you to feel embarrassed or overwhelmed. Detours will happen, and when they do, it’s just a matter of correction. However, if you need help, you shouldn’t be afraid to ask for it. Talk to your friends and family and ask them to help keep you accountable. Whether it’s a matter of redoubling an effort or just tightening up your routine, an accountability partner should help you get back on track. On that note, it’s also so important to –

7. Celebrate Milestones
In the same way we would plot out that cross-country trip with a few stops along the way, you should never pass a milestone without celebration! If you were looking to change your exercise regiment, and two months in this new plan is now just part of your routine – celebrate it. If you were looking to do more volunteer work in your community and a backpack drive was a huge success – celebrate it. If you’re down 25 pounds a bit ahead of schedule – celebrate it. Now, it should be noted that a weight-loss celebration should probably not be celebrated with a layer cake and ice cream, but treating yourself to a movie, a spa day, a new putter, a day-trip to the next city north, or that new gadget you’ve had your eyes on is a great way to reinforce your small successes.

At Contemporary Health Center, it’s no secret that our mission is to help you look and feel your best. While you’re making plans for 2015, we’d love to know how we can help. From Medi Weight-Loss to our aesthetic services to our health and beauty products, CHC is committed to helping you be the best “you!” As 2014 comes to a close, we’d like to thank each of you for being a part of the Contemporary Health Center family.

Here’s to making 2015 your best year ever!


Healthy for the Holidays

While the wintertime months can certainly fly by in a hurry, they can leave effects that linger well into the new year. It’s important to remember that continuing healthy habits and managing stress are also important even during the holidays!

Here are six tips to help you stay healthy and happy for the season.

Do Less, Live More
In the hustle and bustle of the holiday season, it’s easy to get caught up in all the things we believe we “must” do. From holiday party appearances, to door-busting sales, to cookie swaps, to office gatherings, and everything in between! It’s important that you’re also thinking of yourself during the holidays. Take the time to rest when you need it and get plenty of sleep. Don’t let your typical routine get run-over in the name of busyness.

Stay Active
Would you believe that inactivity, more than overindulgence, is the primary contributor to holiday weight gain? Don’t skip your usual exercise routine during the winter holidays. Instead, keep on track with your usual level of physical activity. You might even lose some weight before it’s resolution time!

Be Picky
For some of us, the treats that surround the holiday season are a must. We’ll sacrifice an extra 3 hours on the treadmill for a slice of Aunt Patsy’s pecan pie, right? The point here is that if you’re going to indulge (and this doesn’t mean overindulge), make it count. Don’t waste those calories on store-bought Christmas cookies you could get any old place. If you’re banking some wintertime calories to be able to spend on holiday treats, make sure those treats are special.

Phones Down
The constant “ding” of emails, social media updates, game reminders, and other alerts from your cell phone can actually put you in a constant state of fight-or-flight with adrenaline hitting your system every time you hear the chime. When you’re spending time with loved ones especially, make sure your phone isn’t at the center of your attention. Save yourself the stress and be more in the moment with your friends and family.

Warm Up
Hot food, and especially hot drinks, can do more than just warm you up in the winter. They can actually help improve your mood. That mug of hot herbal tea will trigger the release of endorphins – the natural chemicals in your body that encourage feelings of happiness and well-being. Share a hot beverage with a friend and enjoy a good, long chat.

Focus on Fun, Not Food
We tend to associate holidays with food – turkey on Thanksgiving, cookies on Christmas, chocolates on Valentine’s Day, etc. And while Christmas Day just wouldn’t be the same without Uncle Vincent’s sweet potato casserole, this doesn’t mean that food is the reason for the get-togethers. Try to encourage togetherness beyond the meal table. Trim the tree, hang some lights, sing a few songs, dust off the board games, or find a park to throw some frisbee. Focus on making memories more than getting full.


Choosing Starches: Whole Grains & Starchy Vegetables

What Is a Starch?
Starches are a complex carbohydrate found in plants. Plants with larger amounts of starch include legumes, cereals, grains, and some vegetables, including corn and potatoes. Starch provides energy for the plant to grow, similar to how our bodies use starch for energy. There is another complex carbohydrate found in plants called cellulose, the main component of fiber. Non-starchy vegetables have fiber, but little, if any starch. They are less energy dense than their starchy counterparts. In the Short-Term Maintenance Phase, you add starches back into your nutritional plan. You should choose whole grains and starchy vegetables, which are the most nutrient-dense starches.

What Are Whole Grains?
All grains begin as whole grains. Whole grains are the entire seed of the plant (also called a kernel) and consist of three components:
Bran — multi-layered outer skin of the kernel; contains fiber, B vitamins, and antioxidants
Germ — contains many B vitamins, some protein, minerals, and healthy fats
Endosperm — contains starchy carbohydrates, proteins, and small amounts of vitamins and minerals; largest part of the seed

Whole grains contain all three components. The germ and bran help slow the digestion of grain, helping you avoid spikes in blood sugar. Refined grains have the germ and bran removed before processing, leaving only the white endosperm. Refined grains, such as white flour, white rice, and enriched flours, are quickly converted into sugar and can cause blood sugar levels to spike.

Additionally, when grains are refined, they lose many of the nutrients that make them beneficial. When wheat, the most popular grain in the U.S., is processed it loses more than half of its B vitamins, 90 percent of its vitamin E, and virtually all its fiber. Refined grains have some of the vitamins and minerals lost in processing added back in, but this does not make them a whole grain.

Types of Whole Grains
• Wild rice (actually a seed)
• Brown rice
• Whole-wheat flour
• Oatmeal and whole oats
• Barley
• Whole rye
• Bulgur
• Popcorn
• Amaranth
• Millet
• Quinoa
• Sorghum
• Triticale

Determining Whole-Grain Products

It is typically a whole grain if the first ingredient is:
– Whole grain (name of grain)
– Whole (name of grain)
– Whole wheat
– Stone ground (name of grain)
– Brown rice
– Oats
– Wheat berry

It is typically not a whole grain if the first ingredient is:
– Wheat flour
– Semolina
– Durum wheat
– Organic flour
– Multigrain
– Enriched flour
– Wheat germ
– Bran

• Be wary of packages labeled organic flour, wheat flour, or multigrain because these statements do not necessarily indicate a whole-grain product.
• When choosing loose whole grains, such as quinoa, amaranth, or barley, the ingredient list should include only this grain.

Click here to download a .pdf file with some insight into serving sizes for starches!


Flatter Your Figure

A healthier lifestyle begins with the personal commitment to make changes to your daily life. As your thoughts go, so your actions will follow! It’s important to remember that a healthy lifestyle means something different from person to person. For example, the foods that give you off-the-charts energy could be pretty ho-hum for someone else. Likewise, a specific exercise regiment that produces amazing results for your friends may do little for you. Our bodies are different not only in the way we operate, but also in the way we’re shaped. While you’re walking the journey toward looking and feeling your best, set yourself up for confidence by dressing to match your body shape. Here are a few examples of what to wear and what to avoid when you’re heading out for the day!

PearA Pear Shape
If you have a well-defined waist but your hips are wider than your bust line, you fall into the pear-shaped category. The goal for dressing this body type is finding clothes that balance out the bottom and top halves by making you appear slimmer through the hips. Short sleeves or shoulder pads can help balance out your top, while low-rise, straight-legged pants slim the bottom. Choose skirts that are straight or slightly flared, but avoid anything that hugs the hips too closely. Wearing a chunky necklace draws attention away from your bottom half. Don’t wear skirts or pants that are tapered at the bottom and stay away from skirts, dresses or belts that add additional bulk to your bottom half.


AppleAn Apple Shape
If you are round through the middle and narrower in the legs then you have an apple-shaped body. Dress to bring attention away from your midsection
to your face, and choose colors, patterns and shapes that lengthen your body. Wearing the same color on top and bottom will give the illusion of
a longer body. For tops, choose lower necklines and don’t tuck in shirts. Fabrics that flow rather than cling to the midsection are generally more flattering, and skirts should either be straight or slightly flared.


HourglassAn Hourglass Shape
If your hips and bust are proportioned and you have a well-defined waist then you fall into the hourglass category. The goal here is to wear clothing that defines your waist without adding bulk to the top or bottom. Wear soft, clingy fabrics that are fitted but not too tight. Belts that cinch at the waist are perfect for defining your figure. Stay away from baggy styles that don’t show off your waist, which may make you look heavy or boxy. Avoid high necklines (unless you have a small bust) as they make your top half look disproportionately larger than your hips.



Remember these are just guidelines! Of course, no matter what your body shape, wear clothes that you feel happy and comfortable in. Remember, confidence is half the battle.