Obesity is a state of malnutrition, and since proper nutrition has a proven relationship to immune function, it should be no surprise that obesity impedes the immune system. Researchers have been churning out studies and literature reviews for decades about the adverse effects of obesity on the immune system. Most notable are the numerous studies about poor outcomes of obese people during the 2009 H1N1 pandemic. Obesity compromises the immune system by making it both over- and under-active, leading to grim outcomes when infection strikes.
According to the CDC, “Morbid obesity, with or without the presence of other underlying high risk health conditions, is associated with a higher risk of 2009 H1N1-related hospitalization and, possibly death. People who are morbidly obese often suffer from other medical conditions and it is possible that some people who are morbidly obese have unrecognized chronic medical conditions.”
The authors of a 2012 literature review say that a “striking number of recent studies have reported obesity to be a predictor for a worse outcome of infection with the 2009 influenza A (H1N1) pandemic strain.” Obesity increased the risk of admission to the ICU and death, and obese people were “disproportionately represented” among deaths and hospitalizations. And obese people who were admitted to the ICU stayed longer and required a longer duration of ventilation than non-obese patients.
Of 534 California residents who were hospitalized for H1N1 during the first four months of the pandemic, the California Department of Health noted that 61% of those who died were obese. They also found that “patients with BMI ≥45 had a 4.2-fold increased odds of dying, with a case-fatality proportion of 34%.”
Why does obesity impair immune function?
Obesity interferes with vital immune system components. As the authors of a 2016 literature review write, “obesity has been shown to increase fat deposition in tissues of the immune system.” The accumulation of fat in lymphoid organs — including the spleen, thymus, bone marrow, lymph nodes, and certain tissue in urogenital, respiratory, and gastrointestinal tracts — “adversely affects immunity in older individuals.” Fat in bone marrow suppresses production of blood cells and platelets. Obesity is associated with reduced thymic output, therefore reducing the ability to properly develop T cells, which the immune system deploys to fight pathogens.
Obesity can cause a lack of oxygen
When excess body fat reaches a certain amount, the local veins are insufficient to support the tissue’s oxygen needs, resulting in a lack of oxygen distributed to certain parts of the body. This condition is called hypoxia and it can be caused by low oxygen in the blood, hypoxemia. Hypoxia is extremely dangerous and can cause immediate damage to your organs.
Obesity is linked to nutrient deficiencies
While malnutrition has long been known as a cause of immune system dysfunction, the “overnutrition” of obesity is often low in critical immunity nutrients. Thiamine, Vitamin B1, deficiency has been observed in 15–29% and Vitamin C deficiency in 35–45% of “obese individuals planning to undergo weight loss surgery.” Vitamin D insufficiency has been observed at a 80–90% rate in obese people. Interestingly, Vitamin D deficiency is also associated with increased rates and poorer outcomes in respiratory infections.
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