Summary List Placement

As the US continues efforts to vaccinate Americans against COVID-19, people with underlying health conditions are being moved to the front of the queue. 

In 15 states, obesity is one of those qualifying conditions. 

That’s because having a body mass index (BMI) above 30, the cut-off line for obesity, is considered to be a risk factor for severe coronavirus complications, according to the Centers for Disease Control and Prevention. 

Unlike other chronic conditions such as diabetes or cancer, obesity comes with a social stigma which can prompt poorer care, even from healthcare providers, according to Dr. W. Scott Butsch, director of obesity medicine at the Cleveland Clinic. The stigma can also cause people to delay medical treatment. 

In some cases, people with obesity might not even realize they qualify for an early vaccine. While BMI is an imperfect measure of health, over 40% of US adults have obesity. That’s an estimated 78 million people, so it’s worth checking your BMi to see if you qualify for a vaccine. 

How to know if your BMI grants you access to a vaccine

Your BMI is determined by body weight relative to height, and you can calculate it online using the CDC website (or if you like math, take your weight in pounds, divide by your height in inches, and multiply that total by 703). 

A number between 25 and 29.9 is considered overweight, 30 and above is considered obese, and 40+ is categorized as severe obesity. 

Obesity  is a qualifying condition for vaccine eligibility in Mississippi, Nebraska, New Jersey, New Mexico, New York, Pennsylvania, Texas,  Virginia, and Wyoming. 

You’re eligible if you have severe obesity in Montana and Missouri.

People with obesity in addition to another underlying, like diabetes, qualify in Massachusetts, New Hampshire, North Dakota, and South Dakota.

Other states may include obesity as a qualifying condition as vaccine rollouts continue. Availability is regularly changing state by state, and even county by county, so check your state’s guidelines. 

Obesity is a known risk factor for COVID-19 complications

Obesity is linked to more severe COVID-19 cases, as well as a higher risk of complications.  In April, researchers found that obesity was the most significant chronic risk factor for hospitalization among coronavirus patients. Evidence has also found that the higher an obese person’s BMI, the more likely they will die of COVID-19.

Obesity is also more common among Black and Hispanic Americans, which data show tend to be disproportionately affected by COVID-19. 

With all the research suggesting people with obesity are high-risk, Butsch said it’s sup rising that more states aren’t making it a priority for early vaccine access. 

“With the call to follow the science, I’m very curious if there’s a small amount of hypocrisy when we don’t follow the evidence in prioritizing people who have obesity in distributing the vaccine,”  he said. 

BMI is an imperfect measure of health

You might have a higher BMI and be perfectly healthy. You may not even appear overweight or obese.

“On an individual level, BMI may not be a perfect indicator of someone’s health risk. It’s one of several measurements that we have to assess health risks,” Butsch said. 

That’s because BMI doesn’t take body composition into account.

Someone with a high amount of muscle mass could weigh enough to be categorized as overweight or obese, even if they’re metabolically healthy . The same is true for people who are especially tall. 

BMI also doesn’t account for where people carry their weight. Not all body fat is created equal; research suggests that belly fat or visceral fat (around the organs) is linked to more health risks, compared to fat around the hips and thighs, for example. 

Since BMI was first created in the 19th century and was based on what was typical for white Europeans at that time, it may not be accurate for assessing the health of different demographics, including people of different races. 

Weight stigma could prevent some from seeking out a vaccine

Weight stigma may discourage people who could benefit from the vaccine from getting one. 

Fears about weight and body image might also prevent people from keeping tabs on their weight, particularly if it’s recently changed, so they might not even know if they’re categorized as obese.

That’s all the more reason to check on your BMI. 

“Many people come into my clinic and are surprised when we discuss the number,” Butsch said. 

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