Decline in mental health during the COVID-19 pandemic associated with worsening obesity

The COVID-19 pandemic, now in its third year, has resulted in multiple public health failures in addition to its specific toll on human life. As a result of the widespread lockdown, many people are stuck inside with little to do. With more than 40% of American adults already struggling with obesity, the pandemic was believed to increase social isolation while reducing access to health care and high-quality, nutritious food sources.

A recent investigation by Jaime Amandoz, MD, and colleagues in Texas found that nearly a third of obese people gained more than 5% of their body weight in the first year of the COVID-19 pandemic, with 1 in 7 gaining 10% . Amandoz believes that the increased anxiety induced in obese patients due to their increased risk of serious illness from COVID-19 and death is the driving force behind the dramatic weight gain.1

“The COVID-19 pandemic is a fascinating model for individual and societal stress and has shown that changes in mental health can indeed prevent people from maintaining a healthy body weight,” Amandos said.

Using surveys, the researchers of this study found very high levels of self-reported stress, anxiety, depression, and maladaptive eating behaviors among obese adults during the COVID-19 pandemic.1 Previous research by this team of researchers looked at the impact of stay-at-home orders on the mental health and behavior of obese patients. They found that 70% of patients felt that weight loss was more difficult during the lockdowns, with the large portions reporting less exercise and more stress-related eating.1

In the current report, Amandoz and other researchers found that the majority of obese patients surveyed gained about 4.3% of their body weight during the pandemic.1 Another study cited in their work shows that 48% of all American adults have gained weight during the pandemic, further supporting this new data.2 Respondents usually have higher education and economic status. The researchers speculated that those of lower socioeconomic status likely faced even more stress and more weight gain.1

Factors associated with greater weight gain include eating less healthy food, lack of sleep, and less exercise.1 Finally, those people who reported the highest levels of anxiety, depression, and stress gained the most weight.1

“It’s not just about telling people to eat less and move more, there’s a mental health aspect that needs to be integrated into treating the whole person,” notes Amandoz.

These results make sense. The stress of the pandemic, combined with isolation and fear, is putting a significant strain on the mental health of obese patients who are already struggling to lose weight. As we move into and beyond the third year of COVID-19, we as clinicians must assess our patients for stress, anxiety, and depression, providing them with improved support and targeted interventions. When access to care is limited, we must find alternatives such as virtual visits and in-office appointments. Education and encouragement become even more important when our patients are dealing with mental health challenges. Addressing these mental health issues should be part of every visit.

Every effort should be made to identify patients at highest risk for weight gain. The challenges faced by isolated obese patients should not be underestimated. The stigma and mental health issues already experienced by obese patients must be taken to be significantly worse during the pandemic, but with support, understanding and encouragement we can mitigate the added strain. Amandoz points out that people on weight management programs usually lose weight.1

As such, we must do everything we can to attract and retain obese patients in these programs, programs that must assess and address patients’ mental and physical health.

Reference:

  1. Almandoz JP, Xie L, Schellinger JN, et al. Changes in body weight, health behaviors, and mental health in obese adults during the COVID-19 pandemic. Obesity (Silver Spring). 2022; 1-12. doi:10.1002/oby.23501
  2. Khubchandani J, Price JH, Sharma S, Wiblishauser MJ, Webb FJ. The COVID-19 pandemic and weight gain in American adults: a national population-based study. Diabetes Metab Syndr. 2022;16: 102392. doi:10.1016/j.dsx.2022.102392

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