Weight loss, healthy eating during COVID-19 can be a struggle

Written by Michael Monostra, an Online Content Editor for Healio, specializing in endocrinology.

 Struggles with losing weight, eating healthy and exercising during the early weeks of the COVID-19 pandemic were reported by more than half of a cohort of adults with obesity, according to a speaker.

 “The COVID-19 pandemic has created a complex situation where people with obesity are finding it more difficult to take care of themselves with appropriate nutrition and physical activity, which is probably being fueled by the reported increases in depression, anxiety and job loss,” Jaime Almandoz, MD, MBA, medical director of the Weight Wellness Program and assistant professor in the division of endocrinology at University of Texas Southwestern Medical Center, told Healio. “These changes in health behaviors and mental health may have lasting effects for body weight, metabolic health and wellbeing well beyond the pandemic.”

Almandoz discussed the findings during a virtual presentation at ObesityWeek Interactive.

Many people with obesity were experiencing high levels of stress, anxiety and depression at the beginning of the COVID-19 pandemic. Almandoz and colleagues surveyed 123 adults with obesity from an academic medical center’s obesity medicine clinics and a community metabolic and bariatric surgery practice (87% women; mean age, 51.2 years; 20% Hispanic; 35% Black; 60% white). Participants completed an online survey in late May about whether they had contracted COVID-19 or experienced symptoms and how their physical and mental health behaviors changed during the pandemic.

Of the cohort, 69.6% said they struggled to lose weight during the pandemic. A decrease in exercise intensity was reported by 55.8% of participants, and 47.9% said they decreased their duration of exercise. Most participants reported struggles with eating; 64.2% said healthy eating was more challenging during the pandemic and 62.1% reported stress eating. About half of participants said they stockpiled food.

Mental health was a concern for most of the cohort, with 83.6% reporting depression and 72.8% saying they had increased anxiety. After adjusting for key demographics, BMI and COVID-19 infection, Hispanic participants were less likely to report anxiety compared with white individuals (adjusted OR = 0.14; 95% CI, 0.04-0.5; P = .02). No other significant associations were found when comparing ethnicities.

Two participants reported testing positive for COVID-19, and 16 reported having COVID-19 symptoms. Additionally, about 10% reported losing their job during the pandemic.

“The mental health aspects of the stress and how that might be informing their self-care behaviors was really quite striking to us,” Almandoz said during the presentation. “If you look at the demographics of the people that we saw, they were relatively high-income as more than 50% have a household income of greater than $75,000 per year, but more than 20% were reporting difficulty affording food and almost 10% reported losing their job. And this was early on in the pandemic, so who knows what kind of financial and psychosocial challenges people are facing now.”

Almandoz said the findings reveal the need for providers to stay in touch with individuals with obesity, especially with COVID-19 cases rising in the U.S.

“We need more information on how to keep all people with obesity engaged in healthy behaviors during the pandemic, especially when traditional office visits are not safe for this high-risk group,” Almandoz told Healio. “We need to find novel ways to interact with our patients through telehealth and mobile devices to support them on their journey to a healthier body weight.”

Researchers are currently working on a second phase of the study in which they will explore the impact of COVID-19 on telehealth utilization, ethnic group differences in health behaviors, and health care access and engagement for individuals with obesity.

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Ms. Jenn Landers | Patient Advocate Alliance LLC
Edited by Dr. Justin Groode