COVID-19 Lockdowns Pose Weight-Related Health Risks for Obese People

By Lisa Rappaport

July 06, 2020

(Reuters Health) - Many people with obesity who don't test positive for SARS-CoV-2 still face health risks from weight-related behaviors like less frequent or intense exercise, and more food stockpiling and stress eating, a small U.S. study suggests.

To see how COVID-19 stay-at-home orders are impacting people with obesity, researchers conducted an online survey from April 15 to May 31 of 123 patients who were being treated at an obesity medicine and bariatric surgery clinic prior to the pandemic.

Most patients reported increased anxiety (72.8%), depression (83.6%), and difficulty achieving weight loss goals (69.6%) since stay-at-home orders were issued.

Many of them also reported behavior changes that would make it harder to lose weight or avoid weight gain, including less exercise time (47.9%), less intense exercise (55.8%), more food stockpiling (49.6%), and more stress eating (61.2%).

Two patients tested positive for SARS-CoV-2, and 14.6% reported some symptoms of infection.

"Even though actual COVID-19 disease burden was low, the pandemic is having a significant impact on those without infections," said study coauthor Sarah Messiah, a professor of epidemiology, human genetics and environmental sciences at the UTHealth Science Center School of Public Health in Dallas.

Participants' mean BMI was 40.2 and 33% had undergone metabolic bariatric surgery.

Many participants reported chronic medical conditions including high blood pressure (67%), sleep apnea (51%), diabetes (30%), hyperlipidemia (25%), asthma (23%), heart disease (15%), and current cancer treatment (4%).

Nearly all of them were under stay-at-home orders (91.5%) and most of them (87%) said they only left home for necessities.

Although most participants reported cooking more at home (63.8%), most also said that healthy eating was harder under stay-at-home conditions (61.2%).

The majority of people surveyed reported no food insecurity (72.8%). However, some participants did skip meals (12.1%).

Results of the study may not be generalizable because the study population included primarily white women with a college education and annual income of at least $75,000, the authors note in Clinical Obesity. All the participants were also established weight-management clinic patients with health insurance, which doesn't reflect the typical American with obesity.

The main limitation of the study was the inability to measure body weight, said Zachary Zeigler, an associate professor of physical activity, nutrition and wellness at Grand Canyon University in Phoenix, Arizona, who wasn't involved in the study.

Even so, the results highlight the work ahead for clinicians as stay-at-home orders lift and people can start to revert to pre-pandemic routines, Zeigler said by email.

"Before COVID, people had to get up and get going, and part of that process may have involved exercise and preparing meals," Zeigler said. "Once this routine was removed, it appears that people fall away from these healthy behaviors that were a piece of their routine."

Economic hardship caused by the pandemic may also make it difficult for people to simply pick up any healthy habits they had before, Dr. Messiah said. The pandemic may also impact the accessibility and affordability of care even after stay-at-home orders lift.

"Due to the increase in obesogenic behaviors related to the COVID-19 pandemic that were found here, it is paramount that healthcare access is not disrupted for patients with obesity," Dr. Messiah said. "Maintaining these vital services will prevent exacerbating the negative health and economic consequences of excess body weight."

SOURCE: Clinical Obesity, published online June 9, 2020.