Deterioration in mental health during the COVID-19 pandemic linked to worsening obesity

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The COVID-19 pandemic, now in its third year, has brought a host of public health setbacks in addition to its specific toll on human lives. Due to the widespread closures, many people have been stuck inside with little to do. With more than 40% of American adults already struggling with obesity, the pandemic was thought to be increasing social isolation while reducing access to health care and high-quality nutritious food sources.

A recent survey by Jaime Amandoz, MD, and colleagues in Texas found that nearly one-third of obese people gained more than 5% of their body weight in the first year of the COVID-19 pandemic, 1 in 7 earning 10%. Amandoz believes the heightened anxiety produced 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 of individual and social stress and has shown that changes in mental health can really make it harder for people to maintain a healthy body weight,” Amandoz said.

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

In the current report, Amandoz and his fellow researchers found that the majority of obese patients surveyed had gained around 4.3% of their body weight during the pandemic.1 Another study cited in their work showed that 48% of all American adults gained weight during the pandemic, further confirming this new data.2 Respondents generally had a higher level of education and economic status. Investigators believe that people of lower socioeconomic status likely face even greater stress and greater weight gain.1

Factors associated with greater weight gain included less healthy eating, less intense sleep and less physical activity.1 Finally, people reporting 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 also needs to be integrated into the treatment of the whole person,” notes Amandoz.

These results make sense. The stress of a pandemic, coupled with isolation and fear, is straining the mental health of obese patients who are already struggling to lose weight. As we move into the third year of COVID-19 and beyond, we as clinicians need to assess our patients for stress, anxiety and depression with enhanced support and targeted interventions. When access to care is limited, we need to find alternatives such as virtual visits and responsible meetings in the office. Education and encouragement become even more important when our patients are dealing with mental health issues. Resolving these mental health issues should be part of every visit.

Every effort should be made to identify patients most at risk for weight gain. The challenges faced by isolated obese patients should not be underestimated. The stigma and mental health issues already faced by obese patients should be assumed to be dramatically worse during the pandemic, but with support, understanding and encouragement, we can ease the added pressure. Amandoz points out that people who participate in weight management programs generally lose weight.1

As such, we should do everything we can to get obese patients into and keep them in these programs, programs that should assess and treat 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. 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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