Stressful situations can cause changes in individual food choices, most notably, choices of highly rewarding foods that are high in fat or sugar. Few studies have examined how a population's food choices change during a country-wide stress-inducing event such as the beginning of the COVID-19 stay-at-home orders in the United States. Food data from a digital behavior change weight loss program, which includes an interface for logging meals, were analyzed to assess self-reported food choices from March 5-March 11 ("pre-COVID") and during the first week of the COVID-19 lockdown (March 12-March 18; "during-COVID"). The final sample consisted of 381,564 participants: 318,076 (83.4%) females, the majority who were aged 45-65 years (45.2%). Results indicate that self-reported servings of fresh fruit and vegetable intake decreased from pre- to during-COVID, while intake of red meat and starchy vegetables increased. More men than women increased their intake of red meat and processed meat. There was less overall change in fruit and vegetable consumption in participants aged 66 and older, compared to younger participants (aged 18-35). The percentage of older participants who reported lean meat and starchy vegetable intake increased, but these groups had a negligible change in younger subjects. More subjects aged 18-35 years reduced their intake of caffeine, desserts, lean meat and salads compared to older participants. No changes were observed in terms of snack or alcoholic beverage intake logged. In conclusion, this study of 381,564 US participants revealed that intake of particular food groups were altered during the first weeks of COVID lockdown.

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There is substantial variability in weight loss outcomes. Psychosocial characteristics underlying outcomes require better understanding, particularly on self-managed digital programs. This cross-sectional study examines differences in psychosocial characteristics by weight loss and engagement outcome, and which characteristics are most associated with weight loss, on a self-managed digital weight loss program. Some underexplored psychosocial characteristics are included, such as flourishing, or a sense of meaning and purpose in life. A questionnaire was emailed to a random sample of 10,000 current users at week 5 in the program and 10,000 current users at week 17. The questionnaire was completed by 2225 users, and their self-reported weight and recorded program engagement data were extracted from the program’s database. Multiple comparison tests indicated that mental health quality of life, depression, anxiety, work-life balance, and flourishing differed by weight loss outcome at program end (week 17; ≥5%, 2–5%, below 2%) and by engagement tertile at program beginning and end (weeks 5 and 17). Only anxiety was associated with weight loss in a backward stepwise regression controlling for engagement and sociodemographic characteristics. Flourishing did not predict weight loss overall but predicted the weight loss outcome group. Our findings have implications for creating more effective interventions for individuals based on psychosocial characteristics and highlight the potential importance of anxiety in underexplored self-managed digital programs.