Effect of SARS-CoV-2 (COVID-19) Pandemic and Lockdown on Body Weight, Maladaptive Eating Habits, Anxiety, and Depression in a Bariatric Surgery Waiting List Cohort

Abstract

Purpose On January 30, 2020, the World Health Organization declared COVID-19 as a “public health emergency of international concern.” The primary aim of the study was to evaluate weight and food habit changes during COVID-19 outbreak. The secondary endpoint was to explore the psychological factors, arising during the pandemic, influencing weight and dietary variations. Materials and Methods A survey composed of four different items was conducted by telephone interview: (1) anthropometric data and type of procedure, (2) Hospital Anxiety and Depression Scale (HADS), (3) maladaptive eating behaviors, and (4) personal feelings moved by the COVID-19 spread and lockdown. Results Fifty-six patients were enrolled. No significant changes in weight, BMI, and maladaptive eating habits were observed. A significant reduction in the anxiety index score was observed. In 17.8% of cases, a change in obesity class was reported, and among these patients, a substantial modification in bariatric procedures was planned (60%). Conclusion This study showed no effect on weight and BMI nor on rates of maladaptive eating habits associated with quarantine/social isolation among severely obese individuals waiting for the bariatric surgery. At the end of lockdown, a considerable proportion of patients modified their initial obesity class, and in selected cases, it could represent a criteria for rearrangement of the planned bariatric procedure. In obese patients, the lockdown and social distancing generated a reduction of fear of confronting and being negatively judged by others. This psychological aspect was assessed with the reduction of the HADS score.

Status of Weight Change, Lifestyle Behaviors, Depression, Anxiety, and Diabetes Mellitus in a Cohort with Obesity during the COVID-19 Lockdown: Turk-Com Study Group

“…This is in line with previous studies; in Spain, 52% of a population with obesity gained weight [21] and in patients with obesity awaiting bariatric surgery, a small but significant increase in BMI was observed [27]. In a bariatric population with obesity, no significant changes in weight and BMI were observed, but a change in obesity class was reported in 17.8% of cases (10/56) [28].…”

Influence of COVID-19 Pandemic Lockdown on Patients from the Bariatric Surgery Waiting List

“…We did not focus on the maladaptive dietary habits, but we found the decrease in physical activity during lockdown to be a strong risk factor for weight gain since it was declared by 50.5% of patients with no weight gain or weight decrease and 74.5% of patients with weight gain. The period of observation was comparable in both our and the Italian study (2.3 months in the Italian study vs. 2.5 months in ours) [ 6 ].…”

“…A recent study from Italy analyzed the influence of 2.5 months lockdown on a group of 54 individuals before bariatric surgery and showed neither the effect on weight or BMI nor on rates of maladaptive eating habits was associated with social isolation. Additionally, it was also observed in the study that social distancing resulted in a reduction of fear of confronting and being negatively judged by others [ 6 ]. An effect of a mild increase in BMI (42.7 vs. 43.2) after 2 months of lockdown was observed in a Spanish study including 51 patients from the bariatric surgery waiting list [ 7 ].…”

Bariatric surgery for metabolic unhealthy obesity (MUO) during the COVID era: short-term results of a high-volume center

“…Bariatric and metabolic procedures were delayed worldwide during the pandemic also to limit the risks related to inadequate postoperative monitoring for surgical and nutritional complications as a consequence of the constrained access to non-urgent outpatient care [ 16 ], as well as to minimize the risk of viral contagion during hospitalization. This delay had a negative impact on patients with severe obesity [ 11 , 12 , 28 , 29 ], also considering that they are at increased risk for unfavorable COVID-19 outcomes. Indeed, in a series of multivariable‐adjusted analyses based on COVID‐19 patient cohorts, disease severity and mortality were associated not only with older age and male gender [ 30 ], but also with several pre-existing medical conditions including obesity, diabetes, hypertension, heart failure and ischemic heart disease among others [ 2 ].…”

“…As soon as COVID-19 pandemic passed its first peak, questions raised about the strategies to adopt for metabolic and weight control in patients awaiting BS. Indeed, deferring the treatment of obesity, especially under lockdown conditions which entail lifestyle adjustments, mobility restrictions and sleep disruption, may have caused further weight gain and the worsening of obesity complications [ 11 , 12 ]. In our experience, the lockdown had a negative impact on patients’ psychological well-being and eating habits [ 13 ].…”