Impact of COVID-19 pandemic on weight and BMI among UK adults: a longitudinal analysis of data from the HEBECO study

Abstract

BackgroundCOVID-19-related restrictions impacted weight and weight-related factors during the initial months of the pandemic. However, longitudinal analyses are scarce.MethodsAn online, longitudinal study was conducted among self-selected UK adults (n=1,818), involving three surveys during 2020 (May-June, August-September, November-December), covering height, weight and sociodemographic, COVID-19-related and behavioural measures. Data were analysed using generalised estimating equations.ResultsSelf-reported average weight and body mass index (BMI) significantly increased from May-June to August-September (74.95kg to 75.33kg, 26.22kg/m2 to 26.36kg/m2, both p<0.001), and then significantly decreased to November-December (to 75.06kg, 26.27kg/m2, both p<0.01), comparable to May-June levels (p=0.274/0.204). However, there was great interindividual variation, with 37.0%/26.7% reporting an increase and 34.5%/26.3% reporting a decrease in weight/BMI greater than 0.5kg/0.5kg/m2, respectively from May-June to November-December. The average weight/BMI increase was 3.64kg (95% confidence interval: 3.32,3.97)/1.64kg/m2 (1.49,1.79), and the average weight/BMI decrease was 3.59kg (3.34,3.85)/1.53kg/m2 (1.42,1.63). In fully adjusted models, increase in weight/BMI across surveys was significantly negatively associated with initial BMI, and positively associated with monthly high fat, salt and sugar (HFSS) snacks intake and alcohol consumption, and for BMI only, older age. However, associations were time-varying, such that lower initial BMI, higher HFSS snacks intake and high-risk alcohol consumption were associated with maintenance of increased weight/BMI from August-September to November-December.ConclusionThe average weight/BMI of UK adults increased during the early pandemic months, before returning to baseline levels in November-December 2020. However, this masks substantial interindividual variation in weight/BMI trajectories, indicating vulnerabilities associated with changes in food and alcohol consumption throughout the pandemic.What is currently known from previous studiesSmall increases in average weight/BMI have been reported (1.57kg/0.31kg/m2) during the initial three months of the pandemic.Changes in weight/BMI during the early months were not uniform, with significant proportions increasing (11.2-72.4%) as well as decreasing (7.2-51.4%) weight/BMI.Weight/BMI change has been associated with several sociodemographic, lifestyle and behavioural factors.Whether these weight/BMI changes persist over longer durations of the pandemic, and the factors associated with any long-term weight/BMI change is largely unknown.What this paper addsIn UK adults, average weight/BMI first increased and then decreased from May to December 2020 during the pandemic, but this masks large interindividual variability in average changes.Initial BMI at the start of the pandemic and health behavioural factors such as alcohol consumption and high fat, salt and sugar (HFSS) snacks intake were significantly associated with a change in weight/BMI.The strength of the association of alcohol consumption, initial BMI and HFSS snacks intake with weight/BMI change was dependent on the stage of the pandemic, with more pronounced differences becoming apparent during the latter part of 2020.

Understanding obesity and addressing stigma: the role of healthcare professionals

“…An online longitudinal study among UK adults (n=1818), found that self-reported weight and BMI fluctuated throughout the pandemic. However, in those with an overall increase in weight or BMI, a positive association with monthly intake of HFSS foods and alcohol was found (Dicken et al, 2021). In addition to facing greater risks from Covid-19, those living with obesity were also disproportionately affected by the lockdowns.…”

“…A review exploring the pandemic's influence on lifestyle behaviours found that intake of snack foods, often high in fat, sugar and salt (HFSS), increased in the first lockdown, often as a coping mechanism while self-isolating (Bennett et al, 2021;Kass et al, 2021). Physical activity levels also declined, sedentary behaviours increased (Ammar et al, 2020;Kass et al, 2021), and many individuals reported weight gain (Bennett et al, 2021;Dicken et al, 2021;Kass et al, 2021). One international online survey of 1047 respondents in Europe, Asia and Africa found that sitting time increased from 5 to 8 hours daily, while all levels of physical activity decreased (Ammar et al, 2020).…”

Longitudinal associations between physical activity and other health behaviours during the COVID-19 pandemic: a fixed effects analysis

“…Given the evidence for links between PA and other health behaviours, reductions in PA during the COVID-19 pandemic may have had negative impacts on other health behaviours. However, early evidence suggests there has been extensive individual variation in changes in health behaviours during the pandemic, with studies reporting improvements in diet 33 – 40 , alcohol consumption 41 – 43 , and sleep for some individuals 35 , 44 , 45 , despite evidence of population level decreases in PA, increases in sedentary time 27 , 46 , 47 and alcohol consumption 41 , 48 , 49 , and worse dietary choices 38 . The relationship between PA and these health behaviours is likely confounded by other major changes to people’s lives such as having to strictly isolate, family or financial adversity, children not being at school, or psychological distress in the wake of social restrictions 50 .…”

Longitudinal associations between physical activity and other health behaviours during the COVID-19 pandemic: A fixed effects analysis

“…Given the evidence for links between PA and other health behaviours, reductions in PA during the COVID-19 pandemic may have had negative impacts on other health behaviours. However, early evidence suggests that there has been extensive individual variation in changes in health behaviours during the pandemic, with studies reporting improvements in diet [33][34][35][36][37][38][39][40], alcohol consumption [41][42][43], and sleep for some individuals [35,44,45], despite evidence of population level decreases in PA, increases in sedentary time [27,46,47], alcohol consumption [41,48,49], and worse dietary choices [38]. The relationship between PA and these health behaviours is likely confounded by other major changes to people's lives such as having to strictly isolate, family or financial adversity, children not being at school, or psychological distress in the wake of social restrictions [50].…”