Longitudinal Weight Gain and Related Risk Behaviors during the COVID-19 Pandemic in Adults in the US

Abstract

Cross-sectional analyses have shown increased obesogenic behaviors and a potential for weight gain during COVID-19 related peak-lockdown (March–May 2020), but longitudinal data are lacking. This study assessed longitudinal changes in body weight and lifestyle behaviors in the US adults during the pandemic. Methods: We used Qualtrics survey to collect self-reported data on body weight, dietary, physical activity, and psychological variables (n = 727) during the peak-lockdown (April/May) and at post-lockdown (September/October). Peak-lockdown weight data were categorized based on the magnitude of weight gained, maintained, or lost, and behavioral differences were examined between categories at two time points. Results: Body weight increased (+0.62 kg; p < 0.05) at the post-lockdown period. The body mass index also increased (26.38 ± 5.98 kg/m2 vs. 26.12 ± 5.81 kg/m2; p < 0.01) at the post-lockdown period vs. peak-lockdown period. Close to 40% of participants reported gaining either 1–4 lbs or >5 lbs of body weight during the peak-lockdown, while 18.2% lost weight. Weight-gainers engaged in riskier dietary behaviors such as frequent ultra-processed food intake (p < 0.01) and snacking (p < 0.001), were less active, and reported high stress and less craving control during peak-lockdown. Of those gaining >5 lbs, 33% continued to gain weight after the lockdown eased, while 28% maintain higher body weight. In weight-gainers, takeout meal frequency increased, and high ultra-processed food intake and stress, and low craving control continued to persist after the lockdown eased. Conclusion: We show that the COVID-19 lockdown periods disrupted weight management among many Americans and that associated health effects are likely to persist.

Multiplying effects of COVID‐19 lockdown on metabolic risk and fatty liver

“…A survey in US adults during and after the lockdown confirmed a further increase of body weight and body mass index in the post‐lockdown period, as compared with the peak lockdown period. In this series, 33% of subjects who showed a weight gain during the lockdown continued to gain weight after the lockdown, likely due to persistent inappropriate lifestyles 32 …”

“…Accordingly, such preventive measures caused significant changes of lifestyle and dietary habits, with potential influence on metabolic health in the general population. In particular, a weight gain was often reported both in children 27,28 and in adults 29‐32 . A recent systematic review found that the social containment measures due to the COVID‐19 lockdown generated a weight gain in 7.2%‐72.4% of subjects 31 …”

Beyond Lockdown: The Potential Side Effects of the SARS-CoV-2 Pandemic on Public Health

“…In fact, our results showed that symptoms of psychological distress perceived during lockdown were consistently associated with worsening of lifestyle. For adults living in the USA, weight gain was associated with higher levels of psychological distress, which persisted for months after the spring lockdown [ 27 ].…”

Energy Balance-Related Behavior Risk Pattern and Its Correlates During COVID-19 Related Home Confinement

“…This public health action markedly disrupted everyday activities and increased unstructured time for people, making weight management a concern (1-3) frequently referred to on social media as "Quarantine 15, " "gaining the COVID-19, " or "fattening the curve." Indeed, we and others recently showed that 19-28% of adults self-reported gaining 5-10 pounds of body weight during the self-quarantine (3)(4)(5). These self-reported weight increases are of concern because literature on holiday weight gain suggests that fluctuations in body weight in a relatively short period can become permanent and lead to a substantial weight gain over decades (6)(7)(8)(9).…”