Negative impact of the first COVID-19 lockdown upon health-related behaviours and psychological wellbeing in people living with severe and complex obesity in the UK

Abstract

Background Coronavirus disease 2019 (COVID-19) has led to unprecedented changes in the way we live, particularly for people at higher risk of severe illness from COVID-19. People with pre-existing health conditions have been markedly impacted and, in some instances, left unsupported due to reduced provision of routine healthcare services. People living with obesity (PLWO) are identified as at higher risk of severe illness from COVID-19 infection. Currently, there is a paucity of evidence about the impact of the first COVID-19 lockdown on PLWO, including those accessing weight management and bariatric surgery services (WMS). Methods 543 adults (16–80 years) with obesity (BMI ≥ 30 kg/m 2 ) were recruited between 14th May and 9th July 2020 through social media advertisements, professional and patient obesity organisations and WMS. Participants completed an online survey regarding the impact of the first COVID-19 lockdown upon, mental health, well-being, health-related behaviours, risk mitigating behaviours, access to WMS and weight stigma. Findings During the first COVID-19 lockdown, the majority of PLWO reported deterioration of their mental health and health-related behaviours such as diet, physical activity (PA) and sleep. With 55% reporting an unhealthier diet, 61% reduced PA and 80% worsening of their sleep. Higher depression and lower wellbeing scores were found to associate with the greatest adverse impact upon health-related behaviours. PLWO who were attending WMS prior to the first lockdown reported a greater deterioration of their diet, with nearly 50% reporting worsening of their diet and PA worsening compared to PLWO who were not attending WMS. Most participants took two or more risk mitigating actions (73%). PLWO attending WMS reported reduced access (44%) with insufficient information (49%) from their clinical service providers. The majority of participants reported no change in perceived weight stigma. Interpretation This study shows the detrimental impact of the first COVID-19 lockdown on PLWO in relation to health-related behaviours, mental health and access to WMS. Our findings show that PLWO with poor mental health and those attending WMS were most adversely impacted and highlights the need for greater mental health support and continued provision of support from WMS for PLWO during future lockdowns. Funding This research was funded through National Institute for Health Research University College London Hospitals Biomedical Research Centre funding.

Disparate healthcare experiences of people living with overweight or obesity in England

“…Second, the data represents patient experiences in 2018–2020, which includes the period of time during the coronavirus (COVID-19) pandemic where access to and delivery of services has been affected. Recent empirical evidence has demonstrated the impact of the restrictions and lockdowns as a result of the pandemic on people living with obesity [ 16 ], which may have impacted the experiences of people living with obesity during this time. Third, patient comments analysed in this study were based a pre-defined list of words (see supplementary materials), and thus, may not reflect the healthcare experiences of all people living with overweight or obesity.…”

COVID-19 Self-quarantine and Weight Gain Risk Factors in Adults

“…Evidence shows that weight stigma affects weight-related health, including lower physical activity and unhealthy eating behaviors and weight gain [ 68 ]. Although data suggests those with obesity did not experience increased weight stigma during the COVID-19 pandemic [ 69 ], 19–42% of individuals with obesity are discriminated against because of their weight [ 70 ]. Indeed, the odds of engaging in binge eating during COVID-19 were nearly three times higher for individuals teased about their weight before the pandemic than those never teased about their weight [ 71 ].…”

Identification of Measures to Strengthen Resilience in Homes on the Basis of Lockdown Experience during COVID-19

“…It is also noted that people with previous pathologies experienced aggravation and needed more care during home quarantine. This is the case for people with autism spectrum disorder [19], severe and complex obesity [20] and, in general, people with chronic diseases. All these people have faced a lack of exercise, routine checkups and daily medical care [21].…”