Systematic review of the effects of pandemic confinements on body weight and their determinants

Abstract

Pandemics and subsequent lifestyle restrictions such as lockdowns may have unintended consequences including alterations in body weight. Understanding the impact and the mechanisms affecting body weight is paramount for planning effective public health measures for both now and future lockdown-type situations. This systematic review assesses and the impact of pandemic confinement on body weight and to identifies contributory factors. A comprehensive literature search was performed in seven electronic databases and in gray sources from their inception until 1st July 2020 with an update in PubMed and Scopus on 1st February 2021. In total, 2,361 unique records were retrieved, of which 41 studies were identified eligible: 1 case-control study, 14 cohort and 26 cross-sectional studies (469362 total participants). Weight gain occurred predominantly in participants who were already overweight or obese. Associated factors included increased consumption of unhealthy food with decreased intake of healthy fresh fruits and vegetables, changes in physical activity, and altered sleep patterns. Weight loss during the pandemic was observed in individuals with previous low weight, and those who ate less and were more physically active before lock down. Associated factors included increased intake of fruits and vegetables, drinking more water and consuming no alcohol. Maintaining a stable weight was more difficult in populations with reduced income particularly in individuals with lower educational attainment. The findings of this systematic review highlight the short-term effects of pandemic confinements. Learning from the lockdown experience is fundamental if we are to prepare for the next wave; a holistic, reactive, tailored response is needed involving multiple providers.

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

“…However, many reports during COVID-19 show that despite a small increase in population weight/BMI, many individuals have experienced a reduction in weight/BMI [9,10,[13][14][15][16][17]. The average weight increase/decrease reported in this study are larger than the 0.6-3.0kg/2.0-2.9kg average weight increase/decrease reported in a systematic review of COVID-19 studies, until July 2020 [7].…”

“…at the start of the pandemic), as initial dietary changes have been associated with maintaining pandemic weight gain [12]. The time-varying behavioural predictors included HFSS snacks intake, HFSS meals intake, fruit and vegetables intake, physical activity (reduced physical activity vs all other, given the link between reduced physical activity and pandemic weight gain [7,10,21], based on WHO weekly physical activity recommendations of two days per week for strengthening physical activity, and 150 minutes per week for aerobic physical activity [31]), alcohol consumption (£14 weekly units vs >14 weekly units, based on government low-risk drinking recommendations [32]) and smoking status (yes vs no). HFSS foods intake, physical activity and alcohol consumption were assessed at each wave using standard measures (see supplementary material).…”

“…Sustained high intakes of ultra-processed, HFSS foods beyond peak lockdown have been associated with maintaining any weight gained during the start of the pandemic [12]. Previous studies have also identified changes in physical activity as an important predictor of weight change [7,9,10,12,[18][19][20][21], and having an overweight or obese BMI or being female as important predictors of initial pandemic weight gain [7,10,14,47]. In our study, a reduction in physical activity was not significantly associated with a change in weight/BMI, initial BMI was inversely associated with weight/BMI gain, and gender was not significantly associated with a change in weight/BMI in the main analyses between May and December 2020.…”

“…However, reports also suggest that despite significant proportions of people increasing weight and BMI (11.2-72.4%), many have also decreased weight and BMI (7.2-51.4%) during the start of the pandemic [11][12][13][14][15][16][17]. These initial weight trajectories during COVID-19 are associated with several socio-demographic, COVID-19-related and behavioural factors including age, gender, initial BMI, pandemic living and working conditions, diet, physical activity and alcohol intake [7,9,10,12,[18][19][20][21]. Short-term shifts in health behaviours can result in small, yet meaningful changes in bodyweight, as seen with seasonal holiday weight gain during the winter months, which accounts for a large proportion of annual weight gain [22,23].…”

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

“…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 …”