How the pandemic has made life harder for people struggling with obesity
A study of about 400 patients from UT Southwestern Medical Center's Weight Wellness Program and other similar programs found mental health problems contributed to weight gain.
Center Director Dr. Jaime Almandozled the study. He told KERA’s Sam Baker why he focused on the second year of the pandemic.
Why did you study the pandemic’s second year?
We wanted to look at what the impact of the prolonged pandemic was for people with obesity.
We found that:
- On average, people gained about 4.3% of their body weight during the pandemic,
- Nearly a third of people gained more than 5% of their weight
- One in seven gained more than 10% of their body weight during the pandemic.
The study found “deteriorations in mental health” to be a factor. What exactly does that mean?
We found weight gain was strongly associated with:
- Maladaptive eating behaviors that included overeating and binge eating type behaviors
- Also, less sleep and less physical activity.
Our study wasn't able to pinpoint exactly what was going on. We can hypothesize that the stress of the pandemic, and shifts in work from home environment, are changing employment status. And a host of other factors contributed to people just trying to survive and shifting their behaviors to what they could do or what they felt their body needed at that time.
The people in the study had gone through some type of obesity treatment or a weight wellness program. So, they at least had some knowledge of how to guard against weight gain. But that didn't help?
I think for so many people living with obesity, there's not so much a knowledge gap or deficit with what we need to do to achieve a healthier weight. But so much of what goes into how we operationalize that are influenced by factors outside of our control.
With regards to healthy eating patterns and behaviors during the pandemic, there were a host of changes, including changes in food supply:
What restaurants or places were open or available to eat, what we wanted to eat, or what we felt we needed to eat.
Working from home: whether we were then preparing meals or grazing instead of having meals.
There was so much that went into how things changed from a health behavior perspective, including the gyms being closed, people being afraid to go out, to be physically active because of fear of catching COVID, or people just feeling like it wasn't something they needed to or wanted to prioritize.
So, in essence, the pandemic was simply making things worse.
Exactly. It was like a pressure cooker of stress.
You also mentioned less physical activity. Meaning what? Too little exercise or no exercise during that period?
Our participants reported, particularly those who gained weight, that they were exercising less frequently and less strenuously.
How does the pandemic make that happen?
We've seen things go both ways with our patient population. Some people during the pandemic were able to create very nice structures where they were able to have regular physical activity, regular meals, food preparation, etc.
For others, the work-from-home environment meant more sleeping in the office and working from home where their workdays were longer. There was less structure. They may have been looking after additional family members or trying to homeschool children at the same time.
So I think for everyone, the journey is very different.
How or why does sleep contribute to weight gain or change?
Studies show people who sleep less tend to gain more weight. There's a correlation between sleep deprivation and calorie intake. But also, sleep is very important for cardiometabolic health, including heart disease and diabetes risk. So it's important to focus on sleep as another kind of vital sign of health for people with obesity.
So what is the end result?
There are several ways we can approach this. One is in terms of what this means for clinicians. And I think as the pandemic kind of continues, people with obesity should be evaluated for stress, anxiety, and depression, and to get the appropriate support and interventions that they need.
I think our data helped inform clinicians on which groups may be at higher risk for weight gain, thereby exacerbating their obesity.
But at the end of the day, I think what we need to do is focus on treating obesity as a chronic disease with times of kind of remission and recurrence, if we borrow that phrase from other disease states, and to focus on treating the person, their body and their mind, not just the number on the scale.