Mental, physical health of people with obesity affected during COVID-19

The novel coronavirus (COVID-19) pandemic is having a significant impact on people with obesity as they struggle to manage their weight and mental health during shelter-in-place orders, according to new research led by the University of Texas Health Science Center at Houston and the University of Texas Southwestern published in the journal Clinical Obesity.

For the study, researchers surveyed 123 weight management patients at the University of Texas Southwestern Weight Wellness Program and a community bariatric surgery practice. The study was conducted using an online questionnaire from April 15 through May 31. The study population was racially and ethnically diverse, had a mean age of 51, and 87 percent were women. The mean body mass index for these patients was 40.

The study revealed that nearly 73 percent of patient experience increased anxiety and close to 84 percent had increased depression. Nearly 70 percent reported more difficulty in achieving weight loss goals, while 48 percent had less exercise time, and 56 percent had less intensity in exercise. Stockpiling of food increased in nearly half of patients and stress eating was reported in 61 percent.

Two of the patients tested positive for SARS-CoV-2, but nearly 15 percent reported symptoms of the virus. Almost 10 percent lost their jobs and 20 percent said they could not afford a balanced meal.

According to the U.S. Centers for Disease Control and Prevention, more than 42 percent of American adults are obese. Obesity-related health conditions include heart disease, stroke, type 2 diabetes, and certain types of cancer that are some of the leading causes of preventable, premature death.

Jaime Almandoz, MD, MBA, first author and an endocrinologist and assistant professor of internal medicine at the University of Texas Southwestern, said many patients with obesity already struggle with access to appropriate fresh, healthy foods. Some reside in food deserts lacking grocery stores, where the only options are fast food and processed foods from convenience stores.

"Unchecked diabetes, hypertension, and other obesity-related comorbidities will create a huge backlog of needs that will come back to haunt us,” said Almandoz in a statement. “When you throw in disruptions like social isolation, coupled with losing your job and insurance coverage, a potential disaster is waiting to unfold.”

With clinics across the country reporting a decrease in patient visits, Sarah Messiah, PhD, MPH, the study's senior author and professor of epidemiology, human genetics, and environmental sciences at University of Texas School of Public Health in Dallas, said that people with obesity are potentially missing medical appointments, surgeries, and medications due to the pandemic. People who lost their jobs, and thus their health insurance benefits, may now experience less access to care.

"We don't yet know how many additional lives will be lost to heart disease and diabetes simply because people did not receive care during COVID-19," said Messiah in a statement. "Unfortunately, many of these are ethnic minorities who are already hit hard with disease burdens."

The researchers believe their work can inform clinicians and other health professionals on effective strategies to minimize the physical and psychosocial health impacts from COVID-19 among adults with obesity.

"Those with obesity and severe obesity are already at the highest risk of death from COVID-19,” Messiah said. “We're concerned that they can be severely affected if a second wave hits in the fall.”