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.

Keywords: body weight; eating behaviors; physical activity; psychological factors; sedentary activity.

Figure 1

Pattern of Reported Weight Change Between March and September. (a) Percent of participants reporting patterns of body weight fluctuation across weight risk groups. (b) Options of patterns presented to participants to describe their weight change between March and September. Error bars represent 95% Confidence Interval.

Figure 2

Weight change during the post-lockdown (May-September) in participants who reported to have gained, lost, or maintained body weight during the peak-lockdown period (March through May). Error bars represent 95% Confidence Interval.