Improving lifestyle obesity treatment during the COVID‐19 pandemic and beyond: New challenges for weight management

Abstract

Objective The COVID‐19 pandemic has resulted in significant changes to daily life and many health‐related behaviors. The objective of this study was to examine how the stay‐at‐home/safer‐at‐home mandates issued in Colorado (March 2020–May 2020) impacted lifestyle behaviors and mental health among individuals with overweight or obesity participating in two separate behavioral weight loss trials ( n = 82). Methods Questionnaires were used to collect qualitative and quantitative data on challenges to weight loss presented by the COVID‐19 pandemic, including changes in dietary intake, physical activity, sedentary behavior, and mental health during the stay‐at‐home/safer‐at‐home mandates. Results Using a convergent mixed method approach integrating qualitative and quantitative data, the greatest challenge experienced by participants was increased stress and anxiety, which led to more unhealthy behaviors. The majority perceived it to be harder to adhere to the prescribed diet (81%) and recommended physical activity (68%); however, self‐reported exercise on weekdays increased significantly and 92% of participants lost weight or maintained weight within ±1% 5–6 weeks following the stay‐at‐home mandate. Conclusion Study results suggest that obesity treatment programs should consider and attempt to address the burden of stress and anxiety stemming from the COVID‐19 pandemic and other sources due to the negative effects they can have on weight management and associated behaviors.

Early time‐restricted eating compared with daily caloric restriction: A randomized trial in adults with obesity

“…Our study has several limitations. First, our third study cohort was interrupted by COVID-19 at week 6 of the intervention, resulting in insignificant disruptions to the daily lives of our participants, as previously reported (34). The disruption to research also resulted in missing data (DXA, HbA1c, lipids, and REE) and required us to change the primary outcome from DXA weights to clinic and/ or home weights.…”

The effects of the COVID‐19 pandemic on weight loss in participants in a behavioral weight‐loss intervention

“…Our study underscores the importance of behavioral support for successful weight loss, particularly in the face of stress and anxiety. We were able to adapt the delivery of our support to a virtual platform, and participants indicated that this helped them overcome some of the barriers to weight loss posed by the pandemic (5). In contrast to other studies reporting weight gain during the pandemic (4), our data show that, in the context of behavioral support, weight loss was not only possible but greater than previous cohorts in the same study.…”

“…It is possible that greater adherence to the intervention was due to higher motivation at baseline or greater group cohesiveness. Qualitative data from surveys in the COVID cohort have suggested that many participants found group support to be helpful in the face of the pandemic (5). The COVID cohort had lower cognitive restraint at baseline but similar restraint to the pre-COVID cohorts at 12 weeks; therefore, it is possible that changes in restraint contributed to improved weight loss in the COVID cohort, as previous dietary-intervention studies have shown that a greater increase in cognitive restraint during an intervention predicts greater weight loss (23,24).…”

“…Social‐distancing guidelines intended to prevent viral spread during the COVID‐19 pandemic have resulted in major changes to daily routines (3). Several studies have demonstrated that individuals with overweight or obesity reported worsening mental health (4,5), poor eating habits (6,7), less physical activity (PA) (8), decreased sleep quantity and quality (9), and weight gain (4) since the onset of the COVID‐19 pandemic. One study demonstrated that, out of 723 adults with overweight or obesity, 79% of participants self‐reported a decline in behaviors associated with successful weight management (10).…”

National Veterans Health Administration MOVE! Weight Management Program Participation During the COVID-19 Pandemic

“…With high rates of mental health conditions, food insecurity, and limited social support, veterans may be especially vulnerable to COVID-19–related behavior change and weight gain ( 14 – 18 ). Weight management programs, including MOVE!, may need to incorporate additional strategies to help participants overcome the challenges to modifying health behaviors in the context of heightened pandemic-related stress and anxiety ( 19 ).…”