Obesity and weight change during the COVID‐19 pandemic in children and adults: A systematic review and meta‐analysis

Abstract

Many obesity risk factors have increased during the COVID-19 pandemic, including physical inactivity, poor diet, stress, and poverty. The aim of this systematic review was to evaluate the impact of the COVID-19 pandemic, as well as associated lockdowns or restrictions, on weight change in children and adults. We searched five databases from January 2020 to November 2021. We included only longitudinal studies with measures from before and during the pandemic that evaluated the change in weight, body mass index (BMI) (or BMI z-scores for children), waist circumference, or the prevalence of obesity. Random effects meta-analyses were conducted to obtain pooled estimates of the mean difference in outcomes. Subgroups were evaluated for age groups and diabetes or obesity at baseline. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale, and the certainty of the evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A total of 74 studies were included (3,213,776 total participants): 31 studies of children, 41 studies of adults, and 2 studies of children and adults. In children, the pooled mean difference was 1.65 kg (95% confidence interval [CI]: 0.40, 2.90; 9 studies) for weight and 0.13 (95% CI 0.10, 0.17; 20 studies) for BMI z-scores, and the prevalence of obesity increased by 2% (95% CI 1%, 3%; 12 studies). In adults, the pooled mean difference was 0.93 kg (95% CI 0.54, 1.33; 27 studies) for weight and 0.38 kg/m 2 (95% CI 0.21, 0.55; 25 studies) for BMI, and the prevalence of obesity increased by 1% (95% CI 0%, 3%; 11 studies). In children and adults, the pooled mean difference for waist circum-

You are what you eat? Rodent study suggests defended body weight mainly dictated by fat content of diet

“…Recent COVID-19 lockdowns upended our daily routines, including feeding behavior, with at least part of the population showing See accompanying article, pg. 1000. significant weight increases [6] that may be linked to increases in diets higher in fat.…”

“…The Ni‐Hon‐San study, conducted in the 1970s before the drastic worldwide rise in obesity rates, looked at the risk factors for cardiovascular disease in Japanese men living either in Hiroshima, Japan; Honolulu, Hawaii; or San Francisco, California [5]. The diets from these three regions differed drastically, with the California diet having a significantly higher percentage of fat (38%) than the Japanese diet (15%) that correlated with significantly higher body weight (66 kg in California and 55 kg in Japan; +22%) and an elevated risk of cardiovascular heart disease. Recent COVID‐19 lockdowns upended our daily routines, including feeding behavior, with at least part of the population showing significant weight increases [6] that may be linked to increases in diets higher in fat.…”

Pharmacological interventions for the management of children and adolescents living with obesity—An update of a Cochrane systematic review with meta‐analyses

“…Obesity is a major public health concern with increasing incidence and prevalence over the last four decades worldwide. [1][2][3] Between 1.0% and 5.5% of children and adolescents are living with severe obesity, which is often accompanied by comorbidities, such as type 2 diabetes mellitus (T2DM) and psychological comorbidities. [4][5][6] Obesity in childhood often transitions into adulthood, indicating the chronic nature of the disease and emphasizing the need for comprehensive, effective and safe treatment.…”

“…Obesity is a major public health concern with increasing incidence and prevalence over the last four decades worldwide 1–3 . Between 1.0% and 5.5% of children and adolescents are living with severe obesity, which is often accompanied by comorbidities, such as type 2 diabetes mellitus (T2DM) and psychological comorbidities 4–6 …”

The Long Behavioral Tail of the COVID-19 Pandemic—A Cancer Control Perspective

“…Although there are mixed findings on whether unhealthy changes in diet emerged during the pandemic, most studies between 2020 and 2022 have nevertheless observed increases in overweight and obesity. 6 The decreases in physical activity and presence of other factors, such as stress, may underlie these disconcerting changes. Rates of overweight and obesity were already on the upswing before the PHE, yet the pandemic may have accelerated that pattern.…”