Substance use, mental health and weight‐related behaviours during the COVID‐19 pandemic in people with obesity

Abstract

Summary Studies have shown the negative impact of COVID‐19 lockdown orders on mental health and substance use in the general population. The aim of this study was to examine the impact of the COVID‐19 pandemic onsubstance use, mental health and weight‐related behaviors in a sample of adults with obesity after lockdown orders were lifted (June‐September 2020). A retrospective medical chart review identified patients with obesity from one university‐based obesity medicine clinic, and two metabolic and bariatric surgery (MBS) practices. Patients who completed an online survey from June 1, 2020 to September 30, 2020 were included. The primary outcome measure was substance use (various drugs, alcohol, tobacco). Substance use and mental health survey questions were based on standardized, validated instruments. A total of 589 patients (83.3% female, mean age 53.6 years [SD 12.8], mean BMI 35.4 [SD 9.1], 54.5% Non‐Hispanic white, 22.3% post‐MBS) were included. Seventeen patients (2.9%) tested positive for SARS‐CoV‐2 and 13.5% reported symptoms. Nearly half (48.4%) of the sample reported recreational substance use and 9.8% reported increased use since the start of the pandemic. There was substantial drug use reported (24.3% opioids, 9.5% sedative/tranquilizers, 3.6% marijuana, and 1% stimulants). Patients who reported stockpiling food more (adjusted Odds Ratio [aOR] 1.50, 95% CI 1.03‐2.18), healthy eating more challenging (aOR 1.47, 95% CI 1.01‐2.16), difficulty falling asleep (aOR 1.64, 95% CI 1.14‐2.34), and anxiety (aOR 1.47, 95% CI 1.01‐2.14) were more likely to report substance use versus non‐users. Results here show that the COVID‐19 pandemic is having a deleterious impact on substance use, mental health and weight‐related health behaviors in people with obesity regardless of infection status.

Patients Undergoing Bariatric Surgery: a Special Risk Group for Lifestyle, Emotional and Behavioral Adaptations During the COVID-19 Lockdown. Lessons from the First Wave

“…During lockdown, meal planning worsened in 85% of the patients studied compared to 36% in the general Spanish population [ 22 ]. This finding is consistent with other studies reporting that following a healthy eating pattern was much more challenging in BS patients [ 23 , 24 ]. Even though the scores in restrained, emotional and external eating of our participants were analogous to those of the Spanish general population [ 22 ], other authors have described an increase in various dysfunctional eating behaviors such as snacking and binge eating [ 25 ].…”

“…However, this trend worsened during lockdown in the same line as the general population (91% vs. 70%) [ 30 ]. The factors of lifestyle deterioration include not being able to go to work, disruption in routines (family, social, and leisure), fears, and negative emotions [ 30 ], particularly in vulnerable groups such as people with obesity or those who have undergone BS [ 23 , 24 ].…”

Depression and anxiety among individuals with medical conditions during the COVID-19 pandemic: Findings from a nationwide survey in Bangladesh

“…Here, depression and anxiety were associated with physical inactivity, in line with prior findings among people with diabetes ( Melin et al, 2014 ) and other medical conditions ( Bishwajit et al, 2017 ). This association has also been observed among other populations during the COVID-19 pandemic ( Islam et al, 2020 ; Tasnim et al, 2021 ), including people with obesity ( Almandoz et al, 2021 ).…”

Influence of polish national COVID-19 lockdown on the patient characteristics and outcomes of bariatric surgery at a high-volume center—A cohort study

“…A possible explanation is the change in attitude of patients towards their own safety and health concerns. However, recent survey studies have associated national lockdowns periods with poorer weight control, reduced physical activity, and increased binge eating [ 9 , 10 ]. Since the qualification criteria for bariatric surgery at our institution did not change it is difficult to ascertain the cause of reduced operative BMI and weight.…”