Stress, anxiety, depression, and lack of sleep contributed to weight gain over the COVID-19 pandemic for people with obesity, according to researchers at UTHealth Houston and UT Southwestern Medical Center.

Of the 80% of respondents who reported difficulties with weight management, nearly 30% gained more than 5% of their weight and 14.6% gained more than 10%, with those who were more severely overweight gaining more.

The study, which surveyed patients with obesity from March 2021 to November 2021, was recently published in Obesity.  

“This paper was about the durability of the impact of the pandemic,” said Sarah Messiah, PhD, MPH, senior and corresponding author of the study and professor of epidemiology at UTHealth School of Public Health-Dallas. “We knew from other studies that weight gain occurred early in the pandemic, and we wanted to know if this was a short-term challenge only. Eighteen months into the pandemic, we found that people were still struggling.”

The first author of the study was Jaime P. Almandoz, MD, MBA, of UT Southwestern Medical Center. Funding came from grants to Messiah from the National Institutes of Health and the National Institute on Minority Health and Health Disparities.

Messiah said researchers chose the 5% mark because it has been shown to be clinically significant in terms of weight gain or loss on cardiometabolic health.

Stress (85%), anxiety (71.7%), boredom (62.3%), depression (56.2%), and lack of sleep (46.4%) were the most cited reasons for difficulty with weight management, according to respondents. Other reasons were increased hunger, closed gyms, working from home, lack of healthy food options, finances, taking care of children/family, longer work hours, lack of time, and COVID-19 infection.

“Our results point to the specific reasons or drivers of this sustained weight gain. We cannot understate the impact of mental health,” said Messiah, who is also the director of the Center for Pediatric Population Health at UTHealth Houston.

The study included patients from three weight loss programs in Dallas. The majority, 82.6%, were female, and the mean overall age was 52.5. Of the 404 total participants, 49.7% were non-Hispanic white, 25.8% non-Hispanic Black, 18.8% Hispanic, and 5.7% other. Approximately 60% were employed and 28.7% worked from home. Nearly 40% identified as having financial difficulties.

Co-authors from UTHealth Houston School of Public Health were Luyu Xie, PharmD, PhD; M. Sunil Mathew, MSIT; Elisa Morales Marroquin, PhD; and Shreeya Khatiwada, MPH. Other co-authors were Jeffrey N. Schellinger, RD; Natia Murvelashvili, MD; and Carrie McAdams, MD, PhD, of UT Southwestern; and Sachin Kukreja, MD, of Minimally Invasive Surgical Associates in Dallas.