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Mukhopadhyay S. The effects of the COVID-19 pandemic on the mental health of people with obesity. Stress Health 2024; 40:e3359. [PMID: 38126550 DOI: 10.1002/smi.3359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/14/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
Obesity is a risk factor for anxiety and depression. Obesity is also a risk factor for severe COVID-19 disease and therefore may have contributed to adverse mental health outcomes in this vulnerable population during the COVID-19 pandemic. We compare the trajectory of mental health outcomes of people with obesity with normal-weight people before and during the COVID-19 pandemic using nationally representative individual-level longitudinal data from the National Health Interview Survey and Difference-in-Difference regressions. Our results indicate that severe anxiety increased by 2.75 (95% CI: 0.0056-0.0494; p-value 0.014) percentage points, representing a 31.3% relative increase, and anxiety-related prescription drug usage increased by 2.75 (95% CI: 0.0076-0.0473; p-value<0.01) percentage points, representing a 19.2% relative increase among people with obesity, compared to normal-weight people. We conclude that people with obesity experienced an increase in the incidence of severe anxiety and anxiety-related prescription drug usage during the COVID-19 pandemic, which was not observed among normal-weight individuals. Furthermore, women, less-educated, and rural residents with obesity disproportionately bore the burden of the pandemic.
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Yang Z, Huang J, Kwan MP, Liu D. The interplay among individuals' distress, daily activities, and perceptions of COVID-19 and neighborhood cohesion: A study using network analysis. PLoS One 2024; 19:e0293157. [PMID: 38236893 PMCID: PMC10796027 DOI: 10.1371/journal.pone.0293157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/05/2023] [Indexed: 01/22/2024] Open
Abstract
The reduction of social interactions through non-pharmaceutical interventions (NPIs) has been shown to effectively curb COVID-19 transmission. However, these control measures were often accompanied by changes in people's daily routines and constraints on their activity space, which could lead to mental distress (i.e., anxiety and depression). This study examined the interplay among individuals' anxiety, depression, daily activities, and perceptions of COVID-19 and neighborhood cohesion. Taking Hong Kong as an example, an online survey (N = 376) was conducted to collect data from participants between March 14 to May 11, 2022. The data include respondents' self-reported anxiety and depressive symptoms, daily activities (e.g., smartphone use), perceptions of COVID-19 (e.g., the possibility of infecting COVID-19), and perceptions of neighborhood cohesion. Using network analysis, we found that excessive smartphone use, life disturbance by COVID-19, and a community with people getting along well with each other were significant factors associated with participants' anxiety and depression. Using critical path analysis, we observed that NPIs reduced human mobility, led to delayed bedtime, and increased smartphone use, which were associated with participants' mental distress. We also found that NPIs and COVID-19 were associated with people's perceptions of infection and the severity of COVID-19 and human mobility flexibility, which may further lead to mental distress. Our results also demonstrated that people with high education levels were vulnerable. These results provided important insights for designing appropriate interventions without generating deleterious impacts on people's mental health in the future.
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Affiliation(s)
- Zhenchuan Yang
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Jianwei Huang
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Mei-Po Kwan
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Institute of Future Cities, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Dong Liu
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Institute of Future Cities, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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Fortes Cavalcanti de Macêdo P, Brito E, de Magalhães Cunha C, Ribas de Farias Costa P, da Purificação Nazaré Araújo M, Cardoso Martins P, Leila Portela de Santana M. Weight stigma is a predictor of disordered eating in Brazilian college students during the COVID-19 pandemic: A 16-month cohort follow-up. Appetite 2024; 192:107084. [PMID: 37875240 DOI: 10.1016/j.appet.2023.107084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/07/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023]
Abstract
This study examined the relationship between weight stigma and disordered eating behaviors in university students during the COVID-19 pandemic, considering individuals with and without overweight. A national sample of 738 college students completed an online questionnaire at three time points between July 2020 and December 2021, reporting their experiences of weight stigma, perceived increase in weight stigma during the pandemic, internalized weight stigma, and disordered eating behaviors. The findings showed that the trajectories of disordered eating behaviors varied depending on participants' anthropometric status. Among those with overweight, there was a decrease over time in binge eating, food restriction, and purging. Conversely, the non-overweight group experienced a slight increase in binge eating from T2 to T3. Using the Generalized Estimating Equations model, the study revealed that weight stigma predicted disordered eating behaviors in both weight spectrums during the pandemic. Experiences of weight stigma and the perceived increase in weight stigma significantly increased the likelihood of engaging in binge eating, food restriction, and purging among individuals with overweight. Furthermore, the internalization of weight stigma was longitudinally associated with all examined eating behaviors, regardless of anthropometric status. These findings highlight the importance of addressing weight stigma to prevent disordered eating in college students.
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Affiliation(s)
| | - Edleide Brito
- Statistics Department, Federal University of Bahia, Salvador, Brazil.
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de Macêdo PFC, Brito E, de Magalhães Cunha C, da Purificação Nazaré Araújo M, Martins PC, de Santana MLP. Weight stigma and disordered eating behaviors during the COVID-19 pandemic: the mediating role of weight gain concern and psychological distress. Eat Weight Disord 2023; 28:78. [PMID: 37759035 PMCID: PMC10533574 DOI: 10.1007/s40519-023-01608-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVES The purpose of this study is to investigate whether the relationship between weight stigma experiences and disordered eating behaviors during the COVID-19 pandemic is mediated by weight gain concern and psychological distress among university students with and without overweight. METHODS A cross-sectional study was conducted with university students from five regions of Brazil who participated in the baseline assessment of the Online Cohort on Eating Behavior and Health (July/August 2020). Information on the frequency of binge eating episodes, food restriction, and purging, as well as experienced weight stigma, weight gain concern, and psychological distress, were recorded in an online questionnaire. Stratified structural equation modeling (SEM) analyses were performed to address the research questions of interest. RESULTS Out of the total sample (n = 2511), 33.5% of participants reported experiencing weight stigma. The prevalence of binge eating episodes, food restriction, and purging was 43.7%, 24.1%, and 5.4%, respectively. These behaviors were more prevalent in individuals with overweight than in those without this condition. Furthermore, it was observed that weight gain concern and psychological distress mediated the relationship between weight stigma and disordered eating behaviors regardless of body weight status. CONCLUSIONS Experiences of weight stigma and disordered eating behaviors were prevalent among Brazilian university students, especially among those with overweight. Weight gain concern and psychological distress appear to be important factors underlying the relationship between these constructs during the pandemic, and they can contribute to the development of targeted strategies for the prevention and management of disordered eating. LEVEL OF EVIDENCE Level V, cross-sectional study.
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Affiliation(s)
| | - Edleide Brito
- Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | - Carla de Magalhães Cunha
- School of Nutrition, Federal University of Bahia, Campus Canela, Rua Basílio da Gama, Salvador, BA, 40110-907, Brazil
| | | | - Poliana Cardoso Martins
- School of Nutrition, Federal University of Bahia, Campus Canela, Rua Basílio da Gama, Salvador, BA, 40110-907, Brazil
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Daly M, Sutin AR, Robinson E. Longitudinal changes in mental health and the COVID-19 pandemic: evidence from the UK Household Longitudinal Study. Psychol Med 2022; 52:2549-2558. [PMID: 33183370 PMCID: PMC7737138 DOI: 10.1017/s0033291720004432] [Citation(s) in RCA: 348] [Impact Index Per Article: 174.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/27/2020] [Accepted: 11/02/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic has had a range of negative social and economic effects that may contribute to a rise in mental health problems. In this observational population-based study, we examined longitudinal changes in the prevalence of mental health problems from before to during the COVID-19 crisis and identified subgroups that are psychologically vulnerable during the pandemic. METHODS Participants (N = 14 393; observations = 48 486) were adults drawn from wave 9 (2017-2019) of the nationally representative United Kingdom Household Longitudinal Study (UKHLS) and followed-up across three waves of assessment in April, May, and June 2020. Mental health problems were assessed using the 12-item General Health Questionnaire (GHQ-12). RESULTS The population prevalence of mental health problems (GHQ-12 score ⩾3) increased by 13.5 percentage points from 24.3% in 2017-2019 to 37.8% in April 2020 and remained elevated in May (34.7%) and June (31.9%) 2020. All sociodemographic groups examined showed statistically significant increases in mental health problems in April 2020. The increase was largest among those aged 18-34 years (18.6 percentage points, 95% CI 14.3-22.9%), followed by females and high-income and education groups. Levels of mental health problems subsequently declined between April and June 2020 but remained significantly above pre-COVID-19 levels. Additional analyses showed that the rise in mental health problems observed throughout the COVID-19 pandemic was unlikely to be due to seasonality or year-to-year variation. CONCLUSIONS This study suggests that a pronounced and prolonged deterioration in mental health occurred as the COVID-19 pandemic emerged in the UK between April and June 2020.
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Affiliation(s)
- Michael Daly
- Department of Psychology, Maynooth University, Co. Kildare, Ireland
| | | | - Eric Robinson
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
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Rezapour M, Ferraro FR, Alsubaiei S. Behavioral and emotional adaptations of obese and underweight students in response to the COVID-19 pandemic. HUMANITIES & SOCIAL SCIENCES COMMUNICATIONS 2022; 9:326. [PMID: 36164459 PMCID: PMC9491673 DOI: 10.1057/s41599-022-01334-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 09/02/2022] [Indexed: 06/06/2023]
Abstract
Previous studies have investigated the effects of COVID-19 on the general population of college students. However, research evaluating the complex behavioral and psychological impact of the pandemic on both obese and underweight students is currently limited. We used data from a survey conducted from March to April 2020 across 2534 students enrolled in seven US universities. We examined whether the associations between taking various behaviors and being obese and underweight students are unidimensional, or varies based on various negative emotions, and their sociodemographic characteristics. Also, we checked whether emotions of obese and underweight groups are impaired, which consequently might impact taking various cautionary behaviors. The results highlight complex relationships between being obese and underweight students and other considered variables. For instance, despite the associated risk, it was found that obese students are associated with less fear, guilt and irritability due to the pandemic. However, those associations vary based on factors such as level of educations. In addition, while obese students are less likely to avoid a large group of people, the impact changes based on gender. Lack of precautions and emotions is despite the increased risk of hospitalization and death associated with obese and underweight groups. Finally, it was found that there are negative and stable associations between higher social class, income, and the lower likelihood of being obese or underweight. Significant differences and similarities were also found across factors to obese and underweight students.
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Affiliation(s)
| | - F. Richard Ferraro
- Department of Psychology, University of North Dakota, Grand Forks, ND 58201 USA
| | - Sabrina Alsubaiei
- Department of Psychology, University of North Dakota, Grand Forks, ND 58201 USA
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FitzGerald C, Mumenthaler C, Berner D, Schindler M, Brosch T, Hurst S. How is physicians' implicit prejudice against the obese and mentally ill moderated by specialty and experience? BMC Med Ethics 2022; 23:86. [PMID: 36002822 PMCID: PMC9400557 DOI: 10.1186/s12910-022-00815-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/20/2022] [Indexed: 11/29/2022] Open
Abstract
Background Implicit prejudice can lead to disparities in treatment. The effects of specialty and experience on implicit obesity and mental illness prejudice had not been explored. The main objective was to examine how specializing in psychiatry/general medicine and years of experience moderated implicit obesity and mental illness prejudice among Swiss physicians. Secondary outcomes included examining the malleability of implicit bias via two video interventions and a condition of cognitive load, correlations of implicit bias with responses to a clinical vignette, and correlations with explicit prejudice.
Methods In stage 1, participants completed an online questionnaire including a clinical vignette. In stage 2, implicit prejudice pre- and post- intervention was tested using a 4 × 4 between-subject design including a control group. In stage 3, explicit prejudice was tested with feeling thermometers and participants were debriefed. Participants were 133 psychiatrists and internists working in Geneva, hospital-based and private practice. Implicit prejudice was assessed using a Weight IAT (Implicit Association Test) and a Mental Illness IAT. Explicit feelings towards the obese and the mentally ill were measured using Feeling Thermometers. A clinical vignette assessed the level of concern felt for a fictional patient under four conditions: control, obese, depression, obese and depression. Linear regression was conducted to test for association of gender, experience, and specialty with responses to vignettes, pre-intervention IATs and explicit attitudes, and to test for association of interventions (or control) with post-intervention IATs and explicit attitudes. Reported effect sizes were computed using Cohen’s d. Two-tailed p < 0.05 was selected as the significance threshold. Results Compared to internists, psychiatrists showed significantly less implicit bias against mentally vs. physically ill people than internists and warmer explicit feelings towards the mentally ill. More experienced physicians displayed warmer explicit feelings towards the mentally ill and a greater level of concern for the fictional patients in the vignette than the less experienced, except when the patient was described as obese. Conclusions Specialty moderates both implicit and explicit mental illness prejudice. Experience moderates explicit mental illness bias and concern for patients. The effect of specialty on implicit prejudice seems to be based principally on self-selection. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-022-00815-7.
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Affiliation(s)
- Chloë FitzGerald
- iEH2 (Institute for Ethics, History and the Humanities), Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Christian Mumenthaler
- Department of Information Science, Geneva School of Business Administration, Geneva, Switzerland.,University of Applied Sciences and Arts, Western Switzerland, Delémont, Switzerland
| | - Delphine Berner
- iEH2 (Institute for Ethics, History and the Humanities), Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Mélinée Schindler
- iEH2 (Institute for Ethics, History and the Humanities), Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Tobias Brosch
- CISA (Swiss National Centre for Affective Sciences), University of Geneva, Geneva, Switzerland.,Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Samia Hurst
- iEH2 (Institute for Ethics, History and the Humanities), Faculty of Medicine, University of Geneva, Geneva, Switzerland.
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Sesker AA, Lee JH, Luchetti M, Aschwanden D, Stephan Y, Terracciano A, Sutin AR. Personality and change in perceived control during the acute stage of the coronavirus pandemic. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022; 192:111607. [PMID: 35308090 PMCID: PMC8919785 DOI: 10.1016/j.paid.2022.111607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 11/03/2022]
Abstract
Lower perceived control (PC) is related to maladaptive psychological responses to stressful events, yet it is unclear whether longer-term situations are associated with PC change over time. This study examined PC change during the beginning of the coronavirus pandemic and whether trajectories varied by age and personality. Personality was assessed in 2455 U.S. adults (18-100 years) from an online study conducted January-February 2020. PC was assessed across three follow-ups (March-July 2020). Latent growth curves modeled PC change. In controlled models, PC decreased (β = -0.107, p = .005). Older adults had higher PC than younger adults (β = 0.012, p = .001), and experienced less PC decline (β = 0.012, p < .001). All personality traits but Openness were related to PC at baseline (βs ranged from -0.912 to 0.543, ps < .001). Conscientiousness (β = 0.155, p = .002), Extraversion (β = 0.128, p = .008), and Agreeableness (β = 0.099, p = .044) were associated with less PC decline. Employment (β = 0.160, p = .022), health (β = 0.133, p = .002), and disease burden (β = -0.056, p = .014) were also associated with PC change. These results were largely driven by the financial dimension of PC. This study provides evidence for PC change during the COVID-19 pandemic and identifies sociodemographic, personality, and health moderators of PC trajectory.
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Affiliation(s)
| | - Ji Hyun Lee
- Department of Psychology, University of Michigan-Ann Arbor, USA
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Shahnawaz MG, Gupta K, Kharshiing KD, Kashyap D, Khursheed M, Khan NH, Uniyal R, Rehman U. Individual and group level risk factors in preventive health and panic buying behaviors during COVID-19 pandemic in India. CURRENT PSYCHOLOGY 2022; 42:1-17. [PMID: 35496360 PMCID: PMC9034255 DOI: 10.1007/s12144-022-03098-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2022] [Indexed: 12/26/2022]
Abstract
The present research explored individual and group level risk factors in preventive health and panic buying behaviors during the COVID-19 pandemic in India. Perceived susceptibility, perceived severity, COVID-19 anxiety, and personal identity were considered individual-level risk factors. Group based identities such as family, religious groups, and identification with one's nation were considered as group level risk factors. Standardized scales have been used to measure all the constructs under study. Data were collected electronically from 305 Indian respondents. Hierarchical regression analysis in SPSS Version 22 was used to test the hypotheses. Results showed that personal identity and identification with the nation predicted preventive health behavior. Panic buying behavior was predicted by the location of the respondents (containment versus non-containment zones), perceived severity, and one's personal identity. The interplay of individual and social factors is reflective of both individual and collective agencies in the adoption of preventive health behaviors, while only individual-level factors led to panic buying behavior. The findings of this study have implications for curbing, managing, and reinforcing desirable and non-desirable behavior during the present pandemic as well as in the future as well.
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Affiliation(s)
| | - Kaveri Gupta
- Department of Psychology, Jamia Millia Islamia, New Delhi, 110025 India
| | | | - Drishti Kashyap
- Department of Psychology, Jamia Millia Islamia, New Delhi, 110025 India
| | - Masrat Khursheed
- Department of Psychology, Jamia Millia Islamia, New Delhi, 110025 India
| | - Neda Haseeb Khan
- Department of Psychology, Jamia Millia Islamia, New Delhi, 110025 India
| | - Ritika Uniyal
- Department of Psychology, Jamia Millia Islamia, New Delhi, 110025 India
| | - Usama Rehman
- Department of Psychology, Aligarh Muslim University, Aligarh, 20022 India
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Lüdecke D, von dem Knesebeck O. Decline in Mental Health in the Beginning of the COVID-19 Outbreak Among European Older Adults-Associations With Social Factors, Infection Rates, and Government Response. Front Public Health 2022; 10:844560. [PMID: 35359766 PMCID: PMC8963994 DOI: 10.3389/fpubh.2022.844560] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Governments across the world have deployed a wide range of non-pharmaceutical interventions (NPI) to mitigate the spread of COVID-19. Certain NPIs, like limiting social contacts or lockdowns, had negative consequences for mental health in the population. Especially elder people are prone to mental illnesses during the current pandemic. This article investigates how social factors, infections rates, and stringency of NPIs are associated with a decline in mental health in different European countries. Methods Data stem from the eighth wave of the SHARE survey. Additional data sources were used to build macro indicators for infection rates and NPIs. Two subsamples of persons with mental health problems were selected (people who reported being depressed, n = 9.240 or nervous/anxious, n = 10.551). Decline in mental health was assessed by asking whether depressive symptoms or nervousness/anxiety have become worse since the beginning of the COVID-19 outbreak. For each outcome, logistic regression models with survey-design were used to estimate odds ratios (OR), using social factors (age, gender, education, living alone, and personal contacts) and macro indicators (stringency of NPIs and infection rates) as predictors. Results Higher age was associated with a lower likelihood of becoming more depressed (OR 0.87) or nervous/anxious (OR 0.88), while female gender increased the odds of a decline in mental health (OR 1.53 for being more depressed; OR 1.57 for being more nervous/anxious). Higher education was only associated with becoming more nervous/anxious (OR 1.59), while living alone or rare personal contacts were not statistically significant. People from countries with higher infection rates were more likely to become more depressed (OR 3.31) or nervous/anxious (OR 4.12), while stringency of NPIs showed inconsistent associations. Conclusion A majority of European older adults showed a decline in mental health since the beginning of the COVID-19 outbreak. This is especially true in countries with high prevalence rates of COVID-19. Among older European adults, age seems to be a protective factor for a decline in mental health while female gender apparently is a risk factor. Moreover, although NPIs are an essential preventative mechanism to reduce the pandemic spread, they might influence the vulnerability for elderly people suffering from mental health problems.
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Affiliation(s)
- Daniel Lüdecke
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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de Macêdo PFC, Nepomuceno CMM, Dos Santos NS, Queiroz VADO, Pereira EM, Leal LDC, Santos LADS, Nascimento LF, Martins PC, de Santana MLP. Weight stigma in the COVID-19 pandemic: a scoping review. J Eat Disord 2022; 10:44. [PMID: 35351201 PMCID: PMC8961493 DOI: 10.1186/s40337-022-00563-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 02/25/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Weight stigma is a phenomenon associated with adverse behavioural and psychological consequences. Although experts suggest that its increase during the COVID-19 pandemic may be associated with worse health outcomes for people with obesity, a thorough analysis of the main findings and gaps is still needed when relating to this subject. OBJECTIVE We aim to answer three questions: (1) How does weight stigma manifest in the COVID-19 pandemic? (2) How can weight stigma affect people with overweight or obesity in times of COVID-19? (3) What are the perceptions and experiences of weight stigma during the pandemic in individuals who experience overweight or obesity? METHODS We conducted a scoping review of studies addressing weight stigma and the COVID-19 pandemic in electronic databases (Medline/PubMed, CINAHL, Embase, PsycInfo, BVS/Lilacs, Scopus, Web of Science, Google Scholar, and OpenGrey) published until 10th August 2021. All relevant studies were reviewed in full by two researchers. In addition, a narrative synthesis of the data was performed. RESULTS The results included 35 studies out of 8,090 records and identified 13 original research publications, 14 text and opinion papers, and 6 narrative reviews. The results revealed the presence of weight stigma in the media, healthcare settings, interpersonal relationships, and public campaigns during the COVID-19 pandemic. The evidence of increasing weight stigma in the COVID-19 outbreak is limited, though. Many weight discrimination consequences were described during this time, such as impairment in accessing healthcare, worst COVID-19 outcomes, and maladaptive eating. However, only maladaptive behaviours and decline in mental health outcomes were demonstrated empirically in all age groups. This effect occurred regardless of body mass index, but people with high body weight were more likely to experience weight stigma. For some people with obesity, weight stigma in the pandemic has made activities of daily routine difficult. CONCLUSIONS The results suggest that weight stigma in the COVID-19 pandemic occurs in several settings; moreover, although weight discrimination impacts mental health, whether before or during the pandemic, this influence between the pandemic and pre-pandemic scenario is still unclear. Therefore, more research is required in this field while the pandemic lasts, especially with people with obesity. Overall, people with overweight or obesity are more vulnerable to weight stigma than individuals without overweight. In addition, weight stigma refers to discrimination or prejudice based on a person's weight and relates to several consequences, for instance, poor healthcare treatment and mental health problems. In the COVID-19 outbreak, these weight stigma effects tend to become even more critical because they may be associated with unfavourable COVID-19 outcomes and eating disorder risks. Thus, it is crucial to investigate how weight stigma occurs during the pandemic and its impact on health, mainly for the most affected people. We investigated 35 studies published between 2019 and 2021 to map and explore how weight stigma was manifested and the related consequences for people with overweight or obesity in the COVID-19 pandemic. Only about a third of them were quantitative or qualitative, limiting the evidence of weight stigma in the COVID-19 context. The available evidence suggests that weight stigma manifests in several settings such as media, healthcare, public campaigns, and is more common in people with excess weight. However, weight discrimination experiences before or during the pandemic were associated with adverse psychological and behavioural consequences across all age groups, regardless of body weight. For some people with obesity, for instance, weight stigma made it difficult to accomplish their activities of daily routine. Nevertheless, it remains unclear whether weight stigma has increased in the pandemic, thus, more studies are required, especially about people with overweight or obesity.
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The Invisible and Insidious Enemy. Obes Surg 2021; 31:5460-5461. [PMID: 34215974 PMCID: PMC8253466 DOI: 10.1007/s11695-021-05550-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 12/20/2022]
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Abstract
PURPOSE OF REVIEW This review explores potential sources of weight bias and stigma during the COVID-19 pandemic, including "quarantine-15" messages and discussion of obesity in media and public health campaigns. We examine evidence of the effects of weight bias on well-being during the pandemic and highlight unanswered questions to be addressed in future research. RECENT FINDINGS Studies that have investigated weight change during stay-at-home orders have yielded mixed findings and relied predominantly on self-reported retrospective recall, thus providing weak evidence of a widespread "quarantine-15" effect. No studies to date have evaluated the effects on weight stigma and health of obesity-focused COVID-19 media and public health messages. Individuals with a history of experiencing weight bias may be more vulnerable to binge eating and psychological distress during the pandemic. Weight bias and stigma during the COVID-19 pandemic, and their effects on health and well-being, warrant greater investigation and consideration in public health efforts.
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Affiliation(s)
- Rebecca L Pearl
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
| | - Erica M Schulte
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Tubiana A, Morvan R, Garcia S, Lecerf JM. COVID-19 et obésité : la position du Groupe de Réflexion sur l’Obésité et le Surpoids (G.R.O.S.). MÉDECINE DES MALADIES MÉTABOLIQUES 2021. [PMCID: PMC7904454 DOI: 10.1016/j.mmm.2021.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Au-delà de l’âge, qui reste le principal facteur de risque, il existe une grande variété de comorbidités associées aux formes graves de la maladie à coronavirus 2019 (COVID-19). L’obésité est la seule ayant entraîné une réaction du monde médical et social aussi insistante. Cette insistance constitue-t-telle un moyen pertinent et efficace d’aborder la problématique du lien aggravant entre la COVID-19 et obésité ? Cette mise en avant de l’obésité a une répercussion immédiate sur la santé mentale des patients, rajoutant aux difficultés dont ils souffrent déjà, la détresse psychique directement associée à la perception des discriminations dont ils sont victimes. La réitération massive et obsédante (jusqu’à la culpabilisation) de la vulnérabilité des patients obèses va générer ou majorer des troubles psychiques qui, à leur tour, aggraveront les compulsions alimentaires, et renforceront l’éloignement des parcours de soins que l’on constate fréquemment dans cette population. Les comportements liés à la situation inédite des confinements et les discours alarmistes autour de l’alimentation et de la santé sont si contradictoires que leurs effets, favorisant la restriction cognitive, risquent de provoquer des troubles du comportement alimentaire chez des nouveaux patients ou d’aggraver ceux déjà existant.
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15
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Brown A, Flint SW, Kalea AZ, O'Kane M, Williams S, Batterham RL. Negative impact of the first COVID-19 lockdown upon health-related behaviours and psychological wellbeing in people living with severe and complex obesity in the UK. EClinicalMedicine 2021; 34:100796. [PMID: 33754138 PMCID: PMC7970262 DOI: 10.1016/j.eclinm.2021.100796] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has led to unprecedented changes in the way we live, particularly for people at higher risk of severe illness from COVID-19. People with pre-existing health conditions have been markedly impacted and, in some instances, left unsupported due to reduced provision of routine healthcare services. People living with obesity (PLWO) are identified as at higher risk of severe illness from COVID-19 infection. Currently, there is a paucity of evidence about the impact of the first COVID-19 lockdown on PLWO, including those accessing weight management and bariatric surgery services (WMS). METHODS 543 adults (16-80 years) with obesity (BMI ≥ 30 kg/m2) were recruited between 14th May and 9th July 2020 through social media advertisements, professional and patient obesity organisations and WMS. Participants completed an online survey regarding the impact of the first COVID-19 lockdown upon, mental health, well-being, health-related behaviours, risk mitigating behaviours, access to WMS and weight stigma. FINDINGS During the first COVID-19 lockdown, the majority of PLWO reported deterioration of their mental health and health-related behaviours such as diet, physical activity (PA) and sleep. With 55% reporting an unhealthier diet, 61% reduced PA and 80% worsening of their sleep. Higher depression and lower wellbeing scores were found to associate with the greatest adverse impact upon health-related behaviours. PLWO who were attending WMS prior to the first lockdown reported a greater deterioration of their diet, with nearly 50% reporting worsening of their diet and PA worsening compared to PLWO who were not attending WMS. Most participants took two or more risk mitigating actions (73%). PLWO attending WMS reported reduced access (44%) with insufficient information (49%) from their clinical service providers. The majority of participants reported no change in perceived weight stigma. INTERPRETATION This study shows the detrimental impact of the first COVID-19 lockdown on PLWO in relation to health-related behaviours, mental health and access to WMS. Our findings show that PLWO with poor mental health and those attending WMS were most adversely impacted and highlights the need for greater mental health support and continued provision of support from WMS for PLWO during future lockdowns. FUNDING This research was funded through National Institute for Health Research University College London Hospitals Biomedical Research Centre funding.
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Affiliation(s)
- Adrian Brown
- Centre for Obesity Research, University College London, London, UK
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Trust, London, UK
- UCLH Biomedical Research Centre, National Institute of Health Research, London, UK
| | - Stuart W. Flint
- School of Psychology, University of Leeds, Leeds, UK
- Scaled Insights, Nexus, University of Leeds, Leeds, UK
| | - Anastasia Z. Kalea
- Division of Medicine, University College London, London, UK
- Institute of Cardiovascular Science, University College London, UK
| | - Mary O'Kane
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Simon Williams
- Institute of Management and Health, University of Wales Trinity Saint David, Carmarthen, Wales, UK
| | - Rachel L. Batterham
- Centre for Obesity Research, University College London, London, UK
- Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospital NHS Trust, London, UK
- UCLH Biomedical Research Centre, National Institute of Health Research, London, UK
- Corresponding author at: Centre for Obesity Research, University College London, London, UK.
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16
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Kunzler AM, Röthke N, Günthner L, Stoffers-Winterling J, Tüscher O, Coenen M, Rehfuess E, Schwarzer G, Binder H, Schmucker C, Meerpohl JJ, Lieb K. Mental burden and its risk and protective factors during the early phase of the SARS-CoV-2 pandemic: systematic review and meta-analyses. Global Health 2021; 17:34. [PMID: 33781283 PMCID: PMC8006628 DOI: 10.1186/s12992-021-00670-y] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/04/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Mental burden due to the SARS-CoV-2 pandemic has been widely reported for the general public and specific risk groups like healthcare workers and different patient populations. We aimed to assess its impact on mental health during the early phase by comparing pandemic with prepandemic data and to identify potential risk and protective factors. METHODS For this systematic review and meta-analyses, we systematically searched PubMed, PsycINFO, and Web of Science from January 1, 2019 to May 29, 2020, and screened reference lists of included studies. In addition, we searched PubMed and PsycINFO for prepandemic comparative data. Survey studies assessing mental burden by the SARS-CoV-2 pandemic in the general population, healthcare workers, or any patients (eg, COVID-19 patients), with a broad range of eligible mental health outcomes, and matching studies evaluating prepandemic comparative data in the same population (if available) were included. We used multilevel meta-analyses for main, subgroup, and sensitivity analyses, focusing on (perceived) stress, symptoms of anxiety and depression, and sleep-related symptoms as primary outcomes. RESULTS Of 2429 records retrieved, 104 were included in the review (n = 208,261 participants), 43 in the meta-analysis (n = 71,613 participants). While symptoms of anxiety (standardized mean difference [SMD] 0.40; 95% CI 0.15-0.65) and depression (SMD 0.67; 95% CI 0.07-1.27) were increased in the general population during the early phase of the pandemic compared with prepandemic conditions, mental burden was not increased in patients as well as healthcare workers, irrespective of COVID-19 patient contact. Specific outcome measures (eg, Patient Health Questionnaire) and older comparative data (published ≥5 years ago) were associated with increased mental burden. Across the three population groups, existing mental disorders, female sex, and concerns about getting infected were repeatedly reported as risk factors, while older age, a good economic situation, and education were protective. CONCLUSIONS This meta-analysis paints a more differentiated picture of the mental health consequences in pandemic situations than previous reviews. High-quality, representative surveys, high granular longitudinal studies, and more research on protective factors are required to better understand the psychological impacts of the SARS-CoV-2 pandemic and to help design effective preventive measures and interventions that are tailored to the needs of specific population groups.
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Affiliation(s)
- Angela M Kunzler
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
| | - Nikolaus Röthke
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Lukas Günthner
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Jutta Stoffers-Winterling
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry and Epidemiology, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health Munich, Munich, Germany
| | - Eva Rehfuess
- Institute for Medical Information Processing, Biometry and Epidemiology, Chair of Public Health and Health Services Research, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health Munich, Munich, Germany
| | - Guido Schwarzer
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Christine Schmucker
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
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17
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Sutin AR, Stephan Y, Luchetti M, Aschwanden D, Strickhouser JE, Lee JH, Sesker AA, Terracciano A. BMI, Weight Discrimination, and the Trajectory of Distress and Well-Being Across the Coronavirus Pandemic. Obesity (Silver Spring) 2021; 29:38-45. [PMID: 32975032 DOI: 10.1002/oby.23048] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/21/2020] [Accepted: 09/22/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The purpose of this study was to examine the trajectory of psychological distress and well-being across the coronavirus pandemic by BMI category and weight discrimination. METHODS Participants (N = 1,590) were assessed three times: early February 2020 before the coronavirus crisis in the United States and again in mid-March and late April 2020. Participants reported their weight, height, and weight discrimination in February. Depressed affect, loneliness, purpose in life, life satisfaction, and perceived support were assessed in all surveys; anxiety and stress were assessed in the March/April surveys. RESULTS Prior to the pandemic, reporting weight discrimination or being in the underweight or obesity 2 to 3 categories was associated with more distress and lower well-being. Weight discrimination, not BMI, was associated with a twofold increased risk of incident depression from before to during the pandemic. Weight discrimination was associated with declines in purpose in life and life satisfaction across the pandemic. BMI categories were unrelated to changes in distress/well-being across the pandemic. CONCLUSIONS Prior to the pandemic, BMI and weight discrimination were vulnerabilities for greater distress and lower well-being. Weight discrimination, but not BMI, increased risk for incident depression and declines in well-being during the coronavirus pandemic.
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Affiliation(s)
- Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA
| | | | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA
| | - Damaris Aschwanden
- Department of Geriatrics, Florida State University College of Medicine, Tallahassee, Florida, USA
| | - Jason E Strickhouser
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA
| | - Ji Hyun Lee
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA
| | - Amanda A Sesker
- Department of Behavioral Sciences and Social Medicine, Florida State University College of Medicine, Tallahassee, Florida, USA
| | - Antonio Terracciano
- Department of Geriatrics, Florida State University College of Medicine, Tallahassee, Florida, USA
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18
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Thomas DM, Siegel B, Baller D, Lindquist J, Cready G, Zervios JT, Nadglowski JF, Kyle TK. Can the Participant Speak Beyond Likert? Free-Text Responses in COVID-19 Obesity Surveys. Obesity (Silver Spring) 2020; 28:2268-2271. [PMID: 32909373 DOI: 10.1002/oby.23037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 08/27/2020] [Accepted: 09/07/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy, West Point, New York, USA
| | - Benjamin Siegel
- Department of Mathematical Sciences, United States Military Academy, West Point, New York, USA
| | - Daniel Baller
- Department of Mathematical Sciences, United States Military Academy, West Point, New York, USA
| | - Joseph Lindquist
- Department of Mathematical Sciences, United States Military Academy, West Point, New York, USA
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19
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Puhl RM, Lessard LM, Larson N, Eisenberg ME, Neumark-Stzainer D. Weight Stigma as a Predictor of Distress and Maladaptive Eating Behaviors During COVID-19: Longitudinal Findings From the EAT Study. Ann Behav Med 2020; 54:738-746. [PMID: 32909031 PMCID: PMC7499477 DOI: 10.1093/abm/kaaa077] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Weight stigma is common for people with obesity and harmful to health. Links between obesity and complications from COVID−19 have been identified, but it is unknown whether weight stigma poses adverse health implications during this pandemic. Purpose We examined longitudinal associations between prepandemic experiences of weight stigma and eating behaviors, psychological distress, and physical activity during the COVID-19 pandemic in a diverse sample of emerging adults. Methods Participants (N = 584, 64% female, mean age = 24.6 ± 2.0 years, mean body mass index [BMI] = 28.2) in the COVID-19 Eating and Activity over Time (C-EAT) study were cohort members of the population-based longitudinal study EAT 2010–2018. Weight stigma reported by participants in 2018 was examined as a predictor of binge eating, eating to cope, physical activity, depressive symptoms, and stress during COVID-19. Data were collected via online surveys during the U.S. outbreak of COVID-19 in 2020. Results Prepandemic experiences of weight stigma predicted higher levels of depressive symptoms (β = 0.15, p < .001), stress (β = 0.15, p = .001), eating as a coping strategy (β = 0.16, p < .001), and an increased likelihood of binge eating (odds ratio = 2.88, p < .001) among young adults during the COVID-19 pandemic but were unrelated to physical activity. Although associations remained after accounting for demographic characteristics and BMI, the magnitude of longitudinal associations was attenuated after adjusting for prior levels of the outcome variables. Conclusions Young adults who have experienced weight stigma may have increased vulnerability to distress and maladaptive eating during this pandemic. Public health messaging could be improved to support people of diverse body sizes and reduce the harmful consequences of weight stigma.
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Affiliation(s)
- Rebecca M Puhl
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.,Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | - Leah M Lessard
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | - Nicole Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Marla E Eisenberg
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Dianne Neumark-Stzainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
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20
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Dicker D, Bettini S, Farpour-Lambert N, Frühbeck G, Golan R, Goossens G, Halford J, O'Malley G, Mullerova D, Ramos Salas X, Hassapiou MN, Sagen J, Woodward E, Yumuk V, Busetto L. Obesity and COVID-19: The Two Sides of the Coin. Obes Facts 2020; 13:430-438. [PMID: 32659766 PMCID: PMC7841065 DOI: 10.1159/000510005] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/07/2020] [Indexed: 12/26/2022] Open
Abstract
The World Health Organization declared COVID-19, the infectious disease caused by the coronavirus SARS-CoV-2, a pandemic on March 12, 2020. COVID-19 is causing massive health problems and economic suffering around the world. The European Association for the Study of Obesity (EASO) promptly recognised the impact that the outbreak could have on people with obesity. On one side, emerging data suggest that obesity represents a risk factor for a more serious and complicated course of COVID-19 in adults. On the other side, the health emergency caused by the outbreak diverts attention from the prevention and care of non-communicable chronic diseases to communicable diseases. This might be particularly true for obesity, a chronic and relapsing disease frequently neglected and linked to significant bias and stigmatization. The Obesity Management Task Force (OMTF) of EASO contributes in this paper to highlighting the key aspects of these two sides of the coin and suggests some specific actions.
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Affiliation(s)
- Dror Dicker
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom,
- Department of Internal Medicine D and Obesity Clinic, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel,
| | - Silvia Bettini
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
- Department of Medicine, University of Padova, Padova, Italy
| | - Nathalie Farpour-Lambert
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
- Obesity Prevention and Care Program Contrepoids, Service of Therapeutic Education for Chronic Diseases, Department of Community Health, Primary Care and Emergency, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Gema Frühbeck
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, University of Navarra, IdiSNA, CIBEROBN, Spanish Health Institute Carlos III, Pamplona, Spain
| | - Rachel Golan
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Scheva, Israel
| | - Gijs Goossens
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
- Department of Human Biology, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jason Halford
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Grace O'Malley
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
- School of Physiotherapy, Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Dana Mullerova
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
- Department of Public Health and Preventive Medicine, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czechia
| | - Ximena Ramos Salas
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
| | - Maria N Hassapiou
- Technological and Educational Institute of Thessaloniki, School of Food Technology and Nutrition, Department of Nutrition, Thessaloniki, Greece
| | - Jørn Sagen
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Euan Woodward
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
| | - Volkan Yumuk
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Luca Busetto
- European Association for the Study of Obesity (EASO), Teddington, United Kingdom
- Department of Medicine, University of Padova, Padova, Italy
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21
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Lim S, Shin SM, Nam GE, Jung CH, Koo BK. Proper Management of People with Obesity during the COVID-19 Pandemic. J Obes Metab Syndr 2020; 29:84-98. [PMID: 32544885 PMCID: PMC7338495 DOI: 10.7570/jomes20056] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/08/2020] [Accepted: 06/11/2020] [Indexed: 12/15/2022] Open
Abstract
Since December 2019, countries around the world have been struggling with a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Case series have reported that people with obesity experience more severe coronavirus disease 2019 (COVID-19). During the COVID-19 pandemic, people have tended to gain weight because of environmental factors imposed by quarantine policies, such as decreased physical activity and increased consumption of unhealthy food. Mechanisms have been postulated to explain the association between COVID-19 and obesity. COVID-19 aggravates inflammation and hypoxia in people with obesity, which can lead to severe illness and the need for intensive care. The immune system is compromised in people with obesity and COVID-19 affects the immune system, which can lead to complications. Interleukin-6 and other cytokines play an important role in the progression of COVID-19. The inflammatory response, critical illness, and underlying risk factors may all predispose to complications of obesity such as diabetes mellitus and cardiovascular diseases. The common medications used to treat people with obesity, such as glucagon-like peptide-1 analogues, statins, and antiplatelets agents, should be continued because these agents have anti-inflammatory properties and play protective roles against cardiovascular and all-cause mortality. It is also recommended that renin–angiotensin system blockers are not stopped during the COVID-19 pandemic because no definitive data about the harm or benefits of these agents have been reported. During the COVID-19 pandemic, social activities have been discouraged and exercise facilities have been closed. Under these restrictions, tailored lifestyle modifications such as home exercise training and cooking of healthy food are encouraged.
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Affiliation(s)
- Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Soo Myoung Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Ga Eun Nam
- Department of Family Medicine, Korea University College of Medicine, Seoul, Korea
| | - Chang Hee Jung
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.,Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
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