The Weight of Quarantine: Impacts of COVID-19 Restrictions on Unhealthy Weight Gain and Obesity

Illustrated by Haley Pak

Empty shelves that once held Spam, canned soups, ramen, and of course, toilet paper were a common sight at the outset of the COVID-19 pandemic. Within the span of a month, much of America went into self-quarantine/lockdown as people self-isolated at home and non-essential businesses closed. As this country along with the rest of the world shifted towards a sedentary life at home, the uncertainty about the length of lockdowns led many to purchase more non-perishable foods- foods that last longer due to high amounts of fat, salt, and sugar [7][10]. Thus, health experts warned individuals under lockdown to pay attention to diet and exercise in order to prevent unhealthy weight gain and obesity. These also happen to be risk factors for developing COVID-19 [9], the exact disease that lockdowns tried to tackle. Therefore, this begs the question of whether there is actual evidence that lockdowns have led to weight gain and/or obesity. To put it bluntly, did we get fatter and unhealthier during lockdown?

Zachary Zeigler et al. attempted to answer this question by surveying one hundred seventy three adult Facebook users. The survey asked them to describe their changes in weight and eating habits during lockdown, finding that although 59 percent of respondents described their weight as “relatively stable” during lockdown, a significant portion (22 percent) described gaining five to ten pounds [13]. Therefore, it appears that many individuals have experienced an actual increase in weight during lockdown. 

Additionally, the researchers noted that users who reported gaining five to ten pounds were more likely to report changed eating habits including increased “eating in response to sight and smell,” “eating in response to stress” and “snacking after dinner.” However, such responses were also common among all other respondents [13]. These changes in eating behavior point to increases in impulsive eating, providing a potential and logical explanation for the reported weight gain. Thus, Zeigler et al. supports the hypothesis that lockdowns due to COVID-19 truly have impacted our diet and health for the worse, with many American adults gaining weight and therefore, potentially becoming more at risk for developing obesity. 

However, Pamela Keel et al. caution against such interpretations, stating that studies like these tend to be retrospective and are therefore subject to inaccuracies arising from bias [6]. In a study analyzing undergraduate university students, they argue that in reality, a significant difference exists between perceived and actual weight gain during lockdown. Although this study did ask the subjects to fill out surveys regarding their perceived weight gain, it differs from Zeigler et al. in that Keel et al. recorded Body Mass Index measurements (combinations of height and weight that the CDC uses to determine and classify obesity [2]) in January before campus closed and in April after it had closed in April. The purpose of recording BMI is that the CDC uses it to determine and classify obesity [2]. They found that among the 90 students who responded to both surveys, around 28 percent reported perceiving a weight increase in the later survey. Although a little more than a quarter of the students reported unhealthy weight gain, they actually experienced no significant weight gain or BMI increase [6]. Thus, this suggests that most students who reported gaining weight did not actually gain unhealthy weight or even any weight for that matter.

The large gap between actual and perceived unhealthy weight gain suggests that college students are overestimating the weight they gained during lockdown. An explanation for this could be that our culture is obsessed with weight, falsely convincing some that they gained unhealthy weight (increased BMI). Therefore, it is likely that we as college students are not necessarily “fatter” and therefore unhealthier after lockdown than before. College students could have gained less weight than expected despite a pandemic because on average, college students come from wealthier backgrounds than the average American [5]. Thus, they often have greater access to healthy food options as a consequence of living in a wealthy neighborhood and/or owning a vehicle. Their ability to afford food also reduces unhealthy weight gain and the risk of obesity relative to those in food insecure households [4].

Although most college students might have not gained much weight during lockdown, students from low income families or who lack access to healthy food options could be at greater risk for weight gain and obesity during lockdown. Evidence has shown that among school-aged children, both prevalence of obesity and BMI increased at an accelerated rate over the summer when school was not in session [12]. Such impacts also tended to disproportionately affect children of Black, Hispanic, obese, and lower socio-economic populations [5]. Andrew Rundle et al. hypothesized that school closings combined with lockdowns’ impact on food options (and therefore diet) could exacerbate the observed pattern of increased BMI and obesity prevalence among children during the summer. They claimed that students deprived of reduced school lunches could experience greater food insecurity which puts them at risk for unhealthy weight gain and obesity [4]. 

These concerns also extend to poorer American communities that have limited access to healthy food options. Nathaniel Ashby conducted a study that used cell phone location data to examine eating behavior in 65 percent of all U.S. counties, tracking the frequency of visits to unhealthy versus healthy dining locations during the COVID-19 pandemic. When he compared this data to local obesity rates, he found that 10 percent of the most obese counties were more loyal to unhealthy food options compared to ten percent of the least obese [1]. Although visits to unhealthy dining options generally decreased due to closures in March, this decrease was reduced in counties with high obesity rates. Furthermore, those counties also saw the largest increase in April when restaurants began to reopen. 

Candice Myers and Stephanie Broyles have pointed out that many of the counties with what Ashby describes as “fast food patronage” tended to be in the South where poverty rates were higher and access to healthy foods in grocery stores was limited. Additionally, while most restaurants were closed with limited takeout options, many drive-through fast food restaurants reopened, serving as one of the few food options for individuals from high obesity counties [8]. Therefore, lockdown may cause low income individuals to increase their consumption of unhealthy foods which increases their risk of weight gain and obesity. 

Although certain portions of America can afford good health during this pandemic, low-income individuals and communities are less able to do so. Thus, there exists concerns that these people could experience a significant increase in unhealthy weight gain and obesity. However, we need more research similar to Keel et al. to examine the true impact lockdown has had on the most vulnerable populations. As COVID-19 continues to reveal inequalities in our healthcare system and country as a whole, we must also continue to examine the inequalities that stem from our attempts to control the disease. If we fail to do so, we could be putting the most at-risk populations into a more precarious position than before the pandemic, exacerbating existing inequalities and complicating future efforts at remedying them. 

Edited by Sophia Xiao
Illustrated by Haley Pak

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