Examining the Impact of the Pandemic on Health and Weight
Pandemic weight gain is not in your imagination
Restrictions during the pandemic, increased stress levels, disruptions in our daily routines, less travel to places of employment and elsewhere can lead to stress eating and reduced activity and exercise. The result for many has been an increase in weight during the pandemic.
Multiple studies have found an increase in weight, on average, during the early part of the pandemic. For example:
Could the pandemic weight-gain observations simply be an extension of the trends already occurring?
- In a longitudinal analysis of data obtained from February 1 to June 1, 2020, participants in the Health eHeart Study who volunteered to report weight measurements from their Bluetooth-connected smart scale averaged about 1.5 lbs of weight gain for every month of shelter-in-place restrictions. [doi:10.1001/jamanetworkopen.2021.2536]
- Similarly, a survey found that 22% reported having gained from 5-10 lbs within just two months after the onset of the pandemic. [doi: 10.1016/j.orcp.2020.05.004]
- In a prospective review comparing baseline in May 2020 to August 2020, there was an overall average 0.6 kg (1.3 lb) weight gain, with 30% reporting an increase in weight. A total of 18.4% of participants reported significant weight gain of more than 2 kg, whereas 15.9% lost more than 2 kg, and 26% of those with obesity gained greater than 2 kg, compared to 14.8% of those with normal BMI. [doi.org/10.1002/oby.23293]
- A survey of self-reported weight changes from April/May to September/October 2020 found an average 1.4 lb weight gain and that 40% reported a weight gain – persistence in the gain even after the peak lock-down period. [doi.org/10.3390/nu13020671]
- A study of youths, ages 5-15, found, between visits, an average 2.3 kg (5 lb) gain in weight more than compared to pre-pandemic weight increases. And the prevalence of overweight or obesity among 5 to 11 year-olds went from 36.2% to 45.7%.[doi:10.1001/jama.2021.15036]
- A population study found weight gains were more common in women and younger people. [doi.org/10.1111/cob.12453]
Although the observed average weight gains noted may not seem like much, this amount is quite significant over the relatively short time frames and far exceeds typical weight gain in that time.
So, could the pandemic gains be an extension of the trends already occurring?
Abbott and Lanzrath addressed that question by reviewing ExamOne insurance applicant data. Looking back to pre-pandemic values and controlling for various factors, they found that the average BMI increased by 0.22 between July 2018 (with an average BMI of 28.14) and July 2019 (with an average BMI of 28.36) to a 0.47 increase in average BMI between July 2019 (with an average BMI of 28.36) and July 2020 (with an average BMI of 28.83). There was no change, compared to the increasing trend, in older men, but it was quite evident in younger women, as shown here for women ages 18-39:
Even though it remains conceivable that these collective weight increases will decline back toward previous levels, there is no indication at this time that will be the case. Therefore, the implications of these changes could very well impact the overall health and longevity of the population, given the known consequences of obesity.
As we previously illustrated, increases in weight, and the prevalence of obesity, represent important risks for developing many medical conditions. Adipose tissue is metabolically active, and excesses can lead to metabolic dysregulation, endothelial dysfunction, and inflammation. These changes promote increases in blood pressure and cholesterol, insulin resistance, diabetes, and fatty liver, and, as a result, higher rates of coronary artery disease, heart failure, stroke, chronic kidney and liver disease, and many forms of cancer.
Since mortality and morbidity expectations tend to be projected from historical insurance experience, trends toward a faster than expected weight gain in younger ages will likely lead to greater than anticipated risk. It will be essential to consider this increased risk both in the underwriting of overweight and obese applicants and in the projected results for a company’s overall block of business.