COVID-19 increased the vulnerability of people living with obesity

Adults with obesity surveyed in the study reported that their mental health – which is known to be associated with weight gain – had deteriorated between the end of the UK’s first COVID-19 lockdown in July 2020 and September 2021.

The number who struggled to get access to affordable, nutritious food was also substantially higher among this group during the pandemic than was reported in the general population.

The findings serve as a warning about the potential impact of the rising cost of living on people with the disease, according to the researchers. They call for greater support for people living with obesity, both to help address the ongoing impact on their mental health and food poverty longer-term.

The research, which is published in the Journal of Human Nutrition and Dietetics, involved an online survey of 1,187 adults living with obesity in the UK about their mental health, food insecurity and loneliness.

Nearly half of the participants (47.3%) in the study reported that their mental health had grown worse over that period. Nearly a third (32.6%) said they had sought medical support for their mental health. A third (32.4%) reported experiencing moderately severe to severe depression.

Food insecurity – which was assessed using a questionnaire about food they had bought or eaten during the study period – also worsened for some, with 3.1% saying at times they did not eat for a whole day as they lacked enough money or food. Very low food security was identified in 8.1% – nearly three times higher than the levels seen in the general population before the pandemic.

Dr Adrian Brown (UCL’s Centre for Obesity Research), lead author of the study, said: “Our findings suggest that people living with obesity were disproportionately impacted at a time when mental health and food security was declining for everyone during the pandemic.

“We are now entering another period where we are seeing large numbers of people experiencing food poverty, and in some cases, making a choice between buying food or having the heating on. Our findings indicate that people living with obesity will need greater support.”

Obesity affects 28% of adults in England, 25% in Wales and 29% of adults in Scotland. Through the pandemic, people living with obesity were urged to shield themselves by avoiding close contact with others due to the increased risk posed to them by the virus.

Perhaps as a result, the researchers said, almost two thirds (61.7%) of those taking part in the UCL research said they had felt lonely between March 2020 to September 2021, with 27.4% reporting high loneliness – levels that were higher than those seen in other surveys of the general population.

The study follows earlier research by the same team that looked at the mental health of people with obesity during the first COVID-19 lockdown in the UK between March 2020 and July 2020.

Professor Rachel Batterham (UCL Medicine), senior author in both studies, said: “Adults with obesity are twice as likely to die as the result of a COVID-19 infection in England than those without, but our results show that poorer mental health has been another hidden health concern for this group of people.”

The latest UCL study also revealed that many of those living with obesity (79.6%) took active steps to potentially reduce their risk by making changes to their lifestyles. This included buying healthier food, doing more physical activity and eating a healthier diet.

Those with the lowest levels of food insecurity were most likely to buy and eat healthier food.

Despite this, the researchers raise concerns that the combination of COVID-19, the soaring cost of living and a potential reduction in government support due to a recent review of the UK’s Obesity strategy could have long term health implications for the country.

Professor Batterham said: “Poor mental health and food poverty are among the complex factors that drive weight gain. More emphasis is needed to address these if efforts to address obesity are to be successful.”

Dr Brown added: “Obesity is a complex, relapsing, long-term condition. The traditional view has been that we should ‘eat less and exercise more’. But this doesn’t take into account the biological, genetic, social and psychological determinants which all interact in someone developing higher body weight.”