Weight Change-related Factors During the COVID-19 Pandemic: a Population-based Cross-sectional Study Using Social Cognitive Theory

Overview

Journal PeerJ

Specialties Biology
Environmental Health
General Medicine

Date 2022 Aug 2

PMID 35915751

Authors

Roxane Assaf

Jumana Antoun

Affiliations

Soon will be listed here.

Abstract

Background: Published studies during the Coronavirus-19 (COVID-19) pandemic have focused on eating and exercise behaviors and failed to portray a comprehensive understanding of the factors associated with weight change in a setting of a behavioral change framework. This study explores factors associated with weight change during the COVID-19 pandemic among Lebanese residents using the Social Cognitive Theory (SCT) framework, integrating behavioral, environmental, and cognitive factors.

Materials & Methods: This study uses a cross-sectional design using an anonymous online survey. Participants were recruited from a tertiary hospital patient portal and social media posts. The survey included four domains: demographics, cognitive, behavioral, psychological, and environmental factors. Multiple validated self-reported instruments were included Generalized Anxiety Disorder-2 items (GAD-2), Patient Health Questionnaire-2 (PHQ-2), General Self Efficacy Scale (GSES), Alcohol Use Disorders Identification Test-Concise (AUDIT-C), and the dietary pattern evaluation tool.

Results: A sample of 335 complete responses was obtained. Mean age was 39.0 ± 13.4 years old. Participants were mostly females ( = 224, 66.9%), employed ( = 191, 57.4%), nonsmokers ( = 227, 70.5%), reporting depression ( = 224, 80.3%) and anxiety ( = 242, 84.3%). Mean weight change was -7.0 ± 6.0 kg in the decrease weight group and 6.4 ± 5.0 kg in the increase group. When compared to stable weight, the multinomial logistic model factors that were found to correlate significantly to weight gain were: overeating/binge eating (-value = 0.001) and unbalanced food pattern (-value = 0.012). Baseline BMI (-value = 0.003), anxiety (-value = 0.020) and smoking (-value = 0.004) were significant factors of weight loss as compared to stable weight.

Conclusions: COVID-19-related weight change is multifactorial and is associated with specific behavior and individual characteristics. Hence, addressing people's behaviors and relationship to food is vital to control weight change during this continuing and future pandemic or natural occurrence.

References

Webb T, Joseph J, Yardley L, Michie S . Using the internet to promote health behavior change: a systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010; 12(1):e4. PMC: 2836773. DOI: 10.2196/jmir.1376. View

Sidor A, Rzymski P . Dietary Choices and Habits during COVID-19 Lockdown: Experience from Poland. Nutrients. 2020; 12(6). PMC: 7352682. DOI: 10.3390/nu12061657. View

Dixon J . The effect of obesity on health outcomes. Mol Cell Endocrinol. 2009; 316(2):104-8. DOI: 10.1016/j.mce.2009.07.008. View

Herle M, Fildes A, Llewellyn C . Emotional eating is learned not inherited in children, regardless of obesity risk. Pediatr Obes. 2018; 13(10):628-631. PMC: 6220812. DOI: 10.1111/ijpo.12428. View

Lee Y, Kim K, Choi K, Kim M, Cho Y, Sohn C . Development of dietary pattern evaluation tool for adults and correlation with Dietary Quality Index. Nutr Res Pract. 2016; 10(3):305-12. PMC: 4880730. DOI: 10.4162/nrp.2016.10.3.305. View

Matsungo T, Chopera P . Effect of the COVID-19-induced lockdown on nutrition, health and lifestyle patterns among adults in Zimbabwe. BMJ Nutr Prev Health. 2021; 3(2):205-212. PMC: 7841831. DOI: 10.1136/bmjnph-2020-000124. View

Cucinotta D, Vanelli M . WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020; 91(1):157-160. PMC: 7569573. DOI: 10.23750/abm.v91i1.9397. View

Sooriyaarachchi P, Francis T, King N, Jayawardena R . Increased physical inactivity and weight gain during the COVID-19 pandemic in Sri Lanka: An online cross-sectional survey. Diabetes Metab Syndr. 2021; 15(4):102185. PMC: 8744477. DOI: 10.1016/j.dsx.2021.06.022. View

Zhang J, Zhang Y, Huo S, Ma Y, Ke Y, Wang P . Emotional Eating in Pregnant Women during the COVID-19 Pandemic and Its Association with Dietary Intake and Gestational Weight Gain. Nutrients. 2020; 12(8). PMC: 7468999. DOI: 10.3390/nu12082250. View

10.

Rehman H, Ahmad M . COVID-19: quarantine, isolation, and lifestyle diseases. Arch Physiol Biochem. 2020; 129(2):434-438. DOI: 10.1080/13813455.2020.1833346. View

11.

Khubchandani J, Price J, Sharma S, Wiblishauser M, Webb F . COVID-19 pandemic and weight gain in American adults: A nationwide population-based study. Diabetes Metab Syndr. 2022; 16(1):102392. PMC: 8743853. DOI: 10.1016/j.dsx.2022.102392. View

12.

Tan S, Tan C, Tan S . Changes in Dietary Intake Patterns and Weight Status during the COVID-19 Lockdown: A Cross-Sectional Study Focusing on Young Adults in Malaysia. Nutrients. 2022; 14(2). PMC: 8778075. DOI: 10.3390/nu14020280. View

13.

Kuijer R, Boyce J . Emotional eating and its effect on eating behaviour after a natural disaster. Appetite. 2012; 58(3):936-9. DOI: 10.1016/j.appet.2012.02.046. View

14.

Scarmozzino F, Visioli F . Covid-19 and the Subsequent Lockdown Modified Dietary Habits of Almost Half the Population in an Italian Sample. Foods. 2020; 9(5). PMC: 7278864. DOI: 10.3390/foods9050675. View

15.

Al-Musharaf S . Prevalence and Predictors of Emotional Eating among Healthy Young Saudi Women during the COVID-19 Pandemic. Nutrients. 2020; 12(10). PMC: 7598723. DOI: 10.3390/nu12102923. View

16.

Zachary Z, Brianna F, Brianna L, Garrett P, Jade W, Alyssa D . Self-quarantine and weight gain related risk factors during the COVID-19 pandemic. Obes Res Clin Pract. 2020; 14(3):210-216. PMC: 7241331. DOI: 10.1016/j.orcp.2020.05.004. View

17.

Haddad C, Zakhour M, Bou Kheir M, Haddad R, Al Hachach M, Sacre H . Association between eating behavior and quarantine/confinement stressors during the coronavirus disease 2019 outbreak. J Eat Disord. 2020; 8:40. PMC: 7458649. DOI: 10.1186/s40337-020-00317-0. View

18.

Konttinen H . Emotional eating and obesity in adults: the role of depression, sleep and genes. Proc Nutr Soc. 2020; 79(3):283-289. DOI: 10.1017/S0029665120000166. View

19.

Yang G, Lin X, Fang A, Zhu H . Eating Habits and Lifestyles during the Initial Stage of the COVID-19 Lockdown in China: A Cross-Sectional Study. Nutrients. 2021; 13(3). PMC: 8002515. DOI: 10.3390/nu13030970. View

20.

Crandall A, Rahim H, Yount K . Validation of the General Self-Efficacy Scale among Qatari young women. East Mediterr Health J. 2016; 21(12):891-6. DOI: 10.26719/2015.21.12.891. View