We Need a New Approach to Reverse Pandemic Weight Gain
The pandemic has not been kind to many peoples’ waist circumference, or the number of chins they are carrying. Even those who have received the vaccine remain cautious; who knows whether the new variants will prove a danger even to the vaccinated and, anyway, life certainly has not returned to its pre-Covid19 state. Thus, the vulnerability of this group’s response to stress for whom food and/or alcohol has been the remedy for pandemic upset; that urge to overindulge is still very much present. And when chronic anxiety and depression is exacerbated by the current health-related stress, weight gain and substance abuse may follow.
Who is most likely to succumb to eating, drinking or using recreational drugs as the most effective route to comfort? According to a recent publication in Clinical Obesity, one group likely to do so is the obese, and in particular, the obese who may also suffer from mood disorders. In a study on the effects of the pandemic on mood, weight, and substance abuse among a group of obese individuals who were enrolled in a wellness program, the vulnerability of this group to respond to the pandemic (or maybe simply general stress) is well established. Almost 600 people participated in a survey about their mental health, eating patterns, sleep, and use of alcohol and recreational drugs this past summer (June to September 2020).
There was a significant increase in what the authors call maladaptive eating (or more commonly, unhealthy food choices.) Difficulty sleeping was common, and almost half reported the use of recreational drugs and alcohol. They also mentioned decreased time spent in exercise. Almost three-quarters of the respondents said their behavior was generated by stress, two-thirds said anxiety, and about half, boredom. About 40% claimed that depression was behind their overeating and use of drugs and alcohol.
The authors suggest that these “maladaptive” behaviors may be related to the close association of obesity with mental health problems. Certainly this association existed before the pandemic, and is unlikely to disappear when life returns to normal. However, this study did not look at the mood, weight, and behavioral changes among those who were not obese at the start of the pandemic. There are now several reports indicating an increase in both mood disorders and weight (the pandemic 15) among those for whom neither was a problem a year ago.
Obviously depression, anxiety, panic attacks, and other mood disorders can arise without the situational stress of the pandemic. Obesity has been a problem for many decades; it did not take a pandemic to make it into a national health crisis. But we are seeing something new, that is, the effects of months of the chronic stress from social isolation and fear of becoming sick, on the need to find relief by indulgent eating.
Traditional weight-loss programs are not designed to deal with pandemic-related anxiety, depression, and general stress that caused the weight gain and may hamper weight loss. And traditional mental health interventions are just as unlikely to deal the constant overeating associated with the mood changes related to the pandemic. Perhaps it is time for both these disciplines to work together. In fact, a collaboration between professionals who deal with mood disorders, and those who deal with overeating may be useful beyond repairing the effect the pandemic has had on our weight. That emotional overeating is a significant cause of weight gain is well established. But even weight-loss programs that supposedly provide techniques for preventing stress from inhibiting successful dieting, rarely go beyond rather superficial means of stopping the dieter from reaching for food when distressed.
In an ideal world, those seeking help in losing weight gained in association with stress should have access to mental health professionals, as well as those weight-loss specialists. And such help should not be offered only when weight fails to be lost or starts to be regained. In an ideal world, those seeking help for their mental health problems, and who also need to lose weight, should be offered the services of qualified weight-loss professionals.
Perhaps if these two disciplines work together, the mental health professional will be able to offer help to the patient gaining weight on antidepressant therapy. And the weight-loss consultant will be able to offer help to the patient whose mood disorders make it difficult to resist eating foods that reduce stress.
The availability of virtual meetings should allow both professionals and the patient to meet simultaneously and develop a program that promotes weight loss without jeopardizing a risk to mental health. For example, if the patient has been given antidepressant medication that increases serotonin activity, then the inadvisability of a weight-loss diet that depletes the brain of serotonin can be discussed. The necessity of increasing physical activity for weight loss and relief of depression can be emphasized by both professionals, as well as finding activities to decrease isolation and use of food to relieve boredom.
The pandemic will, we all hope, be over in months, not years. But perhaps the now common use of virtual (rather than actual) contacts will continue, and provide a more effective strategy for weight loss.