Changes in Health Behaviors Associated With Weight Gain by Weight Classification During the COVID-19 Pandemic

Purpose: To determine whether perceived changes (i.e. perception of engagement during the pandemic relative to pre-pandemic) in specific health behaviors differ by weight status (i.e. healthy weight, overweight, obese). Design: Cross-sectional. Recruitment took place between June-August 2020, via social media posts and Qualtrics online panels. Setting: Participants completed the survey online through the Qualtrics platform. Sample: Analyses included N = 502 participants (>= 18 years); 45.2% healthy weight (n = 227), 28.5% overweight (n = 143), and 26.3% obese (n = 132). Measures: Study-specific survey items included questions about demographics and perceived changes in health behaviors. Analysis: Logistic regression models, adjusted for age, race, ethnicity, gender, education, and COVID-19 diagnosis, assessed the odds of perceiving changes in health behaviors considered a risk for weight gain. Results: Participants with obesity, but not overweight, were significantly more likely to report deleterious changes to health behaviors compared to healthy weight peers, including: (1) decreased fruit/vegetable consumption [adjusted odds ratio (AOR) = 1.92; 95% confidence interval (CI): (1.13, 3.26)]; (2) increased processed food consumption [AOR = 1.85; 95%CI: (1.15, 3.00)]; (3) increased caloric intake [AOR = 1.66; 95% CI: (1.06, 2.61)]; (4) decreased physical activity [AOR = 2.07; 95%CI: (1.31, 3.28)]; and (5) deterioration in sleep quality [AOR = 2.07; 95%CI: (1.32, 3.25)]. Conclusion: Our findings suggest that adults with obesity may be at greater risk for unhealthy behaviors during a period of prolonged social distancing, potentially exacerbating the obesity epidemic.