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People With Obesity Report Struggles With Mental Health During Pandemic

February 16, 2021

Even after pandemic stay-at-home orders were lifted, people with obesity continued to struggle with mental health challenges, according to a study published online in Clinical Obesity.

“The COVID‐19 pandemic is having a durable negative effect on the health behaviors and mental health of people with obesity,” wrote researchers from the University of Texas (UT) Southwestern Medical Center and the UT School of Public Health, Dallas. “In particular, this group is reporting significant use of substances, increases in anxiety, depression, and difficulty sleeping, which are associated with maladaptive eating and physical activity behaviors.”

Study results stemmed from an online survey of 589 patients with obesity enrolled in the UT Southwestern Weight Wellness Program. The survey took place from June 1, 2020, to September 30, 2020, after local COVID-19 lockdown orders were lifted. Some 17 of the participants in the survey had tested positive for COVID-19.

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Recreational use of drugs and alcohol was reported by 48.4% of survey respondents, according to the study, and 9.8% reported increased use since the pandemic’s start. Substance use during the past 30 days was reported by just over 38% of participants: 24.4% used opioids, 9.5% used sedatives or tranquilizers, 3.6% used marijuana/cannabis, and 1% used stimulants.

Primary reasons for the increased use were stress (72%), anxiety (65%), boredom (49%), and depression (41%).

Jaime Almandoz, MD, MBA (Credit: UT Southwestern Medical Center)

“Many patients with obesity are also challenged by mental health conditions,” said study author Jaime Almandoz, MD, MBA, medical director of the Weight Wellness Program and assistant professor of internal medicine at UT Southwestern. “Those who reported anxiety, depression, and trouble sleeping were 2 to 4 times more likely to increase their use of substances. For those who reported stress eating, there was a sixfold increase in substance use.”

Sleep Problems Hit Unexpected Heights Early in Pandemic

Although 23% of respondents reported no impact, 68.6% said the pandemic made it more difficult to achieve weight loss goals. Half reported decreased exercise time, and 53.6% reported decreased exercise intensity.

In June 2020, a study coauthored by Dr. Almandoz in Clinical Obesity was one of the first to report the effect of lockdown orders on health behaviors of people with obesity.

“Data from this study clearly demonstrate that the COVID‐19 pandemic has continued to impact people with obesity by negatively influencing mental health and facilitating substance use,” said senior author Sarah Messiah, PhD, MPH, a professor at the UTHealth School of Public Health. “It is concerning that a significant proportion of participants have turned to substance use and/or increased substance use during the pandemic to help manage their stress and mental health.”

—Jolynn Tumolo


Almandoz JP, Xie L, Schellinger JN, et al. Substance use, mental health and weight-related behaviours during the COVID-19 pandemic in people with obesity. Clinical Obesity. 2021 February 4;[Epub ahead of print].

Pandemic increases substance abuse, mental health issues for those struggling with obesity [press release]. Dallas, Texas: University of Texas Southwestern Medical Center; February 5, 2021.

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