COVID-19 Amplified Obesity Concerns in the United States

Shanu N. Kothari, MD

Courtesy of ASMBS

Approximately one-third of adults in the United States indicated the COVID-19 pandemic heightened their concerns about obesity, with nearly 28 million people considering weight loss methods they had not considered before the onset of the pandemic, according to new research.¹

The public opinion survey conducted by the American Society for Metabolic and Bariatric Surgery revealed around 6.4 million Americans considered having weight-loss surgery or using anti-obesity prescription drugs during the pandemic. The investigative team noted the findings as particularly interesting, as only around 1% of eligible patients undergo bariatric surgery and only 1 - 3% of patients take prescription drugs for obesity each year.

“We’ve definitely seen a significant rise in interest in weight-loss surgery and other underutilized treatments since obesity was linked to worse outcomes from COVID-19,” said Shanu N. Kothari, MD, co-author of the study and past president of the ASMBS.² “COVID-19 lit the match for many people to get healthier and protect themselves from severe disease, whether that be COVID-19, diabetes, or heart disease. Treating obesity, the source of so many of these diseases, is the best way.”

With obesity affecting around 42% of Americans, research has suggested obesity was tied to severe COVID-19 infection, characterized by increased need for mechanical ventilation and increased mortality. Among nearly 150,000 adults who received a COVID-19 diagnosis at 238 hospitals between March – December 2020, more than half (50.8%) had obesity.

Prior to the pandemic, the investigative team conducted a study that revealed 81% of Americans viewed obesity as an extremely or very serious health problem, but few knew the best methods to combat the disease. Kothari and colleagues repeated some questions posed in the original survey to explore if views on the risks of obesity and its treatment have changed after more than 2 years of the COVID-19 pandemic in America. A survey of 1,714 adults was conducted between December 10 – 28 2021 and data were collected using AmeriSpeak®, a probability-based panel designed to be representative of the US household population.

Upon analysis, the investigative team found 8 in 10 adults (82%) consider obesity the biggest health threat facing the country, even more significant than heart disease (77%), diabetes (76%), and COVID-19 (68%). Black adults considered COVID-19 a bigger health threat than obesity (87% vs. 81%) but were more worried about the dangers of obesity than the general population (45% vs. 29%). The data showed nearly 4 in 10 of all Americans view obesity as a greater risk to their health now than prior to the pandemic.

Investigators additionally suggested COVID-19 was a motivating factor for 39% of Americans who had attempted weight loss in the past year, with 20% considering weight loss-methods that they had not tried before the pandemic, including diet and exercise (65%). Nearly-two thirds of Americans reported paying closer attention to their overall health due to COVID-19. However, weight loss has remained a struggle for the majority of Americans, according to Kothari and colleagues.

The research indicates most people do not go beyond traditional diet and exercise alone or involve doctors in their attempt to lose weight and could potentially overestimate the effectiveness of some treatments. Survey data show 73% of people considered diet and exercise on their own to be the most effective method for long-term weight loss, even more effective than involving a doctor (65%) or weight-loss surgery (56%). Meanwhile, only 23% reported taking prescription medication as effective, followed by dietary supplements (18%).

Regarding safety, more Americans correctly believed someone would have a greater change of mortality from complications of obesity (47%) or COVID-19 (39%) than weight-loss surgery (19%), according to investigators. However, investigators cited a disconnect between the public and the medical community on obesity.

Survey results showed only 41% of patients reported having spoken to their doctor about their weight, with patients more likely to initiate the discussion (60% vs. 39%). Moreover, nearly 1 in 5 people (18%) said concerns surrounding COVID-19 increased the chance they would bring up the issue of their weight to their providers.

The survey revealed most Americans view it as a risk factor for other diseases rather than a disease itself and 73% of those who have tried to lose weight believe obesity is caused by a lack of willpower. Investigators noted these percentages have not changed much since the 2016 ASMBC-NORC Obesity in America Survey, despite obesity being classified as a disease caused by a combination of biological, genetic, social, and environmental factors.

“Our hope is that people turn the fear of obesity and the consideration of new weight-loss strategies into action,” said Teresa LaMasters, MD, president of the ASMBS.² “With greater eligibility for weight-loss surgery and the emergence of effective new anti-obesity medications, Americans have more and better options than ever before, and they should take advantage of them when appropriate.”

References

1. Kissin, R., Khoury, L., Wallenborn, G., & Kothari, S. N. (2023). When the COVID-19 pandemic collides with the obesity epidemic in America – A national survey. Surgery for Obesity and Related Diseases. https://doi.org/10.1016/j.soard.2023.02.020

2. New survey finds covid-19 pandemic changed public's view of obesity. EurekAlert! (2023, March 22). Retrieved March 23, 2023, from https://www.eurekalert.org/news-releases/983013