Helping Patients with Obesity Navigate COVID-Induced Stress

For more than a year, COVID-19 continues to be the monopolizing force around the world. The recent milestone marking half a million deaths in the United States, combined with new variants and hospitalizations, are grim reminders that despite the introduction of vaccines, managing the virus remains just beyond control.

These losses paint only a partial picture. In addition to illness, death and potential long-term side-effects, the psychological impact related to the virus has been significant across populations indiscriminate of gender, race or lifestyle. This can be particularly overwhelming for patients with obesity who already struggle with higher diagnoses of major depression and panic disorders.

The pandemic has brought incredible added stress to these individuals and families. Lost jobs, school closures, quarantines, food insecurity and inconsistent health and safety guidelines each increase anxiety. But when they occur simultaneously, it can be overwhelming. Add a fraught political environment and terrible natural disasters, and even the most optimistic person struggles to remain positive. The outcomes of this growing stress are most commonly seen as depression, anxiety, lack of sleep, anger and irritability. Quarantine and social isolation also have contributed to weight gain across the entire population, which will continue to contribute to an increase in obesity levels.

Another negative effect of psychological and emotional stress for people with obesity is metabolic complications. It has become increasingly clear over the past year that obesity is a high risk factor for COVID-19. These patients become more severely ill and are three times as likely to be hospitalized. As BMI increases, so too does the likelihood of mortality. Stress further contributes to physical deterioration by triggering the body’s response system. This promotes inflammation and decreases immune response, which negatively impacts health outcomes for both children and adults with obesity.

Realistically, herd immunity might be achievable by late 2021. In the meantime, the widespread implications of COVID-induced stress suggest that physicians provide patients with recommendations for stress relief and referrals for continued care to cope with stress though and beyond the pandemic.

The way a structured weight management program can alleviate this is to offer foundational support for patients with obesity. Dr. John Hernried, President & Medical Director of The Hernried Center for Medical Weight Loss in Sacramento, CA, has found that patients recognize that the impact of quarantine on their weight and have renewed interest in weight loss. He says his patients tell him that, “Everything else seems just so out of control these days with the pandemic that continuing in a weight loss program gave them that sense of control.”

In addition, telemedicine is well-suited to the treatment of obesity because specialized equipment is not required. This is an asset for patients, especially younger individuals who prefer the use of technologies. Dr. Jamie Almandoz, an Assistant Professor in UT Southwestern Medical Center’s Division of Endocrinology, agrees. His study on the impacts of COVID-19 on adults with obesity found that they were experiencing stress, anxiety and depression. He suggests that physicians “need to find novel ways to interact with our patients through telehealth and mobile devices to support them on their journey to a healthier body weight.” To that end, Robard’s MyHealthyJourney is a mobile app and digital solution that empowers patients with obesity to securely journal their meals, exercise and hydration, message coaches, schedule visits, and track weight.

Other immediate steps can be taken to help redirect attention away from stressors. Less screen time and more activity — such as indoor exercises and hobbies — benefits both physical and mental health, reduces stress, improves mood and lowers heart rates. In addition, video calls are a great resource for maintaining the social connections that are critical to personal well-being. It is also important to remind patients of the importance of self-care and remaining positive. This can be a challenge even in ordinary times, but “me-time” becomes even more critical when the house is constantly full and the boundaries between work, family and other time constraints become blurred.

The long-term physical and mental health impact of COVID-19 are impossible to determine though it’s safe to predict they will linger. Inquiring about patients’ mental health now and offering stress reduction techniques or professional referrals can go a long way to curbing negative effects and helping to promote physical and cognitive well-being through continued changes as we move forward.