Relationship between stress and weight management behaviors during the COVID-19 pandemic among those enrolled in an internet program

Background: The COVID-19 pandemic resulted in mandated stay-at-home orders, potentially resulting in changes in mental health (e.g., stress, anxiety) and challenges maintaining healthy dietary and physical activity behaviors.

Objective: This study examined how stress was associated with mental well-being and weight loss behaviors during the COVID-19 pandemic among adults enrolled in an internet-based weight loss program.

Methods: Participants enrolled in a weight-loss program residing in Rhode Island or Massachusetts, USA, completed a brief survey on their mental health and current weight-loss behaviors during the COVID-19 pandemic. Surveys were completed between 14 April 2020 and 21 April 2020, approximately one month after stay-at-home orders were mandated. Linear regression was used to examine associations between stress, mental health, and weight-loss behaviors.

Results: A total of 99 participants completed the survey (79% female, 91% white, 52.2 ± 9.8 years, 34.0 ± 5.2 kg/m², 77% reported moderate to extreme stress). Greater stress was associated with higher BMI (p = 0.04), higher education (p = 0.04), working more hours (p = 0.003), and having school-age children at home (p = 0.002). Greater stress was also associated with higher levels of anxiety, worry, and concern regarding COVID-19 (p's < 0.001) and having less time to spend on weight-loss efforts (p < 0.001), after controlling for BMI and education.

Conclusions: Many individuals enrolled in a weight-loss program experienced more stress during COVID-19 compared to before the pandemic. This stress was related to more mental health challenges as well as more difficulties finding time for weight management efforts.