The impact of COVID-19 emergency on weight and nutritional habits of patients who underwent bariatric surgery

ABSTRACT

Introduction: Since the end of 2019, the COVID-19 pandemic has been one of the most important public health problems of the last decades. To date, the most effective instrument to reduce the spread of the infection is strict social distancing, despite economic, social and psychological drawbacks. Obese people are among the most affected by both COVID- 19 mortality and public health measures effects. On one hand, obesity is associated with poorer COVID-19 outcomes and, on the other hand, lockdowns promote weight gain and a worsening of overweight comorbidities. Despite bariatric surgery emerged as the most effective therapy for obesity, only preliminary data are available about the effects of the pandemic on possible weight regain and mental health worsening in bariatric patients. Our aim was to evaluate how Italian lockdown influenced weight, food choices and psychological health of a cohort of patients who underwent bariatric surgery. Methods: We included 87 patients who underwent bariatric surgery at the Surgery of the Alimentary Tract and were followed up at the Unit of Endocrinology and Prevention and Care of Diabetes of the Sant'Orsola University Hospital of Bologna between 12 and 18 months before March 2020 lockdown. Patients' personal, socio-demographic, anthropometric, nutritional and psychological data were collected using medical records, phone interview or psychometric questionnaires at the end of lockdown. Results: Mean differences between body weight at the end of lockdown and at last follow up visit was 0,1±3,8 kg. No significant differences in consumed Kcal were found, but total lipid and oligosaccharides consumption resulted higher than expected. Family composition, psychological distress, anxiety and depression had a significant effect on mean weight and BMI differences at the end of lockdown. Foreigner patients and women obtained higher scores in psychometric questionnaires regarding acute stress and anxiety, while the prevalence of anxiety and depression at the end of lockdown were higher among immigrants. Psychological distress and depression scores were positively correlated to weight and BMI increase, but no relation were found between Kcal and principal macronutrients and differences in weight and BMI. Conclusion: The present study showed that bariatric patients seem generally protected from weight gain due to lockdown induced negative changes in lifestyle. However, people living alone or perceiving a great psychological burden during the emergency had a higher risk to increase weight.