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