When overeating during lockdown might become a problem

 During lockdown, some people have noticed changes in their eating habits, with many noticing that they’re snacking more during the day as a result of being at home more. Whilst snacking doesn’t always cause problems, overeating over a prolonged amount of time can increase your risk of obesity, especially if you already have a BMI of 25 or above (classed as overweight according to the NHS)

Whilst it’s important to eat a balanced diet and to include fats, sugars and sodium, too many of these types of foods can, over time, lead to weight gain and obesity, which brings along an added risk of other health conditions, such as type 2 diabetes, high blood pressure, high cholesterol, cardiovascular problems, stroke, and even some types of cancer.

Severe obesity is included in the NHS’s list of high-risk conditions for COVID-19, alongside high blood pressure, type 2 diabetes and heart disease – all of which have a strong associated link with obesity, or a BMI of over 30. Whilst the NHS classes “very obese” people as having a BMI of over 40, any excess weight can cause health problems that could exacerbate symptoms of COVID-19 if you were to contract it.

Evidence of Obesity as a risk factor for COVID-19

COVID-19 is a novel coronavirus, meaning that we don’t yet have all of the information about it that we have about other illnesses, such as the SARS coronavirus or MERS. However, preliminary research from across the world seems to highlight age and obesity as two of the biggest risk factors of COVID-19 due to the complications that the virus can cause.

An article published on diabetes.co.uk on the 16th April 2020 discusses new research carried out in New York that points towards age and obesity being the biggest risk factors for the novel coronavirus. However, the study hasn’t yet received a peer-review, meaning that it isn’t currently suitable for clinical guidance and the research is preliminary. However, the article brings up the idea that in obese people, the immune system is already working hard all of the time to repair inflammation that’s caused by excess fat. COVID-19 will place a further strain on the immune system as it tries to fight off the virus by creating antibodies, so obesity may contribute to a longer recovery time, or even more severe symptoms, which can lead to hospitalisation.

In addition to this, the Centre for Disease Control (USA) also lists severe obesity as a risk factor for COVID-19 in the same way that the NHS has. The CDC states that “severe obesity increases the risk of a serious breathing problem called acute respiratory distress syndrome (ARDS) which is a major complication of COVID-19”. As obesity can place an added strain on the respiratory system, contacting COVID-19 with a BMI of over 30 may mean that respiratory symptoms are more severe, such as a cough and shortness of breath. Being obese may make it more difficult for the lungs and diaphragm to fully expand and take in oxygen – something that is vital at all times, but especially with an illness that causes respiratory problems such as COVID-19. In turn, if the respiratory system is badly affected, especially if there’s already an added strain on it, this could increase the risk of pneumonia, one of the common complications of COVID-19. To support these claims, a preliminary study in Shenzen, China, (Qingxian et al, 2020) showed that COVID-19 patients with obesity had  “2.42-fold higher odds of developing severe pneumonia” compared with patients of a healthy weight.

The CDC also states that “people living with severe obesity can have multiple serious chronic diseases and underlying health conditions that can increase the risk of severe illness from COVID-19”. One of these underlying health conditions that’s associated with obesity is type 2 diabetes – a group of people known to be at high risk for the novel coronavirus. Although those with diabetes may not be more likely to contract COVID-19 than anyone else, they are more at risk of experiencing complications and more severe symptoms if they do get it. However, having diabetes that is well-managed can reduce these risks.

Help with weight loss

Weight loss can be incredibly difficult, especially if there are underlying health conditions alongside excess weight, as these may reduce the amount of weight you’re able to lose with diet and exercise. However, weight loss medications are available for those with a BMI of over 30 that struggle with losing weight naturally.

One popular weight loss medication is the liraglutide injection, Saxenda. Saxenda has been clinically proven to help with weight loss in obese people, with some studies even suggesting that it may delay or prevent the development of type-2 diabetes.

During a 56-week trial, 63.2% of Saxenda users lost at least 5% of their body weight, compared with just 27.1% of a placebo group. In addition to this, 33.1% lost more than 10% of their initial starting weight, compared with 10.6% from the placebo group. However, despite these results being monitored over the course of 56 weeks, it’s actually expected that most patients will lose at least 5% of their body weight within the first 12 weeks of using Saxenda daily.

Although Saxenda isn’t routinely available on the NHS, guidelines state that if a patient hasn’t lost 5% of their initial starting weight by the end of 12 weeks of using Saxenda, treatment with liraglutide injections should be discontinued. This provides hope for many obese people that are struggling to lose weight naturally, as a 5-10% reduction in body weight has been proven to reduce weight-related complications, something that’s particularly important during the COVID-19 outbreak.

Someone with a BMI of 35 may be able to reduce their BMI by 2-4 points as a result of using Saxenda if they lose 5-10% of their body weight. For example, a person that is 5’7 and weighs 230lb would have a BMI of 35. If that person loses 5% of their initial starting weight, their new BMI would be 33, and if they lose 10%, it would fall again to 31. If a loss of at least 5% can be achieved within the first 12 weeks of starting Saxenda, it provides a promising outlook for if an individual wanted to continue with treatment, but how does it work?

Saxenda contains liraglutide as the active ingredient, which works by mimicking a hormone that our bodies produce naturally after we’ve eaten. This hormone signals to our brain that we’re satisfied and don’t need any more food. Because Saxenda emulates this hormone, it is able to reduce appetite, meaning that you feel fuller sooner, and for longer. This is ideal for those that already eat a balanced diet, but perhaps overeat or consume large portions of food. In essence, Saxenda can help to prevent overeating and excessive snacking, something that lockdown has caused for many people.

Although Saxenda means that you eat smaller portions, you can still enjoy a balanced diet which includes all of the food groups, rather than having to restrict fats, sugars and sodium. As Saxenda causes you to feel satisfied, it may also help you to reduce how much you snack, as cravings between meal times may be reduced.

Is Saxenda suitable for me?

Saxenda might not be suitable for everyone. It’s a prescription medication that helps with weight loss in people with a BMI of over 30 (or over 27 with a weight-related health condition).

Saxenda is suitable for you if your BMI falls into either of the categories above, and if you want to start losing weight. Weight loss medications shouldn’t be taken by those with an eating disorder, or disordered eating, as they may worsen some of the thoughts and feelings surrounding food. However, if you want to reduce your portion sizes, Saxenda is an ideal treatment.

If your BMI is 29 or below (or 27 and below without a weight related health problem), Saxenda and other weight loss medications might not be an option for you, as a vast majority of obesity treatments aren’t indicated for people with a BMI under these levels. However, there might be other things you can do to help yourself during lockdown.

Lockdown weight loss tips

Jules is a teacher from Derbyshire, who’s working from home during the pandemic. She’s found that the added flexibility from working at home has meant that she’s been able to set aside some time each morning for exercise. In addition to this, Jules has also found more time to cook, meaning that she’s including more protein into her diet by having eggs for breakfast instead of bread. These small changes mean that Jules is enjoying a healthy lifestyle whilst working from home – something that isn’t always possible when faced with a commute and rigid working hours.

 

Photo courtesy of Jules - a healthy brunch full of protein, with tomatoes, olives and feta as a side salad

If you’re working from home, you may find that slightly changing your routine could help you to overcome overeating and excessive snacking. For example, if you find that you usually snack more before lunch, it might help you to make a satisfying and fulfilling breakfast each morning, like Jules. Feeling satisfied after a meal can help with reducing cravings for snacks.

Unfortunately for some, not everyone is able to work from home during lockdown, and many have found themselves furloughed, with nothing to do during working hours. Boredom can often lead to overeating, so it’s important to keep your mind active whilst still eating a balanced diet. The way we eat is often tied to our emotions and behaviours, so keeping your mind active and healthy is important in all aspects of health, as it can help you to avoid under or over eating.

If you’ve found yourself furloughed or with no work during the pandemic, it might help you to take up a new hobby such as painting, reading, learning an instrument (if you have one), or learning more about a subject that you’re interested in. Taking part in enjoyable activities both keeps your mind occupied as well as boosting your mental health, something which is incredibly important at all times, but especially during this pandemic when we aren’t able to visit friends or family.

Some people have found themselves being less active during lockdown because of the government restrictions and the fact that gyms and swimming pools are closed. Luckily, some personal trainers are giving people tips on what they can do at home to stay active during the pandemic. Whilst it might not replace your gym membership, these tips can help you to keep moving at home, without you needing to flout any rules.

David Dellacioppa, Exercise Expert and owner of PT Corner in Buxton, Derbyshire, says: "Aim to look after both your physical and mental health during this difficult period as they come hand in hand with one another. Look to achieve at least 20 minutes of exercise daily. These may include activities such as body weight workouts, yoga, Thai Chi and meditation." In addition to this, David knows that some people will be missing their gym equipment, and has suggested some DIY weights that you can make from objects around your home: "If you'd like to use equipment at home, you can try using tinned goods, bottles of water, rucksacks/bags bags or old milk cartons, anything that you're able to add weight to so that you can continue with your weight workouts from home"

All in all, our advice for reducing overeating during lockdown is to keep your mind and body active as much as you can in order to boost mental health and prevent boredom, which in turn can hopefully help you to create a healthier relationship with food.