Dr. White said it was important not to view pandemic weight gain as a product only of diet and exercise behaviors. “The social context and the physical context of our families is so incredibly important in terms of their risk of weight gain,” she said.
My colleague Dr. Mary Jo Messito, who directs the pediatric weight management program at N.Y.U. School of Medicine and Bellevue Hospital, said, “My patients are suffering terribly.” They face many barriers to exercise because of fears of being exposed to Covid, she said, and also food insecurity and a very high level of stress. “So many people don’t meet their goals because they have unaddressed mental health needs,” Dr. Messito said, pointing to the need for more mental health resources for low-income communities.
“I work to try to give people resources where they are,” she said, offering handouts and information about healthy food for people on limited budgets, but acknowledging, “it’s not going to compete with fast food for calories for dollar.” She recommends in-home exercise programs or talks about how to mask up and go outside safely, and she talks about avoiding sugary drinks.
Dr. Elsie Taveras, a professor of nutrition in the department of pediatrics at Harvard Medical School and the chief of general pediatrics at Massachusetts General Hospital, said that the challenge ahead will be to find ways to “go beyond surface counseling,” to help families find ways to turn this around, perhaps looking for help from experts in mental and behavioral health. Doctors will need to think about the dual burden of weight gain combined with the social risks brought on by the pandemic.
“If a patient with obesity comes in for a visit and I also know the family is living in a motel or they’re food insecure,” she said, “I need to adapt my plan to circumstances rather than say, ‘increase fruits and vegetables.’”
Pandemic weight gain is a problem for adults as well as children, Dr. Taveras said. “We’re home more, have more access to our beds, our refrigerators, our screens, we are experiencing extreme stress and uncertainty, and food and rest are things people turn to for comfort.”
“It’s important for people to have self-compassion here,” Dr. Hassink said. And it’s overwhelming to tackle all of this at once. “Maybe we should be helping people pick one thing they think they could change to make it healthier, strategize about how they might make progress on one thing.”