COVID-19 is a supernova in human history. As Vinay Prasad and Jeffrey Flier write in STAT news:
[COVID-19] is an expanding, all-encompassing set of events and responses to them that touch every aspect of the human condition, simultaneously worsening and improving human health in myriad ways, through immediate and delayed paths.
You’re reading this newsletter - and I’m writing it! - because of COVID-19. But beyond that mundane factoid, the pandemic has had far-reaching impact across our lives.
It’s brought healthcare disparities to the forefront of our discussions of the healthcare system.
It’s shown our depressing collective inability to quickly organize pragmatic clinical trials to learn what works and what doesn’t to fight a new disease.
It’s rapidly expanded the use of telehealth with all of its promise and pitfalls.
But there seems to be a common and particularly upsetting impact that I’ve been seeing over and over again: the stress of the pandemic and its resultant increase in social isolation has made people eat more crap, drink more booze, do less exercise, and gain a bunch of weight.
Let’s call this phenomenon the COVID-15.
Why is everyone gaining weight during the pandemic?
I’ve noticed that patients are coming to see me for follow up with tighter clothing than they had 6 months ago.
Blood pressure is up a few points despite no change in medications.
Blood sugar and triglycerides are creeping higher and higher.
Belts loops are starting to get strained, or maybe people have just switched to elastic waisted clothing.
The consistency of their stories is kind of astounding. I’ve noticed a few different themes keep coming up:
“Working from home means I’ve been inside so much more and we have this junk food lying around so I just keep snacking”
“I’m staying up late watching TV and reading the news so I’m not sleeping that much. When I’m tired like this, I can’t bring myself to start exercising”
“Everything that’s going on in the world is stressing me out, so I’ve found myself baking much more (and eating everything that I bake)”
“I’m petrified that I'll get infected if I leave the house, so I’ve just been staying at home”
There’s data to back up these anecdotal reports
People are getting less physical activity all over the US, and this isn’t confined to cities that have been overrun with COVID cases.
Oreo sales are up 30%. Spam is up 37%. General Mills, Tyson Foods, Campbell Soup, and Kraft Heinz all saw sales gains between 10% and 20%.
It’s crazy to think that more than 40% of the soaring sales in Fig Newtons and Nutter Butter cookies came from first-time buyers.
And we can’t forget that alcohol sales increased by as much as 55% during the pandemic.
Sometimes weight gain can feel perplexing to people. It seems like you’re doing “everything right” but for some reason the weight doesn’t come off.
The COVID-15 generally requires no such guessing game when it comes to etiology.
We know *how* this is happening, but *why* is it happening?
While the fear of COVID-19 has made us feel powerless to stop something we can’t even see, the insidious effects of social distancing on loneliness can’t be dismissed as a factor here.
We’re not only constantly aware of the pandemic and fearful of what it might do to our lives, but we’re spending more time alone and ruminating.
While fear can be an incredibly potent motivator, powerlessness acts as a demotivator. Feeling impotent leads to inaction. These things are self-reinforcing.
The social isolation is only compounding these complicated and mostly negative emotions. Humans are a social species - forced abstinence from social interaction probably has similar negative effects on our health as loneliness does.
In my anecdotal report from the patients I’ve been seeing, the people who seem to be most susceptible to the COVID-15 seem to be the lucky ones, at least on the surface.
They’re the folks who don’t worry about food insecurity, are able to work from home, and haven’t had to go out much in public because their jobs can be performed remotely.
My unsolicited advice on treating the COVID-15
If you happen to be one of the folks whose worst outcome from this pandemic has been dealing with the COVID-15, you should consider yourself very lucky!
The solution to treating the COVID-15 is straightforward but not easy: you need to reframe things for yourself.
Change “I have to” to “I get to.”
Instead of “I have to go for a walk today,” it’s “I get to go for a walk today.”
Instead of “I have to do 15 minutes of exercise,” think “Because I’m not intubated and confined to a hospital bed, I get to do 15 minutes of exercise.”
Instead of “I have to eat healthy,” think “I’m lucky enough to have money to buy the high quality fuel that my body runs best on.”
Something can be simple and straightforward, but also not easy. I think that the COVID-15 is one of those things.
Think of your time at home with fewer things to do and places to go as an opportunity you may never get again. Don’t waste it. You get to make this time productive, but you certainly don’t have to.
Plus, don’t forget that no one has ever felt anxious about the world while breathing hard and sweating from exercise. Seriously, try feeling depressed after doing 50 burpees.
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