0352/2023 - Home office is associated with weight gain during the Covid-19 pandemic: Brazilian population-based studies
Home office está associado ao ganho de peso durante a pandemia de Covid-19: estudos brasileiros de base populacional
Autor:
• Fernanda O. Meller - Meller, F. O. - <fernandameller@unesc.net>ORCID: https://orcid.org/0000-0002-1174-4721
Coautor(es):
• Antônio A. Schäfer - Schäfer, A. A. - <antonioaschafer@unesc.net>ORCID: https://orcid.org/0000-0002-8834-0434
• Bianca Languer Vargas - Bianca, L. V. - <bicalang@gmail.com>
ORCID: https://orcid.org/0000-0002-0984-1215
• Vanise S. F. Viero - Viero, V. S. F. - <vanisedossantos@hotmail.com>
ORCID: https://orcid.org/0000-0002-7780-3595
• Elizabet Saes-Silva - Saes-Silva, E. - <betssaes@gmail.com>
ORCID: https://orcid.org/0000-0003-2356-7774
• Micaela R. Quadra - Quadra, M. R. - <micaelarquadra@gmail.com>
ORCID: https://orcid.org/ 0000-0002-6380-7720
• Samuel C. Dumith - Dumith, S. C. - <scdumith@yahoo.com.br>
ORCID: https://orcid.org/0000-0002-5994-735X
Resumo:
Background: The Covid-19 pandemic caused changes in life, affecting habits and behaviors, and one of its consequences is an increase in weight. We aimed to evaluate the association between remote work and weight gain during the Covid-19 pandemic in two cities in southern Brazil.Methods: A population-based cross-sectional study carried out in the southern region of Brazil. Data were collected face-to-face, in households ed by census sampling. The outcome was weight gain, and the exposure was remote working. To verify this association, Poisson Regression was used to calculate the crude and adjusted prevalence ratio and its 95% confidence intervals, using 5% significance level.
Results: In total, 2,152 individuals were interviewed. The prevalence of weight gain during the pandemic was 38.4% (95%CI 36.1-40.7), being significantly higher in those who worked remotely (47.0% vs 37.7, p=0.02). Those individuals who worked remotely were 23% more likely to gain weight during the pandemic compared to those who did not work remotely (PR: 1.23; 95%CI 1.02-1.49).
Conclusions: Health and education services may be encouraged to implement educational actions at the collective level, aimed at enlightening the population and preventing weight gain in periods of confinement.
Palavras-chave:
Covid-19, home office, weight, cross-sectional study.Abstract:
Introdução: A pandemia de Covid-19 provocou alterações na vida, afetando hábitos e comportamentos e uma de suas consequências é aumento de peso. O objetivo foi avaliar a associação entre trabalho remoto e ganho de peso durante a pandemia de Covid-19 em duas cidades do sul do Brasil.Métodos: Estudo transversal de base populacional realizado na região sul do Brasil. Os dados foram coletados face a face, em domicílios selecionados por amostragem censitária. O desfecho foi ganho de peso e a exposição foi trabalho remoto. Para verificar essa associação, utilizou-se Regressão de Poisson para calcular a razão de prevalência bruta e ajustada e seus intervalos de confiança de 95%, com nível de significância de 5%.
Resultados: Foram entrevistados 2.152 indivíduos. A prevalência de ganho de peso durante a pandemia foi de 38,4% (IC95% 36,1-40,7), sendo maior naqueles que trabalharam remotamente (47,0% vs 37,7, p=0,02). Indivíduos que trabalharam remotamente tiveram 23% mais chances de ganhar peso durante a pandemia comparados àqueles que não trabalharam remotamente (RP: 1,23; IC95% 1,02-1,49).
Conclusões: Os serviços de saúde e educação podem ser incentivados a implementar ações educativas em nível coletivo, visando o esclarecimento da população e a prevenção do ganho de peso em períodos de confinamento.
Keywords:
Covid-19, home office, peso, estudo transversal.Conteúdo:
INTRODUCTION
Two years after the arrival of Covid-19, much evidence is available about its reflection and control measures in the lives of the world population 1. The implementation of social distancing, popularly called "staying at home", has brought changes in the daily routine globally, affecting people's habits and behaviors 1,2. Among these changes, those that can have direct impacts on health stand out, such as eating habits and physical activity 2.
Adherence to remote working, school closures, and restrictions on commerce and leisure events led to an increase in the time spent at home 2. As a result, several studies have already shown, for example, an increase in sedentary behavior and a decrease in the practice of physical activity 3, changes in eating habits 4, and increased weight gain 5,6, alcohol consumption 1, and symptoms of stress, anxiety, and depression 2.
Studies have shown that, the reasons for weight gain during periods of social distancing include worsening in the quality of food and an increase in energy consumption, caused by the greater intake of processed and ultra-processed foods, as well as more time available for the preparation of culinary recipes, and an increase in meal delivery orders 7,8. Also noteworthy is the fact that those most affected by weight gain associated with pandemic confinement are precisely those who were previously overweight 5,8,9, which could result in future damage to health, since small weight changes in short periods can become triggers for the permanence of the acquired weight 10.
During the Covid-19 pandemic, remote working had a considerably frequency in the Brazilian population, with 7.9 million people working remotely in November 2020 11. Even after the pandemic, this work practice has been continued according to data from the Institute of Applied Economic Research (IPEA) from Brazil, in which was demonstrated that 20.5 million employees can work remotely in Brazil, especially those with higher education level 12. Remote work can be associated with positive and negative behaviors and feelings, such as increase in sedentary behaviors and in domestic physical activity 13, stress-related symptoms, job satisfaction 14 and back pain 15. Among them, weigh gain is commonly debate as one of the main negative outcomes of this practice 16,17.
In addition to the different consequences for physical and mental health generated by the Covid-19 pandemic context, Brazil, as well as several countries in the world, has been facing an obesity epidemic for years, which itself already has negative impacts on health in the individual and collective dimensions. Therefore, any and all factors that may lead to an increase in the number of obese people must be monitored very carefully, in order to collect evidence that will help in monitoring and managing the problem of the obesity epidemic. In this sense, the current study aimed to evaluate the association between remote work and weight gain during the Covid-19 pandemic in two cities in southern Brazil.
METHODS
Population and Sampling
This is a cross-sectional study carried out with a representative sample of adults aged 18 years or older, living in the urban area of two cities in southern Brazil (Rio Grande, Rio Grande do Sul state and Criciúma, Santa Catarina state).
The municipality of Rio Grande has approximately 211 thousand inhabitants (96% urban), with a Human Development Index (HDI) of 0.7441 18. Criciúma is located in the extreme south of the state of Santa Catarina, approximately 206 km from the capital Florianópolis, and has approximately 217 thousand inhabitants (98.6% residing in the urban area), and an HDI of 0.7882 18.
Two-stage sampling 19 was used to obtain a representative sample of the urban population of Rio Grande and Criciúma. First, census sectors were systematically selected based on data from the 2010 population census 20, with probability proportional to the size of the sector. Second, households were selected. An average of 10 households per census tract were randomly selected, totaling an estimated number of 2,894 potentially eligible individuals.
Logistics and Ethical Aspects
Data collection took place between October 2020 and January 2021, with previously trained interviewers, using the appropriate Personal Protective Equipment (PPE). The interviews were carried out in front of the homes of the eligible, using a pre-coded and standardized questionnaire, composed mostly of closed questions, using tablets. This instrument was built using RedCap® (Research Electronic Data Capture) software, followed by data transfer to the computer.
This research was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics and Research Committee on Human Beings of the Federal University of Rio Grande (FURG), under opinion 4,055,737. All ethical principles established by the National Health Council in Resolution 466/12 were respected. Participants were informed about their right to refuse participation and about confidentiality procedures. Those who agreed to participate in the study informed this decision after reading the Free and Informed Consent Form.
Variables
The outcome investigated was weight gain, identified by the following question: “During the period of social distancing, did you notice any change in your body weight?”, with the answer options: no, it remained the same; yes, it increased; yes, it decreased. Those who answered “yes, it increased” were considered for the outcome and the other answers as “no increase”. The variable was dichotomized into “no” and “yes”.
The exposure (or independent) variable was remote work, identified by the question “How has social distancing imposed by the Covid-19 pandemic affected your job/work?”, with the answer options: I didn’t work before pandemic and I stayed out of work during the pandemic; I stayed working; I continued working, but at home, remotely; I did start working during the pandemic; and I lost my job. Those who answered “I continued working, but at home, remotely”, were considered “yes”, and the other answers, as “no”.
The covariables used to adjust for possible confounders in the relationship between outcome and exposure are described in the Table 1.
Statistical Analysis
Statistical analyses were performed using STATA software version 11.0 (StataCorp LP, College Station, Texas). Univariate analysis was used to present absolute and relative frequencies in order to describe the sample according to each variable of interest. P-values using Fisher´s exact test was shown. To verify the association between the outcome and the independent variable, the Poisson Regression model was used, considering the effect of the sample design to calculate the crude and adjusted prevalence ratio (PR) and its corresponding 95% confidence intervals (95%CI) and p-values. The significance level was set at 5% for two-tailed tests.
For the adjusted analysis, the covariables with a significance level of 20% (p-value <0.20) were considered confounders and remained in the final model.
The interaction was tested between remote work and the municipality (Rio Grande and Criciúma) on the occurrence of the outcome, but there was no interaction (p=0.59); therefore, the analyses were not stratified by municipality.
RESULTS
A total of 2,152 individuals aged 18 years and over participated in the present study, with a response rate of 70%. Of these, the majority were female (59.8%), approximately a third (31.1%) were 60 years of age or older, only 10.5% lived alone, and 25.6% had a monthly income above 2000,00 BRL per month. Approximately 48.3% performed paid work in the previous month, almost a quarter of respondents were obese, and 34.5% reported morbidities. Almost 20% perceived greater stress and 13% had depressive symptoms (data not shown in table).
One in ten respondents reported consuming sweets every day of the week, 13.7% began to eat more and of worse quality during the pandemic, and almost 40% reported performing less physical activity during the pandemic. The proportion of individuals who started working from home (remote work) was 7.8% (Table 2).
The prevalence of weight gain during the pandemic was 38.4% (95%CI 36.1; 40.7%), with 37.7% for the group that did not work remotely during the pandemic and 47.0% for those who worked remotely (p=0.02 using Fisher´s exact test) (data not shown in table). In the crude analysis, it was observed that those individuals who switched to working remotely during the pandemic were 25% more likely (95%CI 1.04; 1.51) to gain weight during the pandemic compared to those who did not switch to working remotely. After adjusting for possible confounding factors, this association remained statistically significant (PR: 1.23; 95%CI 1.02; 1.49) (Figure 1).
DISCUSSION
Main finding of this study
The current study aimed to evaluate the association between home office and weight gain amid the Covid-19 pandemic in two cities in southern Brazil, and the findings showed important factors associated with weight gain during the Covid-19 pandemic. Individuals who started working from home during the period of social isolation presented 23% higher weight gain than individuals who did not work remotely.
What is already known on this topic
Social isolation, despite being an important and necessary measure to contain the spread of the novel coronavirus, caused countless changes in daily life. One of the most significant adaptations was the need to work from home 21. Similarly to the current study, changes in body weight during remote working, including weight gain, were found in a cross-sectional study conducted during the Covid-19 pandemic in Bangkok, Thailand, in which 41% of the participants reported weight gain in the analyzed period 22.
While working from home, people can be overly exposed to many factors, among them, easy access to food (especially highly palatable foods) and negative aspects of mental health 21,23. Studies conducted all over the word, demonstrated that changes in daily life, and financial and infection worries caused by the pandemic, were associated with depression and stress 24–27. Linked with this, social isolation also changed food consumption and dietary behaviors. A decrease in the intake of fruits and vegetables and an increase in consumption of ultra-processed foods, snacking behaviors, late night food intake, and the number of daily meals has been reported in the literature 23,28,29.
In agreement, studies conducted during the pandemic have associated stress, depression, and anxiety with emotional and binge eating, and all these variables with the preference for sweets and ultra-processed foods 10,30–33. In addition, relations were also found between an increase in the consumption of high-density energy food or inadequate dietary practices with emotional, uncontrolled, and binge eating, and these last eating behaviors with a higher body mass index 31,34,35. It is important to mention that obese individuals are more likely to present emotional eating during the pandemic 36.
A longitudinal study from the United States found that individuals with weight gain during the pandemic presented a higher frequency of snacking, daily meals, and intake of ultra-processed foods 10. In a Spanish population, increases in the consumption of sugar-sweetened beverages and snacks and previous excess weight, were associated with weight gain 37. Other studies with a North American and an Italian population evidenced that psychological distress and self-reported depression, as well as having excess weight before the pandemic, were also associated with weight gain 38,39.
What this study adds
The balance of family and work obligations, maintenance of mental well-being, in addition to health and rest needs, can be very difficult for some people working from home 21, and weight gain might be a result of this. While working from home, people can be overly exposed to many factors, among them, easy access to food (especially highly palatable foods) and negative aspects of mental health 21,23.
This context is necessary since a possible mechanism to explain the association between working from home and weight gain, is the connection between stress and depression and emotional eating (a strategy used as a way of coping with a critical situation) and the preference for comfort foods (foods that provide well-being, but that are often nutritionally inadequate) 23,40–42. Starting to work from home could have favored and intensified negative mental health outcomes from the pandemic, which, in turn, favor these negative eating behaviors as ways of coping and, therefore, lead to weight gain 21–23,40,42–44.
Although the variables previously cited (obesity, depressive symptoms, stress, increase in and worsening quality of food consumption, higher frequency of sweet and soda consumption) were associated with weight gain in the present study (data not shown) even after including them in the adjusted analysis model as possible confounders, the association between remote work and weight gain remained. This could suggest that other variables involved in this relationship may explain this association.
The trend in the next years is that the practice of remote work increases significantly, especially among professionals with high education 45,46. Although remote work has benefits reported in studies such as improvements in job satisfaction, mental health, and well-being 47,48, the opposite is also observed, with prejudices in physical and mental health outcomes being found 14,15.
A study also developed amid the Covid-19 pandemic found that remote work was related to reduced mental well-being, association that was influenced by eating habits, social factors, and physical activity 17. This highlights the importance of the nutritional factors in the remote work practice. Another research conducted in Poland have shown that 55.5% of the sample reported having increased their weight while working remotely during the pandemic 16. This increase was accompanied by changes in eating behaviors, such as increase in food intake, reported by 44.0% of the sample. Moreover, statistically significant association between changes in eating behavior and changes in body weight was found 16.
Thus, considering the worldwide tendency of remote work and the damages related to overweight, study this association is quite important. It has been discussed that work demands may affect eating and physical activity behaviors, therefore, leading to excess weight. On the other hand, that nutritional status may influence the performance at work and the employee’s health. Although this topic is still not well elucidated in literature, studies are essential to elaborate policies and strategies of coping with this outcome 49.
Limitations of this study
Some limitations of the present study should be mentioned. Firstly, the cross-sectional nature of this study is a limitation, as it does not allow establishing a temporal relationship between the events studied. Therefore, it is not possible to clarify whether the relationship between them is causal or not. In addition, data about weight gain in this study was self-reported and no question was asked about usual weight and how much weight (in kilograms or pounds) was gained by sample participants. This makes the information closely linked to the personal perception of each individual interviewed. Finally, information on the type of remote work that the interviewees performed was not collected. Moreover, working hours were also not collected.
As strengths, it is important to highlight that this is a population-based study and the interviews were conducted face-to-face, in the participants’ households, a distinction when compared to other surveys conducted during the Covid-19 pandemic, which have mostly collected data using online platforms.
CONCLUSION
In conclusion, approximately one-third of the individuals surveyed reported weight gain during the pandemic, and those who started working remotely had greater weight gain than their peers.
With the growing global epidemic of obesity, comorbidities related to weight gain are already well known by the scientific community and health professionals. Thus, the expansion in the number of remote work vacancies from the pandemic period, associated with greater weight gain among employees who work remotely, lights up an alert about the need to create monitoring programs and actions to prevent weight gain in this population to avoid a future overload of the Brazilian public health system with the increase in the cases of diseases that are known to be preventable through weight gain control.
Moreover, the growing trend of remote work and its demands, capable of affecting the health in several aspects and favoring weight gain, makes epidemiological studies including detailed measurements needed to clarify the possible causes of weight corporal variations during the remote work. This may help government agencies and health professionals in understanding the etiology and prevention of weight gain, as well as improving the employee’s health and performance at work.
Funding: This work was supported by the Foundation to Support Research in the State of Rio Grande do Sul (FAPERGS, Brazil), protocol number 20/2551-0000277-2.
Declarations of interest: None.
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Two years after the arrival of Covid-19, much evidence is available about its reflection and control measures in the lives of the world population 1. The implementation of social distancing, popularly called "staying at home", has brought changes in the daily routine globally, affecting people's habits and behaviors 1,2. Among these changes, those that can have direct impacts on health stand out, such as eating habits and physical activity 2.
Adherence to remote working, school closures, and restrictions on commerce and leisure events led to an increase in the time spent at home 2. As a result, several studies have already shown, for example, an increase in sedentary behavior and a decrease in the practice of physical activity 3, changes in eating habits 4, and increased weight gain 5,6, alcohol consumption 1, and symptoms of stress, anxiety, and depression 2.
Studies have shown that, the reasons for weight gain during periods of social distancing include worsening in the quality of food and an increase in energy consumption, caused by the greater intake of processed and ultra-processed foods, as well as more time available for the preparation of culinary recipes, and an increase in meal delivery orders 7,8. Also noteworthy is the fact that those most affected by weight gain associated with pandemic confinement are precisely those who were previously overweight 5,8,9, which could result in future damage to health, since small weight changes in short periods can become triggers for the permanence of the acquired weight 10.
During the Covid-19 pandemic, remote working had a considerably frequency in the Brazilian population, with 7.9 million people working remotely in November 2020 11. Even after the pandemic, this work practice has been continued according to data from the Institute of Applied Economic Research (IPEA) from Brazil, in which was demonstrated that 20.5 million employees can work remotely in Brazil, especially those with higher education level 12. Remote work can be associated with positive and negative behaviors and feelings, such as increase in sedentary behaviors and in domestic physical activity 13, stress-related symptoms, job satisfaction 14 and back pain 15. Among them, weigh gain is commonly debate as one of the main negative outcomes of this practice 16,17.
In addition to the different consequences for physical and mental health generated by the Covid-19 pandemic context, Brazil, as well as several countries in the world, has been facing an obesity epidemic for years, which itself already has negative impacts on health in the individual and collective dimensions. Therefore, any and all factors that may lead to an increase in the number of obese people must be monitored very carefully, in order to collect evidence that will help in monitoring and managing the problem of the obesity epidemic. In this sense, the current study aimed to evaluate the association between remote work and weight gain during the Covid-19 pandemic in two cities in southern Brazil.
METHODS
Population and Sampling
This is a cross-sectional study carried out with a representative sample of adults aged 18 years or older, living in the urban area of two cities in southern Brazil (Rio Grande, Rio Grande do Sul state and Criciúma, Santa Catarina state).
The municipality of Rio Grande has approximately 211 thousand inhabitants (96% urban), with a Human Development Index (HDI) of 0.7441 18. Criciúma is located in the extreme south of the state of Santa Catarina, approximately 206 km from the capital Florianópolis, and has approximately 217 thousand inhabitants (98.6% residing in the urban area), and an HDI of 0.7882 18.
Two-stage sampling 19 was used to obtain a representative sample of the urban population of Rio Grande and Criciúma. First, census sectors were systematically selected based on data from the 2010 population census 20, with probability proportional to the size of the sector. Second, households were selected. An average of 10 households per census tract were randomly selected, totaling an estimated number of 2,894 potentially eligible individuals.
Logistics and Ethical Aspects
Data collection took place between October 2020 and January 2021, with previously trained interviewers, using the appropriate Personal Protective Equipment (PPE). The interviews were carried out in front of the homes of the eligible, using a pre-coded and standardized questionnaire, composed mostly of closed questions, using tablets. This instrument was built using RedCap® (Research Electronic Data Capture) software, followed by data transfer to the computer.
This research was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics and Research Committee on Human Beings of the Federal University of Rio Grande (FURG), under opinion 4,055,737. All ethical principles established by the National Health Council in Resolution 466/12 were respected. Participants were informed about their right to refuse participation and about confidentiality procedures. Those who agreed to participate in the study informed this decision after reading the Free and Informed Consent Form.
Variables
The outcome investigated was weight gain, identified by the following question: “During the period of social distancing, did you notice any change in your body weight?”, with the answer options: no, it remained the same; yes, it increased; yes, it decreased. Those who answered “yes, it increased” were considered for the outcome and the other answers as “no increase”. The variable was dichotomized into “no” and “yes”.
The exposure (or independent) variable was remote work, identified by the question “How has social distancing imposed by the Covid-19 pandemic affected your job/work?”, with the answer options: I didn’t work before pandemic and I stayed out of work during the pandemic; I stayed working; I continued working, but at home, remotely; I did start working during the pandemic; and I lost my job. Those who answered “I continued working, but at home, remotely”, were considered “yes”, and the other answers, as “no”.
The covariables used to adjust for possible confounders in the relationship between outcome and exposure are described in the Table 1.
Statistical Analysis
Statistical analyses were performed using STATA software version 11.0 (StataCorp LP, College Station, Texas). Univariate analysis was used to present absolute and relative frequencies in order to describe the sample according to each variable of interest. P-values using Fisher´s exact test was shown. To verify the association between the outcome and the independent variable, the Poisson Regression model was used, considering the effect of the sample design to calculate the crude and adjusted prevalence ratio (PR) and its corresponding 95% confidence intervals (95%CI) and p-values. The significance level was set at 5% for two-tailed tests.
For the adjusted analysis, the covariables with a significance level of 20% (p-value <0.20) were considered confounders and remained in the final model.
The interaction was tested between remote work and the municipality (Rio Grande and Criciúma) on the occurrence of the outcome, but there was no interaction (p=0.59); therefore, the analyses were not stratified by municipality.
RESULTS
A total of 2,152 individuals aged 18 years and over participated in the present study, with a response rate of 70%. Of these, the majority were female (59.8%), approximately a third (31.1%) were 60 years of age or older, only 10.5% lived alone, and 25.6% had a monthly income above 2000,00 BRL per month. Approximately 48.3% performed paid work in the previous month, almost a quarter of respondents were obese, and 34.5% reported morbidities. Almost 20% perceived greater stress and 13% had depressive symptoms (data not shown in table).
One in ten respondents reported consuming sweets every day of the week, 13.7% began to eat more and of worse quality during the pandemic, and almost 40% reported performing less physical activity during the pandemic. The proportion of individuals who started working from home (remote work) was 7.8% (Table 2).
The prevalence of weight gain during the pandemic was 38.4% (95%CI 36.1; 40.7%), with 37.7% for the group that did not work remotely during the pandemic and 47.0% for those who worked remotely (p=0.02 using Fisher´s exact test) (data not shown in table). In the crude analysis, it was observed that those individuals who switched to working remotely during the pandemic were 25% more likely (95%CI 1.04; 1.51) to gain weight during the pandemic compared to those who did not switch to working remotely. After adjusting for possible confounding factors, this association remained statistically significant (PR: 1.23; 95%CI 1.02; 1.49) (Figure 1).
DISCUSSION
Main finding of this study
The current study aimed to evaluate the association between home office and weight gain amid the Covid-19 pandemic in two cities in southern Brazil, and the findings showed important factors associated with weight gain during the Covid-19 pandemic. Individuals who started working from home during the period of social isolation presented 23% higher weight gain than individuals who did not work remotely.
What is already known on this topic
Social isolation, despite being an important and necessary measure to contain the spread of the novel coronavirus, caused countless changes in daily life. One of the most significant adaptations was the need to work from home 21. Similarly to the current study, changes in body weight during remote working, including weight gain, were found in a cross-sectional study conducted during the Covid-19 pandemic in Bangkok, Thailand, in which 41% of the participants reported weight gain in the analyzed period 22.
While working from home, people can be overly exposed to many factors, among them, easy access to food (especially highly palatable foods) and negative aspects of mental health 21,23. Studies conducted all over the word, demonstrated that changes in daily life, and financial and infection worries caused by the pandemic, were associated with depression and stress 24–27. Linked with this, social isolation also changed food consumption and dietary behaviors. A decrease in the intake of fruits and vegetables and an increase in consumption of ultra-processed foods, snacking behaviors, late night food intake, and the number of daily meals has been reported in the literature 23,28,29.
In agreement, studies conducted during the pandemic have associated stress, depression, and anxiety with emotional and binge eating, and all these variables with the preference for sweets and ultra-processed foods 10,30–33. In addition, relations were also found between an increase in the consumption of high-density energy food or inadequate dietary practices with emotional, uncontrolled, and binge eating, and these last eating behaviors with a higher body mass index 31,34,35. It is important to mention that obese individuals are more likely to present emotional eating during the pandemic 36.
A longitudinal study from the United States found that individuals with weight gain during the pandemic presented a higher frequency of snacking, daily meals, and intake of ultra-processed foods 10. In a Spanish population, increases in the consumption of sugar-sweetened beverages and snacks and previous excess weight, were associated with weight gain 37. Other studies with a North American and an Italian population evidenced that psychological distress and self-reported depression, as well as having excess weight before the pandemic, were also associated with weight gain 38,39.
What this study adds
The balance of family and work obligations, maintenance of mental well-being, in addition to health and rest needs, can be very difficult for some people working from home 21, and weight gain might be a result of this. While working from home, people can be overly exposed to many factors, among them, easy access to food (especially highly palatable foods) and negative aspects of mental health 21,23.
This context is necessary since a possible mechanism to explain the association between working from home and weight gain, is the connection between stress and depression and emotional eating (a strategy used as a way of coping with a critical situation) and the preference for comfort foods (foods that provide well-being, but that are often nutritionally inadequate) 23,40–42. Starting to work from home could have favored and intensified negative mental health outcomes from the pandemic, which, in turn, favor these negative eating behaviors as ways of coping and, therefore, lead to weight gain 21–23,40,42–44.
Although the variables previously cited (obesity, depressive symptoms, stress, increase in and worsening quality of food consumption, higher frequency of sweet and soda consumption) were associated with weight gain in the present study (data not shown) even after including them in the adjusted analysis model as possible confounders, the association between remote work and weight gain remained. This could suggest that other variables involved in this relationship may explain this association.
The trend in the next years is that the practice of remote work increases significantly, especially among professionals with high education 45,46. Although remote work has benefits reported in studies such as improvements in job satisfaction, mental health, and well-being 47,48, the opposite is also observed, with prejudices in physical and mental health outcomes being found 14,15.
A study also developed amid the Covid-19 pandemic found that remote work was related to reduced mental well-being, association that was influenced by eating habits, social factors, and physical activity 17. This highlights the importance of the nutritional factors in the remote work practice. Another research conducted in Poland have shown that 55.5% of the sample reported having increased their weight while working remotely during the pandemic 16. This increase was accompanied by changes in eating behaviors, such as increase in food intake, reported by 44.0% of the sample. Moreover, statistically significant association between changes in eating behavior and changes in body weight was found 16.
Thus, considering the worldwide tendency of remote work and the damages related to overweight, study this association is quite important. It has been discussed that work demands may affect eating and physical activity behaviors, therefore, leading to excess weight. On the other hand, that nutritional status may influence the performance at work and the employee’s health. Although this topic is still not well elucidated in literature, studies are essential to elaborate policies and strategies of coping with this outcome 49.
Limitations of this study
Some limitations of the present study should be mentioned. Firstly, the cross-sectional nature of this study is a limitation, as it does not allow establishing a temporal relationship between the events studied. Therefore, it is not possible to clarify whether the relationship between them is causal or not. In addition, data about weight gain in this study was self-reported and no question was asked about usual weight and how much weight (in kilograms or pounds) was gained by sample participants. This makes the information closely linked to the personal perception of each individual interviewed. Finally, information on the type of remote work that the interviewees performed was not collected. Moreover, working hours were also not collected.
As strengths, it is important to highlight that this is a population-based study and the interviews were conducted face-to-face, in the participants’ households, a distinction when compared to other surveys conducted during the Covid-19 pandemic, which have mostly collected data using online platforms.
CONCLUSION
In conclusion, approximately one-third of the individuals surveyed reported weight gain during the pandemic, and those who started working remotely had greater weight gain than their peers.
With the growing global epidemic of obesity, comorbidities related to weight gain are already well known by the scientific community and health professionals. Thus, the expansion in the number of remote work vacancies from the pandemic period, associated with greater weight gain among employees who work remotely, lights up an alert about the need to create monitoring programs and actions to prevent weight gain in this population to avoid a future overload of the Brazilian public health system with the increase in the cases of diseases that are known to be preventable through weight gain control.
Moreover, the growing trend of remote work and its demands, capable of affecting the health in several aspects and favoring weight gain, makes epidemiological studies including detailed measurements needed to clarify the possible causes of weight corporal variations during the remote work. This may help government agencies and health professionals in understanding the etiology and prevention of weight gain, as well as improving the employee’s health and performance at work.
Funding: This work was supported by the Foundation to Support Research in the State of Rio Grande do Sul (FAPERGS, Brazil), protocol number 20/2551-0000277-2.
Declarations of interest: None.
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