We’ve all seen plenty of news surrounding what has become known as the dreaded “Quarantine Fifteen”--much like the college “Freshman Fifteen”. A considerable number of Americans have reported changes in their diet, exercise habits, and weight since the coronavirus pandemic began. The way that these changes are affecting people’s health has also been quite dependent on other factors such as race/ethnicity and socioeconomic status. Stress from the pandemic has created two different food-related reactions within people: an increase in restrictive dieting and an increase in binge-eating. Both of these reactions can easily develop into serious eating disorders--which is why some behavioral medicine experts are seeing an overall rise in eating disorders since the pandemic began.
[Eating disorders increase due to COVID-19 pandemic ]
Now, how does this relate to some recent findings in neuroscience? Dr. Jen Beshel’s lecture on the leptin conserved neural circuit in the brain provided excellent insight as to why obesity has become such a problem in modern times. The human body, as we know, evolves slowly over time, and as man makes more rapid innovations sometimes we outpace our bodies’ abilities to adjust to these innovations. One example is how drastically the food landscape has changed within the past 100 years. While food insecurity still exists all over the world, food accessibility has gone up tremendously due to the rise of cheap, processed, and fast food. The downside to this is that our bodies are not necessarily wired to ingest high-calorie, high-fat, and high-sugar foods on a regular basis--especially in those that have genetic predispositions to obesity.
Dr. Beshel discussed a study done on mice in which one mouse had a mutated OB gene, which resulted in what we now refer to as an “obese” phenotype. This mouse was deficient for leptin--a hormone that is critical in the experience of satiety, or fullness. This deficiency led to the mouse essentially eating with no “off switch”, which resulted in rapid and dangerous levels of weight gain. Another finding from Dr. Beshel’s study also showed that elevated levels of leptin are typically found in obese individuals, as an increase in adipose tissue seems to increase leptin production. But instead of increasing feelings of satiety, these individuals seem to have a “leptin resistance” that inhibits their ability to limit food intake. High food intake mixed with an unhealthy diet can lead to becoming obese very quickly.
So how does this relate back to the pandemic? During times of high stress, people tend to view food and food cues in one of two ways: as a way of controlling their life in an uncontrollable world or as a source of comfort. The first view tends to lead to restrictive dieting, excessive exercise, and body dysmorphia--all common symptoms of starvation eating disorders like anorexia or bulimia. But the eating disorder that has seen the greatest rise due to pandemic stress is binge eating disorder--a condition where individuals tend to overeat because they view food as a source of emotional comfort.
Binge eating disorder is also on the rise because the pandemic has changed our food landscape yet again, especially for people with low socioeconomic status. Not everyone can afford to get fresh groceries delivered, not everyone can afford healthy takeout, some neighborhoods don’t have a supermarket around for miles, and some grocery delivery services don’t even deliver to low-income areas. People who were living in food deserts before the pandemic are finding their food options more limited than ever--especially during the “panic buying” phase of lockdown. The stress over all of these uncontrollable factors makes indulging in readily available “comfort food” almost too easy.
[Link to news article: Chicago Tackles COVID-19 Disparities In Hard-Hit Black And Latino Neighborhoods]
Putting all of these different ideas together, we can see why there is so much disparity between Covid cases in low versus high-income areas. Low-income individuals are more likely to have pre-existing conditions (like obesity), rely the most on fast food and cheap, processed food options, live in crowded homes or apartment buildings, and, of course, work many essential jobs. It’s the perfect storm to create the level of Covid disparity that we see when comparing northside Chicago Covid cases to southside Chicago Covid cases.
All Americans, regardless of location and class, are going through a struggle with weight control during the pandemic. But this issue is hitting the communities that are most vulnerable to death or serious complications from Covid the hardest. A closer look at these two connected issues shows that increasing food accessibility is not enough, we must also be working to bring nutritious food to impoverished communities as a first step to diminishing health disparities.
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