Substance Use, Mental Health, and Weight-Related Behaviors During the COVID-19 Pandemic Among Metabolic and Bariatric Surgery Patients.
PURPOSE
The impact of the COVID-19 pandemic on behavioral issues among those who have completed bariatric surgery (BS) is not well described in ethnically diverse populations. The aim of this study was to compare the impact of COVID-19 lockdown orders and after lockdown orders were lifted on substance use, mental health, and weight-related behaviors among a sample of post-BS adults.


MATERIALS AND METHODS
A retrospective medical chart review identified BS patients from one university-based obesity medicine clinic and two BS practices. An online non-anonymous survey was implemented in two phases: during lockdown (April 1-May 31, 2020) and after lockdown orders were lifted (June 1, 2020-September 30, 2020) to obtain information about the COVID-19 pandemic's impact on BS patients.


RESULTS
A total of 189 (during lockdown=39, post-lockdown=150) participants (90.4% female, mean age 52.4 years, SD 11.1, 49.8% non-Hispanic White, 30.6% non-Hispanic Black, 16.1% Hispanic) participated. Lockdown participants were more likely to have sleep problems (74.3% vs. 56.1%, P=.039) and feel anxious (82.0% vs. 63.0%, P=.024) versus post-lockdown participants. A majority (83.4%) reported depression in both lockdown/post-lockdown. Post-lockdown participants were more than 20 times more likely to report substance use compared those in lockdown (aOR 20.56, 95% CI 2.66-158.4).


CONCLUSIONS AND RELEVANCE
The COVID-19 pandemic is having a substantial negative impact on substance use, mental health, and weight-related health behaviors in diverse BS patients. These findings have important implications for post-BS patient care teams and may suggest the integration of screening tools to identify those at high risk for behavioral health issues.
['Messiah|Sarah E|SE|0000-0001-6685-2175', 'Uppuluri|Maduri|M|', 'Xie|Luyu|L|', 'Schellinger|Jeffrey N|JN|', 'Mathew|M Sunil|MS|', 'Ofori|Ashley|A|', 'Kukreja|Sachin|S|', 'Schneider|Benjamin|B|', 'Dunn|Samuel H|SH|', 'Tavakkoli|Anna|A|', 'Almandoz|Jaime P|JP|']
D000328:Adult D050110:Bariatric Surgery D000086382:COVID-19 D003140:Communicable Disease Control D005260:Female D006801:Humans D008297:Male D008603:Mental Health D008875:Middle Aged D009767:Obesity, Morbid D058873:Pandemics D012189:Retrospective Studies D000086402:SARS-CoV-2 D019966:Substance-Related Disorders
Substance use Mental health Behaviors COVID-19 Bariatric surgery