Recent studies have suggested that indirect consequences of the COVID-19 pandemic may include increased anxiety, panic, and more emotional eating, in addition to fruit and vegetable shortages and greater consumption of less healthy foods. Previous literature indicates that emotional eating may contribute to weight gain and obesity. The purpose of this study was to predict a variance of patronage to unhealthy eating establishments among the obese population during the COVID-19 pandemic. Anonymized geographical positioning data was obtained from ~10% of mobile devices from unhealthy eating locations from December 1, 2019 to April 30, 2020. These locations included establishments characterized as “fast food”, in addition to ice cream, donut, snack or dessert establishments. The data was merged with the 2016 obesity rates and the 2018 poverty rates in the county the unhealthy eating location resided and the 2015/2017 estimated food environment index. This resulted in 17,234,452 observations from 138,989 establishments in 65% of counties in the U.S. for analysis. A Poisson spline regression indicated patronage to unhealthy eating establishments were significantly higher (p<0.001) in the obese populations; 10% of the counties with the highest obesity rates had the highest patronage to unhealthy eating establishments. These disparities appear to have increased as the COVID-19 pandemic spread.

Study strengths: This study applied a unique perspective on the indirect impacts of COVID-19 among the obese population. The study highlighted the need for future research in this area to assess opportunities for intervention.

Study limitations: The granularity of the data is limited to the county level. Additionally, about 25% of the counties of the U.S. are not included due to missing data. The results included in this study are observational and therefore cannot account for the unique variables affecting an individual’s dining choices.

What this means for your practice: More research is needed to understand how the COVID-19 pandemic has affected obese populations and their families, and to what extent these changes may persist in the future. Awareness of potential disparities can be useful in understanding challenges families may have surrounding eating habits.

Original citation: Ashby, N. J. (2020). The Impact of the COVID‐19 Pandemic on Unhealthy Eating in Populations with Obesity. Obesity. Accepted. doi: 10.1002/oby.22940

About the Author: Chenin Treftz, Ph.D., R.D.N., is a member of the research faculty at the University of Nevada, Reno. Dr. Treftz has expertise in research, community nutrition, and higher education. Dr. Treftz has been a member of the Rethink Your Drink team since 2012.

The goal of Rethink Your Drink Nevada is to promote healthy beverages and reduce sugary drinks. To support this goal, free educational resources are available to eligible medical and dental care practices in Nevada. For more information, please visit or e-mail

Leave a Reply

Your email address will not be published. Required fields are marked *