The Impact of the COVID-19 Pandemic on Eating Behavior and Weight Change

Study Overview
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Brief Summary
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Background: The indirect effects of the COVID-19 pandemic on mental health are of increasing concern. Perceived stress can lead to binge eating and weight gain. Researchers want to learn more about the relationship between eating behavior and the pandemic. Objective: To study how the stress of the COVID-19 pandemic is affecting eating behaviors and weight. Eligibility: English-speaking adults ages 18 and older who have access to a computer or smartphone connected to the internet. Design: This is an online study. Participants will answer surveys through the study website. Participants will complete a one-time survey. It will ask about their experiences throughout the COVID-19 pandemic, their socioeconomic standing, their mental and physical health, and their eating habits. They will have the option to repeat the survey once a month for the next 12 months. This will show changes in their thoughts and behaviors over time. They will provide their email address to get survey links. Participants will also have the option to complete a 2-minute survey on their smartphone. They will complete the survey daily for 7 days in a row. It will ask about their stress and eating behavior in real time, in their home environment. They will provide their phone number to get survey links via text message. If a participant has taken part in a previous NIH study on the Phoenix AZ campus, they will be asked to share their first and last name, date of birth, and email address. This information will be used to connect data from this study to their past data. Participation is typically 25 minutes but may last up to 1 year. ***To participate in this study go to the REDCap study link: https://redcap.link/nihcovidstudy.***...

Detailed Description
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Study Description: We will recruit previous NIDDK study participants as well as newly recruited individuals from the general population to examine how the COVID-19 pandemic has exacerbated the impact of psychosocial stressors that impact eating behavior and weight. The study will describe the relationship between specific COVID-19 related stressors (e.g. fear of becoming sick) and self-rated measures of food insecurity, unpredictability, perceived stress, behavioral health dysfunction, eating behaviors and weight change among a range of participants including previous NIDDK-Phoenix study volunteers and various newly recruited volunteers from the general global population. Participants will be invited to enroll in a follow- up study which will involve completing additional surveys on a monthly basis for 12 months. A smaller U.S. only cohort of these participants may also enroll in a 2 minute daily at-home survey study for 1-weekthat will utilize Ecological Momentary Assessment (EMA) to examine stress and eating behavior in real-time, in the home environment. Participants will complete an online consent form and online survey through a secure weblink (REDCap). Because the situation with the COVID-19 pandemic is rapidly changing, survey data collection is an effective way to measure outcomes at multiple time points with relatively low subject burden. Objectives: Primary Objective: to examine the food environment and psychosocial stressors related to COVID-19 with self-reported measures of behavioral health symptoms, eating behaviors and weight. Secondary Objective: to determine whether sociodemographic, existing behavioral health dysfunction, or environmental condition moderates this relationship and to identify risk and resilience factors among study participants regarding the impact of the COVID-19 pandemic on eating behavior and weight. Endpoints: Primary Endpoints: measures of eating behavior and body weight. These endpoints will be measured repeatedly using an online platform (REDCap) at baseline and then monthly for up to 12 months. We also plan to examine these COVID-19 related measures with previously collected phenotypic data (e.g. biological samples and behavioral data) from former NIDDK-Phoenix participants. Secondary Endpoints: in addition to those outlined as primary endpoints, we will examine data gathered from demographic forms and additional questionnaires measuring environmental conditions and psychosocial stress.

Official Title
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The Impact of the Food Environment and Psychosocial Stress From the COVID-19 Pandemic on Eating Behavior and Weight Change

Conditions
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Obesity, COVID-19

Participation Criteria
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Eligibility Criteria
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INCLUSION CRITERIA: In order to be eligible to participate in this study, an individual must meet all the following criteria: 18 years of age or older Able to read and write English Consistent access to computer or mobile devices connected to the internet Able to provide informed consent online and/or in-person In order to be eligible to participate in the EMA arm of the study, an individual must meet all the following criteria: 1. Access to a mobile device with WI-FI and data EXCLUSION CRITERIA: 1. Non-English-speaking individuals. Non-English-speaking subjects as a population will be excluded from participation in this protocol. The primary aim of the protocol relates to the questionnaires administered to the participants online. There are currently no validated, translated forms of these questionnaires available; therefore, we will restrict enrollment to English speaking subjects only.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Ecological Momentary Assessment (EMA) volunteers<br>Volunteers with access to mobile device with Wi-Fi and data recruited for an additional 1-week daily assessment study utilizing EMA to examine COVID-19 related stress and eating behavior in real-time | |
| General global population volunteers<br>Newly recruited volunteers 18 and above from the general global population that agree to participate in the COVID study | |
| NIDDK-Phoenix study volunteers<br>Previous research participants, who signed consents that allow data sharing that agree to participate in the COVID study | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Nighttime Eating Behavior | 2 questions taken from the Night Eating Diagnostic Questionnaire (NEDQ), a self-report questionnaire containing 14 questions about eating after the evening meal and waking up in the night to eat. Symptoms are rated on a 5-point Likert-type scale, which are then summed to obtain a NEQ Global Score. | Baseline and 12 months | 
| The Intuitive Eating Scale-2 (IES-2) | The IES-2 consists of 23-items measuring individuals tendency to follow their physical hunger and satiety cues when determining when, what, and how much to eat. Scores are rated on a 5-point Likert scale ranging from strongly disagree to strongly agree. Items are summed and an average score is computed for the entire scale and its four subscales. | Baseline and 12 months | 
| Three Factor Eating Questionnaire (TFEQ) | TFEQ consists of 18 items on a 4-point response scale (definitely true/mostly true/mostly false/definitely false) (scores recorded on a 0-100 scale). Higher scores in the respective scales are indicative of greater cognitive restraint, uncontrolled, or emotional eating. | Baseline and 12 months | 
| Loss of Control Eating | 2 questions to assess eating a large amount of food and sense of loss of control over one s eating behavior | Baseline and 12 months | 
| Food Frequency Questionnaire (FFQ) | Semiquantitative self-administered questionnaire that estimates average daily intake of foods, drinks, energy, and major nutrients out of about 124 different foods. | Baseline and 12 months | 
| Changes in self-reported weight | Changes in self-reported weight from baseline to 12 months | Baseline and 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Obesity, Food Intake, Food Insecurity, Resilience, Unpredictability, Natural History