Our next public health challenge: Losing the ‘COVID-15’

An important government survey recently revealed that most Americans avoided increased hunger during the first year of the COVID-19 pandemic. Unfortunately, we ate too much bad food during the lockdown, increasing our obesity crisis instead. 

A serious hunger threat was presented by COVID when 22 million Americans lost their jobs, restaurants stopped service, and millions of children lost daily access to a school lunch. As the lines outside food pantries began to lengthen, one national magazine warned that, “A shadow of hunger looms over the United States.”  But thanks in part to such warnings, public and private food assistance efforts were dramatically increased while household purchasing power was boosted through a flood of federal cash assistance, so actual food deprivation was largely avoided.  

On Sept. 8, the Department of Agriculture made front page news when it issued its annual report on household food security, revealing survey data collected in December 2020 at the height of the pandemic.  These data showed that only 3.9 percent of households had experienced “very low food security” in 2020, which was actually below the 4.1 percent that experienced this condition in 2019.  

This good news is easy to explain. To manage and buffer the impact of COVID on household income, Congress authorized an astonishing $5.3 trillion in new spending up through March 2021, including stimulus checks to individuals and enhanced unemployment insurance, plus Child Tax Credits of up to $300 per child beginning in July 2021.  As a result, aggregate personal income and consumer spending for goods both increased during the crisis. Restaurants halted table service, but food and beverage purchases for off-premise consumption increased by 14 percent in the first year of COVID.

Federal spending on direct food assistance also increased. Outlays through the Supplemental Nutrition Assistance Program (formerly referred to as food stamps) increased 71 percent thanks to larger enrollments and more generous monthly benefits, and the Biden administration later made permanent a 25 percent increase in average SNAP benefits over pre-pandemic levels. A new Pandemic Electronic Benefit Transfer (P-EBT) program was created for school children, and private food banks began serving 55 percent more people. The lines were long precisely because the food was there. America’s food safety net was doing its job.

Food deprivation was largely avoided during the pandemic, but Americans made food choices that worsened their dietary health. An American Psychological Association survey conducted by The Harris Poll in late February found that 42 percent of American adults had experienced unintended weight gain since the start of the pandemic, with a median gain of 15 pounds each — the all-too-real “Covid 15.” In March, a research letter reported that one sample of middle-aged men and women from across the country had gained about 1.5 pounds each month from February to June 2020. The Centers for Disease Control and Prevention reported this month that the number of states with a high obesity prevalence for adults had increased from 12 to 16 during the pandemic.

For children, clinical results told a similar story. A report in the journal “Pediatrics” found that 15.4 percent of children were obese between June and December of 2020, up from 13.7 percent in the same period a year earlier.  In August, electronic health records for 200,000 children in California found that the share of 5- to 11-year olds considered overweight or obese had increased during the pandemic from 36 percent to 45.7 percent. 

The pandemic made healthy eating more difficult. Americans stocked up on shelf-stable canned, packaged and frozen items to reduce shopping trips, while cutting back on perishable fruits and vegetables. To relieve stress, they went for starchy, processed comfort foods and to relieve boredom, they snacked throughout the day. Sales of Doritos, Cheetos, and Tostitos chips increased by $1.1 billion in 2020. Trapped indoors, people exercised less and more people tried their hand at baking — cookies and chocolate cake, of course. 

So while we locked down to bring the virus under control, too many Americans let their eating disciplines slip farther out of control. Prior to COVID, 42 percent of American adults were clinically obese, three times the level of the 1960s. Obesity emerged as a significant added risk factor for those who contracted COVID, but even before the pandemic it was contributing to 300,000 deaths a year, especially from diabetes and cardiovascular disease. 

America will eventually come out of the COVID nightmare, but it will find its dietary health nightmare has worsened.    

Robert Paarlberg is an associate in the Sustainability Science Program at the Harvard Kennedy School, and a member of Bipartisan Policy Center’s Food and Nutrition Security Task Force. He is the author of “Resetting the Table: Straight Talk About the Food We Grow and Eat” (Knopf 2021).