Eating in the lockdown during the Covid 19 pandemic; self-reported changes in eating behaviour, and associations with BMI, eating style, coping and health anxiety.

Appetite. 2021;161:105082

Plain language summary

The Covid-19 pandemic resulted in national lockdowns, which resulted in isolation within people’s homes. This cross-sectional survey examined changes in eating patterns and behaviour during lockdown. Of the 620 participants included in the study, eating higher energy density foods was more common in females with a higher BMI and higher health anxiety. Although there was a change in emotional eating behaviours across the sample as a whole, it was not in the expected direction, with many participants reporting a decrease in emotional eating after the implementation of lockdown. There were also increases in fruit and vegetable consumption and home prepared foods. Many of these behavioural responses were influenced by pre-lockdown tendencies. Therefore, it is important to consider these when understanding coping strategies during lockdown, and how to support clients as we come out of lockdown.

Expert Review

Reviewer: Laura Falconer

Conflicts of interest: None

Take Home Message:
  • National lockdowns, as seen during the 2020/21 Covid-19 pandemic, impacted eating behaviour and associations with BMI, eating style and health anxiety.
  • Given the new nature of this research, it is not clear what impact confounding factors such as food insecurity had on changing eating behaviours.
  • Disproportionate risks were seen in certain demographics and in those shielding due to their heightened risk from Covid-19.
  • Retrospective and longitudinal studies to monitor the impact of lockdowns on eating behaviour and health anxiety are needed.

Evidence Category:
  • A: Meta-analyses, position-stands, randomized-controlled trials (RCTs)
  • B: Systematic reviews including RCTs of limited number
  • X C: Non-randomized trials, observational studies, narrative reviews
  • D: Case-reports, evidence-based clinical findings
  • E: Opinion piece, other

Summary Review:
The role of eating behaviours and psychological responses during lockdown has become an area of interest, particularly with the uncertainty of going into future lockdowns. With Covid-19, and individual’s responses to it, being a relatively new research topic, there is not yet enough evidence for longitudinal outcomes of the findings in these studies. It is also difficult to ascertain the influence of confounding variables prior to the national lockdown, such as food insecurity, not accounted for due to the unpredictable start to the pandemic. There has also been disproportionate risks between certain demographics and their Covid-19 risk, therefore further research on the impact of this on health anxiety and subsequent eating behaviours is required. This highlights a wider need for continued research on the topic.

Clinical practice applications:
Those who had problematic eating behaviours and higher BMI pre lockdown will need to be supported with healthier coping practices if subsequent lockdowns occur, to prevent health related anxiety and consumption of high energy density foods. Furthermore, those who were shielding in their homes were also more likely to show an increase in emotional eating post lockdown. Therefore, clients who spent a large amount of lockdown shielding will need additional support, to develop coping strategies to prevent risk of emotional eating and health anxiety.

Considerations for future research:
Both retrospective and longitudinal studies monitoring the impact of eating behaviours and health anxiety pre and post lockdown are needed. This will help further the evidence base of the potential role of Covid-19 related health anxiety on eating patterns, coping strategies and dietary choices.


The global coronavirus pandemic (Covid 19) resulted in national lockdowns where individuals were asked to isolate in their homes to stop the spread of the disease. Using a cross-sectional survey, the current paper aimed to examine self-reported changes in eating patterns and behaviour during the lockdown in the UK, and associations with BMI, demographic variables, eating styles, health anxiety, food insecurity and coping strategies. Participants (N = 620) were recruited online through social media advertising. The results showed that there were self-reported changes to food consumption during the lockdown across the sample. Increases in consumption of HED (high energy density) snack foods during the lockdown was associated with sex, pre-lockdown eating behaviour (emotional eating and uncontrolled eating), and Covid-specific health anxiety. Increases in positive eating practices such as eating more home prepared foods, and fruits and vegetables, were associated with adaptive coping strategies. Higher emotional eating (EE) during the lockdown was associated with a higher BMI, higher pre-lockdown EE and maladaptive coping strategies. Maladaptive coping strategies moderated the relationship between BMI and EE during the lockdown. In particular a higher BMI was associated with higher EE during the lockdown if an individual also had higher maladaptive coping strategies. These findings suggest that changes to eating behaviour may be part of a wider style of maladaptive or adaptive coping, particularly in those with a history of EE or uncontrolled eating. Preparing individuals to adopt more adaptive coping strategies during lockdown situations may be crucial to improving health during subsequent the lockdown events.

Lifestyle medicine

Fundamental Clinical Imbalances : Neurological ; Digestive, absorptive and microbiological
Patient Centred Factors : Mediators/Health anxiety
Environmental Inputs : Diet ; Nutrients ; Psychosocial influences
Personal Lifestyle Factors : Nutrition ; Hydration
Functional Laboratory Testing : Not applicable

Methodological quality

Jadad score : Not applicable
Allocation concealment : Not applicable
Publication Type : Journal Article


Nutrition Evidence keywords : Health anxiety ; Covid-19 ; Eating behaviour ; Lockdown ; BMI