Age- and weight group-specific weight gain patterns in children and adolescents during the 15 years before and during the COVID-19 pandemic

Abstract Background/Objectives There is a concern that measures aiming to limit a further spread of COVID-19, e. g. , school closures and social distancing, cause an aggravation of the childhood obesity epidemic. Therefore, we compared BMI trends during the 15 years before and during the COVID-19 pandemic. Subjects/Methods To assess the change in weight dynamics during the first months of COVID-19, we compared the trends of 3-month change in BMI-SDS (ΔBMI-SDS) and the proportions of children showing a high positive (HPC) or high negative (HNC) weight change between 2005 and 2019 and the respective changes from 2019 (pre-pandemic) to 2020 (after the onset of anti-pandemic measures) in more than 150, 000 children (9689 during the pandemic period). The period of 3 months corresponds approximately to the first lockdown period in Germany. Results During the COVID-19 pandemic, we found a substantial weight gain across all weight and age groups, reflected by an increase in the 3-month change in BMI-SDS (β = 0. 05, p < 0. 001), an increase in the proportion of children showing HPC (OR = 1. 4, p < 0. 001), and a decrease in the proportion of children showing HNC (OR = 0. 7, p < 0. 001). Besides, we found the same trends since 2005 on a low but stable level with a yearly increase of ΔBMI-SDS by β = 0. 001 (p < 0. 001), the odds of HPC increased by OR highₚos = 1. 01 (p < 0. 001), and the odds of HNC decreased by OR highₙeg = 0. 99 (p < 0. 001). These rather small effects accumulated to β = 0. 02, OR highₚos = 1. 14, and OR highₚos = 0. 85 over the whole period 2005–2019. Alarmingly, both the long-term and the short-term effects were most pronounced in the obese subgroup. Conclusions There are positive dynamics in different measures of weight change, indicating a positive trend in weight gain patterns, especially within the group of children with obesity. These dynamics are likely to be escalated by COVID-19-related measures. Thus, they may lead to a significant further aggravation of the childhood obesity pandemic.