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Background: Obesity and rapid weight gain are established risk factors for noncommunicable diseases and have emerged as independent risk factors for severe disease following Coronavirus Disease 2019 (COVID-19) infection. Restrictions imposed to reduce COVID-19 transmission resulted in profound societal changes that impacted many health behaviours, including physical activity and nutrition, associated with rate of weight gain. We investigated which clinical and sociodemographic characteristics were associated with rapid weight gain and the greatest acceleration in rate of weight gain during the pandemic among adults registered with an English National Health Service (NHS) general practitioner (GP) during the COVID-19 pandemic. Methods and findings: With the approval of NHS England, we used the OpenSAFELY platform inside TPP to conduct an observational cohort study of routinely collected electronic healthcare records. We investigated changes in body mass index (BMI) values recorded in English primary care between March 2015 and March 2022. We extracted data on 17,742,365 adults aged 18 to 90 years old (50.1% female, 76.1% white British) registered with an English primary care practice. We estimated individual rates of weight gain before (δ-prepandemic) and during (δ-pandemic) the pandemic and identified individuals with rapid weight gain (>0.5 kg/m2/year) in each period. We also estimated the change in rate of weight gain between the prepandemic and pandemic period (δ-change = δ-pandemic—δ-prepandemic) and defined extreme accelerators as the 10% of individuals with the greatest increase in their rate of weight gain (δ-change ≥1.84 kg/m2/year) between these periods. We estimated associations with these outcomes using multivariable logistic regression adjusted for age, sex, index of multiple deprivation (IMD), and ethnicity. P-values were generated in regression models. The median BMI of our study population was 27.8 kg/m2, interquartile range (IQR) [24.3, 32.1] in 2019 (March 2019 to February 2020) and 28.0 kg/m2, IQR [24.4, 32.6] in 2021. Rapid pandemic weight gain was associated with sex, age, and IMD. Male sex (male versus female: adjusted odds ratio (aOR) 0.76, 95% confidence interval (95% CI) [0.76, 0.76], p < 0.001), older age (e.g., 50 to 59 years versus 18 to 29 years: aOR 0.60, 95% CI [0.60, 0.61], p < 0.001]); and living in less deprived areas (least-deprived-IMD-quintile versus most-deprived: aOR 0.77, 95% CI [0.77, 0.78] p < 0.001) reduced the odds of rapid weight gain. Compared to white British individuals, all other ethnicities had lower odds of rapid pandemic weight gain (e.g., Indian versus white British: aOR 0.69, 95% CI [0.68, 0.70], p < 0.001). Long-term conditions (LTCs) increased the odds, with mental health conditions having the greatest effect (e.g., depression (aOR 1.18, 95% CI [1.17, 1.18], p < 0.001)). Similar characteristics increased odds of extreme acceleration in the rate of weight gain between the prepandemic and pandemic periods. However, changes in healthcare activity during the pandemic may have introduced new bias to the data. Conclusions: We found female sex, younger age, deprivation, white British ethnicity, and mental health conditions were associated with rapid pandemic weight gain and extreme acceleration in rate of weight gain between the prepandemic and pandemic periods. Our findings highlight the need to incorporate sociodemographic, physical, and mental health characteristics when formulating research, policies, and interventions targeting BMI in the period of post pandemic service restoration and in future pandemic planning. Miriam Samuel and team analyzed health records of 17 million adults in England, examining patterns of weight change before and during COVID-19 and identifying groups most prone to rapid weight gain. Author summary: Why was this study done?: Restrictions imposed during the Coronavirus Disease 2019 (COVID-19) pandemic may have led to lifestyle changes that are associated with weight gain. Some studies have suggested that women, younger adults (18 to 29 years), and those living in more deprived areas were at greatest risk of weight gain during the pandemic, but these were limited by small sample size. There are currently no large-scale analyses of how the pandemic impacted preexisting patterns of weight gain, and how this varied by sociodemographic and clinical characteristics. What did the researchers do and find?: We used data from the routinely collected health records of 17 million adults living in England to investigate patterns of weight change before and during the pandemic and describe which groups were most likely to have experienced unhealthy patterns of weight gain. We found that, among adults with measures of weight recorded in their healthcare records, women, younger adults (18 to 29 years), those living in the most deprived areas, and those of white British ethnicity were most likely to have gained weight rapidly before and during the pandemic. The same groups were also most likely to have experienced extreme acceleration in their rate of weight gain during the pandemic. Almost all the long-term conditions (LTCs) increased the risk of unhealthy patterns of weight gain, with mental health conditions, such as depression, having the greatest estimated effect. What do these findings mean?: The COVID-19 pandemic appears to have had the greatest impact on women, young adults, and those living in the most deprived areas in terms of unhealthy patterns of weight gain. We present, to our knowledge, new evidence that people with mental health conditions were more likely to have unhealthy patterns of weight gain during the pandemic, highlighting the need to consider sociodemographic, physical, and mental health characteristics in research, policies, and interventions around weight. We recommend that future pandemic planning should consider how to mitigate the unequal indirect impact of a pandemic on patterns of weight gain to prevent preexisting health inequalities being further exacerbated. Changes in healthcare activity during the pandemic affected patterns of weight monitoring in primary care, which may have introduced new bias to the analyses. [ABSTRACT FROM AUTHOR]

METHODS This was a whole population study, assessing the impact of the COVID-19 pandemic on the number of people with a new diagnosis of type 2 diabetes in England. Impact of the COVID-19 pandemic on new diagnoses of type 2 diabetes in England Keywords: observational study; population study; type 2 diabetes EN observational study population study type 2 diabetes 3424 3429 6 10/05/23 20231101 NES 231101 BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has been associated with a reduction in new diagnoses of type 2 diabetes, with an estimated 60 000-70 000 missed or delayed diagnoses across the UK from March to December 2020.[[1]] Using population-based National Audit data, we aimed to: (a) compare observed with expected numbers and incidence rates of new type 2 diabetes diagnoses in England from April 2020 to March 2022 to assess whether new diagnoses in 2021/2022 made up for the reduced number earlier in the pandemic; and (b) assess whether patient characteristics in newly diagnosed people were different prepandemic versus postpandemic onset. While we have seen excess cases of new diagnoses of type 2 diabetes in those aged younger than 30 years, in older age groups, missed diagnoses seem to remain an ongoing issue, raising concerns about the heightened risk of microvascular and macrovascular complications because of suboptimally managed vascular risk factors in the undiagnosed elderly people. [Extracted from the article]

Aims: To assess weight change in the Healthier You: NHS Diabetes Prevention Programme (NHS DPP) delivered via video conferencing (remote) sessions or delivered via specific digital interventions through apps or websites, during the COVID‐19 pandemic compared to group‐based face‐to‐face interventions, pre‐pandemic. Methods: Prospectively collected national service‐level data relating to individuals with non‐diabetic hyperglycaemia (HbA1c 42–47 mmol/mol (6.0%–6.4%) or fasting plasma glucose 5.5–6.9 mmol/L) referred to the NHS DPP from June 2016 to March 2022. Results: Between March 2020 and March 2022, 335,961 people were referred to the programme and were offered a choice of remote or digital intervention. This was preceded by 556,793 people referred to the face‐to‐face programme between June 2016 and February 2022. Uptakes to intervention sessions were 47% for those offered a choice and 39% for face‐to‐face. Remote and digital participants were significantly younger (60 and 56 vs. 65 years) and heavier (86.1 kg and 91.0 kg vs. 84.1 kg) compared to face‐to‐face. Weight change was assessed for 42,407 remote, 7699 digital and 97,205 face‐to‐face participants with sufficient time to have finished the programme and no missing data. Mean weight losses for participants attending at least one intervention session were: 2.40 (2.36–2.44) kg, 2.59 (2.49–2.68) kg and 2.01 (1.98–2.04) kg for remote, digital and face‐to‐face participants respectively. Corresponding mean weight losses for those who completed the programme were: 3.24 (3.19–3.30) kg, 4.76 (4.60–4.92) kg and 3.04 (3.00–3.07) kg. There were no significant differences in weight change between interventions by ethnicity and deprivation. Conclusions: Weight losses achieved through remote and digital interventions were greater than those previously achieved through face‐to‐face interventions, without evidence of exacerbation of health inequalities. [ABSTRACT FROM AUTHOR]

• There is urgency to act to limit the indirect effects of the COVID-19 pandemic on people with diabetes. • We aimed to identify the extent of these impacts and practical solutions that could improve clinical services. • The pandemic has major adverse indirect impacts.. However, several practical solutions where identified. • Healthcare teams may be able to take advantage of new ways of working to improve the lives of people with diabetes. The COVID-19 pandemic has caused major disruptions in clinical services for people with chronic long-term conditions. In this narrative review, we assess the indirect impacts of the COVID-19 pandemic on diabetes services globally and the resulting adverse effects on rates of diagnosing, monitoring, and prescribing in people with type 2 diabetes. We summarise potential practical approaches that could address these issues and improve clinical services and outcomes for people living with diabetes during the recovery phase of the pandemic. [ABSTRACT FROM AUTHOR]