Age-related differences in the association between financial hardship and weight change during the COVID-19 pandemic

Objective To examine the association of financial hardship with weight changes in the US during the COVID-19 pandemic. Methods We used data from the COVID-19's Unequal Racial Burden survey, a nationally representative, cross-sectional, online survey of diverse adults living in the US, 12/2020-2/2021. This study included 1,000 Asian, Black, Latino (half Spanish-speaking), and White adults and 500 American Indian or Alaska Native, Native Hawaiian or Pacific Islander, and multiracial adults (5,500 total). Age-specific (18-39, 40-59, ≥60) associations between financial hardship domains and weight change were estimated using multinomial logistic regression, adjusted for demographic and health characteristics. Results Financial hardship during the COVID-19 pandemic was prevalent across all age groups (18-39: 76.2%; 40-59: 75.6%; ≥60: 50.6%). Among adults aged 18-39 and ≥60 years old, food insecurity was significantly associated with weight loss (18-39: aOR=1.42, 95% CI=1.04, 1.95; ≥60: aOR=3.67, 95% CI=1.50, 8.98). Among all age groups, unmet healthcare expenses was also associated with weight loss (18-39: aOR=1.31, 95% CI=1.01, 1.70; 40-59: aOR=1.49, 95% CI=1.06, 2.08; ≥60: aOR=1.73, 95% CI=1.03, 2.91). Among adults aged 18-39 and ≥60 years old, lost income was significantly associated with weight gain (18-39: aOR=1.36, 95% CI=1.09-1.69; ≥60: aOR=1.46, 95% CI=1.04, 2.06), and among adults 40-59 years old, experiencing increased debt was significantly associated with weight gain (aOR=1.50, 95% CI=1.13, 1.99). Conclusions For those aged 18-39 and ≥60 years old experiencing financial hardship during the COVID-19 pandemic was associated with both weight loss and weight gain. Less correlation was observed among adults aged 40-59.