Americans gained nearly 2 pounds per month under COVID-19 shelter-in-place orders in 2020, according to a new study published Monday in JAMA Network Open.

Those who kept the same lockdown habits could have gained 20 pounds during the past year, the study authors said.

“We know that weight gain is a public health problem in the U.S. already, so anything making it worse is definitely concerning, and shelter-in-place orders are so ubiquitous that the sheer number of people affected by this makes it extremely relevant,” Gregory Marcus, MD, the senior author and a cardiologist at the University of California, San Francisco, told The New York Times.

Marcus and colleagues analyzed more than 7,000 weight measurements from 269 people in 37 states who used Bluetooth-connected scales from Feb. 1 through June 1, 2020. Among the participants, about 52% were women, 77% were white, and they had an average age of 52.

The research team found that participants had a steady weight gain of more than half a pound every 10 days. That equals about 1.5 to 2 pounds per month.

Many of the participants were losing weight before the shelter-in-place orders went into effect, Marcus told The Times. The lockdown effects could be even greater for those who weren’t losing weight before.

“It’s reasonable to assume these individuals are more engaged with their health in general, and more disciplined and on top of things,” he said. “That suggests we could be underestimating — that this is the tip of the iceberg.”

The small study doesn’t represent all of the nation and can’t be generalized to the U.S. population, the study authors noted, but it’s an indicator of what happened during the pandemic. The participants’ weight increased regardless of their location and chronic medical conditions.

Overall, people don’t move around as much during lockdowns, the UCSF researchers reported in another study published in the Annals of Internal Medicine in November 2020. According to smartphone data, daily step counts decreased by 27% in March 2020. The step counts increased again throughout the summer but still remained lower than before the COVID-19 pandemic.

“The detrimental health outcomes suggested by these data demonstrate a need to identify concurrent strategies to mitigate weight gain,” the authors wrote in the latest JAMA Network Open study, “such as encouraging healthy diets and exploring ways to enhance physical activity, as local governments consider new constraints in response to SARS-CoV-2 and potential future pandemics.”

Sources:

JAMA Network Open: “Body Weight Changes During Pandemic-Related Shelter-in-Place in a Longitudinal Cohort Study.”

The New York Times: ” How Much Weight Did We Gain During Lockdowns? 2 Pounds a Month, Study Hints.”

Annals of Internal Medicine: “Worldwide Effect of COVID-19 on Physical Activity: A Descriptive Study.”

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