BMI and Screen Time in Adolescents Before and After the COVID-19 Pandemic

Background: The COVID-19 pandemic led to many disruptions in daily life activities due to the need for social distancing to slow the spread of the disease. Across the United States communities cancelled youth sporting activities, businesses closed, and school districts shifted to online learning in order to physically distance people and to decrease the spread of COVID-19. These measures led to increased opportunity to engage in screen time while decreasing opportunity for physical activity. Obesity is an increasing problem with many long-term health consequences. The social impacts of the COVID-19 pandemic put adolescents at risk for behavior changes associated with obesity.

Methods: We did retrospective chart review of patients aged 12-18 years who had a well check in a pre-pandemic period from 6/1/2019-3/11/2020 and a second well check in a post-pandemic period , from 6/1/2020-3/11/2021. Patient encounters from 4 different clinics in Lubbock, Texas were analyzed. At total of 676 subjects were included in our final dataset. Information for both pre- and post-COVID visits collected included BMI, BMI percentile, and either daily screen time of <2 hours or screen time >2 hours. In the pre-pandemic period, 496 of the encounters recorded screen time use and in the post-pandemic period 503 encounters recorded screen time use. SPSS software was used to run analysis. Our study was approved for expedited review under Lubbock IRB# L21-113.

Results: Results showed the BMI percentile pre-COVID (mean=68.6200, SD=29.1762) was less than the BMI percentile post-COVID (mean= 69.9232, SD=29.2334). A paired measures T-test found the difference to be significant, t(675)= 2.872, p= 0.004. The prevalence of obesity in our population was 0.251 in the pre-COVID period and 0.275 in the post-COVID period. The percentage of adolescents who had more than 2 hours of screen time per day was 42.1% in the pre-COVID period and 55.5% in the post-COVID period. A pairwise group comparison (n=263) looking at adolescents who had less than two hours of screen time both pre- and post-COVID compared to those how had less than 2 hours of screen time pre-COVID and more than 2 hours of screen time post-COVID had a p=0.6823.

Conclusion: Obesity is a multifactorial disease process with screen time being just one factor. In our study the prevalence of obesity and getting more that 2 hours of daily screen time both increased from the pre-pandemic to the post-pandemic period. However, when looking at how increased screen time was related to the increase in BMI, the results were not statistically significant. Further research will look at multiple lifestyle variables to see how they are influencing changes in BMI and how the COVID-19 pandemic has altered changes in these behaviors.