COVID‐19 related anxiety in children and adolescents with severe obesity: A mixed‐methods study

Recent studies report negative mental health effects of the COVID‐19 related lockdown measures in general paediatric cohorts. Since obesity is a risk factor for COVID‐19 in adults, children (including adolescents) with obesity might perceive themselves to be vulnerable. Using a combined quantitative and qualitative approach, we explored COVID‐19 related anxiety in paediatric patients with severe obesity in the Netherlands using semi‐structured telephone interviews and the Paediatric Quality of Life Inventory (PedsQL) questionnaire, which had also been completed by the study population at baseline in the year prior to the COVID‐19 outbreak. In total, 75 families participated in the semi‐structured telephone interviews during the lockdown, April 2020. Characteristics of included patients were: median age 10.5 years (interquartile range = 7.6‐15.2); 52% female; mean BMI standard deviation score 3.8 (SD = 1.0). COVID‐19 related anxiety was reported for 24/75 (32%) children. The mean decrease in PedsQL score between baseline visit and COVID‐19 outbreak did not differ between children for whom anxiety was reported vs those for whom it was not (mean change −10.3 ± 36.5 vs −3.3 ± 24.4, P = .54). Self‐imposed strict quarantine measures were taken by 19/75 (25%) families. During follow‐up, several families reported that the previous contact alleviated their anxiety. In conclusion, healthcare professionals should address possible COVID‐19 related anxiety in children with severe obesity. Addressing COVID‐19 related anxiety could mitigate its potential negative effects.