Changes in sociocultural attitudes towards appearance, body image, eating attitudes and behaviours, physical activity, and quality of life in students before and during COVID-19 lockdown.

Background: The coronavirus pandemic resulted in national lockdowns that are associated with a rise in important macro-stressors for populations worldwide. The aim of the present study was to assess the impact of the COVID-19-related lockdown period on the sociocultural attitudes towards appearance, body image, eating attitudes and behaviours, physical activity, and quality of life of Lithuanian university-aged students of both genders.

Method: A total of 1850 students completed the body image, health-related behaviour and quality of life assessments three months before the first lockdown, of which 959 provided consent and an e-mail to be contacted by for further surveys. Of these 959, 230 completed the same questionnaire during the second lockdown providing the informed consent for the participation in the COVID-19-impact for the lifestyle study and use their first round data for the comparison with the lockdown. The age of the participants was 23.9 ± 5.4 years. Independent comparisons were used to test lifestyle and body image differences between men and women before and during the lockdown. Paired-sample statistics were conducted to evaluate any changes in the male and female groups separately with Cohen's d employed to represent effect sizes.

Results: No body image or disordered eating changes were found, however, body appearance evaluation increased in women (effect size 0.15). Significant increases in media pressures (in women, effect size 0.16) and the internalization of thin/low body fat beauty ideals (effect size 1.18-1.46) were observed during the lockdown when compared to baseline. No changes in quality of life were evident for men, however, for women, an increase in general and psychological domain was observed (effect size 0.17). We observed a significant decrease in physical activity (in men, effect size 0.46), an increase in internet browsing time (effect size 0.52-0.8), a decrease in unhealthy eating habits (effect size 0.49-0.60), an increase in sleep duration (in women, effect size 0.40) and lower self-rated health (in men, effect size 0.42) during the lockdown when compared to baseline.

Conclusions: These findings suggest that the majority of students cope with lockdown-related situation well. However, based on the Tripartite influence model, we can speculate that a drastic increase in the internalization of stereotyped thin/low body fat ideals might trigger body image concerns and increase disordered eating after the lockdown. Specific interventions helping students to decrease internalization of stereotyped body ideals, to promote positive body image and physical activity may be beneficial during and after the COVID-19-related lockdown.