I don’t think I am alone. My patients are complaining of weight gain too. As a result of the stay-at-home instructions, many of us altered our activity levels, diets, and routines. The result — The Quarantine 15.

Obesity may be an unexpected outcome of this infectious disease pandemic.

Why are we gaining weight?

Various theories attempt to explain the mysterious Quarantine 15. Some blame stress. Stress increases our body’s cortisol production. Cortisol is the “stress hormone” known to increase the appetite.

When under stress, we alter our food intake. Some people undereat. The medical term for undereating stressed-out individuals is “weirdos.” “Normal” people tend to grab a bag of Doritos and dip them in hot fudge covered ice-cream.

Ice-cream and other sugary carbohydrates trigger a dopamine surge. Dopamine hormone dopamine is produced in the pleasure center of the brain, an area of the brain called the nucleus accumbens. Dopamine is our mind’s reward system.

When times are tough, rewards and treats provide relief. Some believe we naturally gravitate towards carb-laden foods when stressed out to get a quick energy boost. The sugar rush makes us feel better, temporarily. But what follows is the crash and crave phase. The crash makes us feel hungry again as our brains seek out more dopamine.

Dopamine and cortisol.

Is the Quarantine 15 a result of a complex combination of physiological hormonal changes? Perhaps. But I suspect we are just bored.

Boredom leaves us feeling tired and sluggish. We tell ourselves we were “forced” to stop working out when gym and fitness centers closed during the lockdown. But many did not substitute an evening jog, daily walk, or even get up off the couch.

Not only did we decrease our physical activity, but alcohol sales also skyrocketed up 27% during the pandemic. People are doing less and drinking more, and increased alcohol consumption means more calories.

What goes better with a craft beer than some fresh local takeout! Since restaurants were closed to dine-in, many of us began ordering take-out. Food delivery services increased sales during the lockdown. Many of us ordered food to “to support the local restaurants.”

Hey, we are #inthistogether, and everyone has to do their part.

As we cope with the mental, physical, and emotional stress of the pandemic there are things we can do to stop packing on the pounds. The internet is full of “helpful” tips such as managing stress eating and workouts from home. But the first step in treating any problem is making a conscious decision to work on it. We have to internalize the decision and commit to effort.

Effort and hard work are required if we want to get a handle on our love handles. Weight loss is hard. If it were easy, everyone would do it.

No quick fixes

I would be a hypocrite to write a listicle of five magic steps to guarantee everyone sheds the extra baggage. Instead, I experience share from my own ups and downs. These weight management hacks help me get back up each time I fall.

1. Tracking: Use the Myfitness Pal app to track my food and exercise. It provides personal accountability. It is no fun to type in seven cookies. Entering my intake changes my behavior. I try not to judge myself but rather collect the data for monitoring and identifying areas for improvement. Weight is like a business metric problem. If you can’t measure it, you can’t manage it.
2. Hydration: Drink lots of water all day long. Our minds often can not distinguish between the sensation of thirst and hunger. At least that is what my skinny friends tell me… Sounds right…Probably is.
3. Ask the question: This tip sounds pedantically simplistic, but it works. Ask yourself, “Am I really hungry?” This question forces a pause. We stop and process our actions and can sometimes break the reflex eating cycle.
4. Exercise: It took me 47 years and a medical degree to accept that regular exercise is an important tool for a happy life and a healthy body. The key first step is to decide “this is what I am going to do.” If you are just starting out, set the bar as low as possible. The goal is to make exercise so easy you can’t talk yourself out of it.
5. Mindfulness: Managing your mind is essential to a healthy body. Find a free meditation app and give it a try. I was highly skeptical but Headspace is now an established part of my day. Reducing the underlying stress can prevent overeating at the starting point.

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The term is “rolling nervous breakdowns.” New in its entrance on the medical and office scene, it nevertheless presents serious consequences and is a direct result of the insecurity brought on by COVID-19. The virus has tumbled the workforce as little else has, even the recession of 2007–2008.

Executives in offices all over the country, and possibly the more business-related economies of the world, are now feeling the struggles faced by the offices. Disruptions and work-around solutions may not work adequately, and what is missing in online work may not substitute for the in-office community.

Working at a kitchen table garbed in pajamas with a cup of coffee isn’t as effective, emotionally, as chatting at the water cooler. While some may have seen this idle chatter a waste of company time, it served a purpose just as company golfing events or joyful dinner meetings do. Appearing to be strictly social, they bond and allow for connection and the exchange of ideas, which is a source of corporate enrichment and growth, both personal and financial.

“What we’ve all found out the hard way the last five months is that we are working harder and it’s more intense and there are no breaks, or community. And it bleeds into weekends and you are kind of on 24/7,” the senior executive said, asking not to be named to discuss internal matters. “We are having rolling nervous breakdowns.”

The At-Home Worker

The dream of getting up when you want, taking breaks when you want, and sitting and staring out a window is not what it seemed. Now, the workweek has been transformed into something no one would want. A 9-to-5 existence may have more allure with the advent of the 24/7 work world of a corporate online presence.

The demands of the job are ever-present and, seemingly, relentless as the emails come tumbling into the in-box. Responses are needed sometimes in the middle of the night as corporations have re-invented themselves into worldwide entities.

There is no stable night-and-day existence any longer. With this loss of stability comes uncertainty and anxiety and the fear of a corporate presence monitoring your computer’s activity. The folly of believing that the ridding business of the five-day workweek would be beneficial and viewing it as a leftover from the 20th century isn’t a boon for business.

Companies can use network firewalls and router logs to monitor Internet traffic connected to your computer. Network analyzers can scan networks for prohibited content and determine the originating workstation. It’s also possible to monitor requests for websites or Internet data during scheduled times. Employers use this information to monitor how much time you spend browsing the Web while you’re working.

A Dream, Not a Reality

Writers envisioned worker independence, more time for family life, and a change of attitude for work and play even in the 21 Century. But were they wrong and short-sighted in their view?

The emotional needs of workers were to be met in the new work world, but did this really happen in 2020 as COVID-19 forced these changes in business life? Apparently not. The social life of real, physical contact was gone, and with it a sense of community or belonging to the herd.

Even though business articles chirped about the wonderful life the virus made possible, this is questionable at best.

If there’s one thing the pandemic has shown, it’s that the standard nine-to-five, five-days-a-week workweek is gone. Employees can still be productive — arguably even more productive — without clocking in every weekday for 40 hours per week.

Workers aren’t working 40 hours a week. The most likely scenario is that they’re working more with a concomitant build-up of stress to go with the increased hours. There is no putting work aside and assuming your normal, social life at home or play.

True, flexibility is there, but how useful is that if businesses have been closed, physicians’ offices are using telemedicine, and even the car dealerships are buying, selling, and bringing cars to purchasers? The chain-to-the-home approach to life is here. There’s no flexibility if you can’t avail yourself of it.

The medical consequences will we see as these pandemic forces bring changes never expected in business plans? For one, the immune system does not adapt well to stress, it becomes weaker and makes individuals more vulnerable to not only disease but the dysfunction of the body.

The stress raises blood pressure, anxiety, and cloaks the everyday in a depressive fog of uncertainty. Work pressures that are ever-present, may be measured in cognitive problems, insomnia, and even dermatologic disorders.

The longer the aura of uncertainty pervades workers’ lives, the more damaging the stress can be in terms of medical issues.

Rolling Re-Openings, Closings

How do you plan your at-home work life, especially if you have kids when states and school systems are continually operating at the whim of the virus? Upticks in infection rates result in closing where openings were expected. Shops are closed that were to be opened, and life is a roller coaster of the unexpected.

How do you work if you have to homeschool your children because there’s no school, or school on a “hybrid” basis? What about daycare? Is it even possible when the virus is everywhere, and you have no assurance it is safe?

Is this the reality that business writers were flooding the internet with when they said the 40-hour-work week was dead? No, they never thought we’d be facing something like the 1918 Spanish Flu epidemic, only worse. We are now a country of hundreds of millions and no longer tucked into urban centers. The virus is everywhere and projects are that the fall will bring a tsunami of illness as the seasonal flu interacts with the COVID-19 virus.

As one article indicated, a “much larger remote workforce post-COVID may be a myth…” If it becomes a reality because corporations will realize gains in terminating office leases, in-house amenities, and even healthcare, what will it look like? Who will handle the serious emotional adjustment of the workers?

According to one report, 42 percent of the American workforce works at home, and 20 million lost their jobs. Only nine million workers have returned to work.

The new “working-from-home economy,” which is likely to continue long past the coronavirus pandemic that spawned it, poses new challenges — from a ticking time bomb for inequality to an erosion of city centers — according to Stanford economist Nicholas Bloom.

And the pandemic has other implications for some workers.

The Inequality Question

Not everyone can work from home, and for those who can’t, it means an additional, almost unfathomable burden.

From New York and California to Texas and Arizona — in urban and rural areas alike — people of color are suffering at greater rates, according to county data, state analyses provided to POLITICO by public health researchers, and interviews with more than a dozen experts. And ongoing gaps in data collection and lagging access in “testing deserts” make it hard to know truly how deep the problem runs.

Not only are infections high among minorities, but a report in late June from the Centers for Disease Control and Prevention found that Black and Latino Americans with coronavirus have been hospitalized at nearly five times the rate of white people. For Native Americans, the hospitalization rate is six times greater.

The groups that will feel the effects of the virus the worst are also those who will have inadequate health and mental healthcare available to them. First, they can’t afford it, and they don’t have it available in their area or they must work however they can despite the dangers.

Telehealth or telemedicine isn’t an option when you don’t have a stable address, a computer, or an internet connection. Therefore, they are left to fend for themselves, and the death rate keeps going up.

As we worry about rolling nervous breakdowns, who is collecting data on these communities and their nervous breakdowns? If we depend on POC (people of color) to harvest the food, ship our supplies and make our lives possible, what becomes of them?

The need is great and urgent and must be addressed.

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