Review of the Unprecedented Impact of the COVID-19 Pandemic on the Occurrence of Eating Disorders

Karien Meier; Daphne van Hoeken; Hans W. Hoek

Disclosures

Curr Opin Psychiatry. 2022;35(6):353-361. 

In This Article

Abstract and Introduction

Abstract

Purpose of Review: To review the recent literature on the impact of the coronavirus disease-2019 (COVID-19) pandemic on incidence and severity of symptoms of eating disorders (EDs).

Recent Findings: A worrying increase of EDs in- and outpatients has been reported since the COVID-19 pandemic began in 2019/2020. Restrictions implemented during the pandemic to protect populations against COVID-19 increased the risk for onset and for worsening of EDs by disrupting eating and exercise routines, social isolation, lack of support, and limited access to healthcare. Substantial increases since the start of the pandemic have been reported for overall incidence (15%), hospital admissions (48%) and emergency department visits (11%) for EDs, with even higher increases among women and children or adolescents with an ED. During the pandemic, ED patients reported increased severity of ED-specific symptoms and increased anxiety, depression and suicidal ideations and -attempts. Treatments shifted largely toward online methods for continuity of care, despite concerns about the quality of care provided and difficulties in self-monitoring. Our review provides preliminary evidence for a similar effectiveness of online treatment to prepandemic face-to-face treatment. In-person assessment remains essential for detecting EDs and for those requiring medical admission.

Summary: Although the ongoing COVID-2019 pandemic affected mental health globally, research shows that it particularly affected individuals with an ED diagnosis or at risk for an ED, especially women, children and adolescents, and those with anorexia nervosa.

Introduction

The emergence of coronavirus disease-2019 (COVID-19) has impacted almost every aspect of life for most people worldwide. The global COVID-19 pandemic has impaired mental health, especially in people with preexisting psychiatric conditions. For instance, depressive and anxiety disorders have been exacerbated during the pandemic, with 28% and 26% increases in global prevalences, respectively.[1] The incidence of other syndromes, such as posttraumatic stress disorder and burnout, has also increased, especially among medical personnel.[2] Emergency department visits for a variety of mental health conditions increased considerably during the pandemic compared to the prepandemic period, particularly among young individuals.[3]

The pandemic has had far-reaching consequences for individuals with an ED – affecting their daily routines, social contact, and access to healthcare. Eating disorders (EDs) are disabling, often chronic, and potentially fatal mental health disorders.[4–6] The global health-related burden of EDs is significant, and in young women it is greater than that of other health conditions.[7] EDs are associated with an increased mortality risk, impaired quality of life, heavy personal and family burden, and high healthcare costs.[4–6] Since the start of the pandemic, many studies have reported rapidly increasing numbers of ED cases, along with deterioration of ED symptoms and psychopathology among those affected.[8–16]

Although the pandemic is not yet resolved and its full consequences have yet to be established, our aim is to provide a synopsis of the evidence up to date on the impact of the COVID-19 pandemic on individuals with an ED.

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