COVID-19 led to a spike in eating disorders. How can physicians help?
MDlinx Jan 12, 2023
Rates of eating disorders (EDs) among US individuals increased throughout the COVID-19 pandemic, studies have revealed.
As patients with disordered eating continue to navigate the aftermath of COVID-19 lockdowns, physicians can help them recover from related EDs by focusing on nutrition, weight and exercise management, and avoidance of potentially harmful eating behaviors.
ED rates rose during pandemic
In 2020, a group of researchers predicted that the COVID-19 pandemic would have a notable effect on patients who struggle with EDs.
“There will no doubt be a plethora of research in the coming months and years documenting what impact COVID-19 will have on the ED community from both a clinician and patient perspective,” the researchers wrote in an article published by the Journal of Eating Disorders.
Touyz S, Lacey H, Hay P. Eating disorders in the time of COVID-19. J Eating Disord. 2020;8(1):19.
And just as they suspected, EDs became increasingly common during the pandemic. A study published in 2022 by JAMA Pediatrics looked at changes in the volume of patients seeking care for EDs that occurred upon the emergence of the COVID-19 pandemic.
Hartman-Munick SM, Lin JA, Milliren CE, et al. Association of the COVID-19 pandemic with adolescent and young adult eating disorder care volume. JAMA Pediatrics. 2022;176(12):1225.
Investigators used an observational case series design to assess volume changes in inpatient and outpatient care for EDs in 14 medical centers and one private ED treatment program.
The researchers found a 7.2% monthly increase in inpatient admissions after the onset of COVID-19 through April 2021, a figure over 10 times the pre-pandemic monthly increase of 0.7%. For outpatient visits, researchers noted an 8.1% increase in new assessments compared with pre-pandemic percentages.
These findings revealed a “significant COVID-19 pandemic-related increase in both inpatient and outpatient volume of patients with EDs across sites, particularly in the first year of the pandemic,” according to the authors.
Symptoms got worse
Individuals who already had been diagnosed with EDs reported worsening symptoms during the pandemic.
A systematic review published by the Journal of Public Health concluded that the COVID-19 pandemic lockdowns were triggering environments for people with EDs that caused them anxiety, depression, and changes in eating habits, often reigniting their symptoms.
Gao Y, Bagheri N, Furuya-Kanamori L. Has the COVID-19 pandemic lockdown worsened eating disorders symptoms among patients with eating disorders? A systematic review. J Public Health. 2022;30(11):2743–2752.
Researchers suggested that the social isolation, disruption of lifestyle routine, and lack of access to social and medical support associated with the lockdowns laid the groundwork for symptomatic deterioration.
COVID-19 therefore not only created conditions that allowed for new EDs to develop but also possibly exacerbated existing disorders.
Hard times for teens
Among those who struggled with disordered eating throughout the COVID-19 pandemic, teenagers were especially at risk.
An article published by the AMA found that young people experienced a steep rise in EDs during the pandemic.
Lubell J. How teens’ eating-disorder treatment has changed during pandemic. AMA. July 5, 2022.
The research speculated on the reasons behind this spike.
For some, the lack of structure and routine associated with the lockdowns was difficult to handle. This, combined with the perfectionistic, overachieving nature of some teens may have paved the way for disorders such as anorexia nervosa to develop.
In addition, constant exposure to social media pressure to diet, exercise, and refrain from eating too much during the lockdowns possibly created fertile ground for EDs to surface.
For such cases, the research suggested that clinicians encourage teens whose body image is informed by social media to limit their use—or delete the apps altogether.
Keep clear recovery goals in mind
The research indicates that the COVID-19 pandemic and its related lockdowns did little to improve the mental well-being of patients across the US, especially those with EDs.
As these patients navigate the aftermath of the COVID-19 lockdowns, physicians can help ease them into recovery with evidence-based treatments.
According to an article published by the National Institute on Mental Health, doctors typically treat EDs with psychotherapy, nutritional counseling, and medical care and monitoring.
Eating disorders: About more than food. National Institute of Mental Health. Updated 2021.
With these approaches, they may be able to help patients:
Restore sufficient nutrition
Bring their weight to a healthy, stable place
Cut down on excessive exercising
Stop binge-eat and binge-purge behaviors
Meeting these goals may also require physicians to incorporate patients’ families into treatment. As noted by the NIH, family members can not only encourage patients with disordered eating to seek the help they need but also can provide additional support throughout treatment.
This is especially true for adolescents, who tend to have better health outcomes when their families assume an “ally” role with the patient and their clinicians.
Patients with EDs had a particularly hard time during the COVID-19 pandemic. Doctors, however, can help ease their symptoms by employing tried and true treatment methods for individuals of all ages.
What this means for you
Patients with EDs may have felt “triggered” by their environments during the COVID-19 pandemic. Increased depression and anxiety, social media use, and pressure to avoid weight gain during lockdown may have led to a higher prevalence and worsening of disordered eating. You can help patients with EDs meet basic recovery goals including restoration of adequate nutrition, stabilizing weight, forgoing excessive exercise, and stopping binging and purging behaviors.
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