Clues to Why AN Symptoms Lessened During the COVID-19 Epidemic

The mystery concerned girls and women with first-onset anorexia nervosa who reported fewer severe symptoms during the COVID-19 epidemic. A meeting abstract presented at the American Academy of Child and Adolescent Psychiatry (AACP) meeting in New York City last October provided additional clues.

Katrien Bracke, MD, of Erasmus Medical Center, Rotterdam, the Netherlands, and colleagues sought to explain the effects of the COVID epidemic and comorbid psychotherapy among girls and women with AN. A comparative cohort study included a group of healthy girls and women aged 12 to 24. Then the investigators compared the symptoms among participants with first-onset AN and the healthy controls. The comparisons were made before the onset of the COVID-19 epidemic (May 3, 2017, to March 2020) and during the epidemic (March 16, 2020, to October 2021). The groups were relatively small (pre-pandemic period, n=37; peri-pandemic period n=38, and the AN group (pre-pandemic n=49; peri-pandemic period, n=30).

AN patients had less internal insecurity, fewer body shape concerns

The investigators found that during the epidemic, AN patients felt less internal insecurity and were less dissatisfied with their body shape than before the epidemic. Those with AN in the peri-pandemic group also reported having fewer eating disorder symptoms overall compared with patients with AN in the pre-pandemic group. Patients in the peri-pandemic group had fewer symptoms of anxiety compared with patients in the pre-pandemic group. However, according to the authors, at the 1-year follow-up, patients in the peri-pandemic group with AN had lower body mass indexes (BMI, kg/m²) than the pre-pandemic AN patients. The authors surmise this may have been due to less access to health care services during this time.

What made the difference? According to the investigators, the fall in symptoms might be explained by fewer social pressures and fewer contacts with their peers during the epidemic.