The COVID-19 Lockdown and Eating Disorder Symptoms

As the COVID-19 pandemic has continued, research on its effects on eating disorders has flourished, and it is now possible to review some effects of the lockdown. Did the pandemic lockdown worsen eating disorder symptoms among those with eating disorders? Yes, according to the results of two recent studies.

Symptoms worsened during lockdown

A team of Australian researchers led by Dr. Yunqi Gao of Australian National University, Acton, Australia, reported that eating disorder symptoms worsened during the isolation period (J Public Health. 2022. Doi.org/10.1007/s10389-022-01704-4). The team concluded this after evaluating 132 studies from Great Britain, Italy, Spain, Belgium, and Portugal.

According to the authors, the pandemic lockdown disrupted lifestyle routines, and led to social isolation, reduced access to the usual support networks, limited or no access to healthcare and mental healthcare services, and social anxiety. Isolation led to worsening symptoms and depression and anxiety among ED patients. Social isolation included working from home or being unemployed during the confinement period and limited interactions with friends and relatives as well.

A major problem for persons with eating disorders was reduced during in-person treatment. As the authors point out, even though patients could receive online treatment through teletherapy and videoconferencing, these approaches could not replace the traditional support they derived from in-office visits. Also, during the pandemic, some psychiatric wards were downsized, closed, or converted into treatment centers for COVID patients.

The lockdown disrupted normal living situations, bringing social isolation and loneliness, financial difficulties, and unhealthy eating patterns. The authors reported that most of the studies showed a moderate to extreme impact on persons with EDs, and that many patients had difficulty getting healthcare services, including mental healthcare.

One of the limitations of the study was that all reports evaluated by Dr. Gao and associates were conducted in Europe, and thus the results may not be generalizable or applicable to other geographic settings, where the regulations may be different or even absent.

A second study: a three-fold increase in consultations

In a “Letter to the Editor” of the Journal of the American Academy of Child and Adolescent Psychiatry (March 2022), Drs. Jake Reed and Katherine Ort provide a valuable real-world example of the increased service demands during early stages of the pandemic. They reported a three-fold increase in the number of consultations for restrictive eating disorders, from 5 to 15, in the child and adolescent psychiatry consultation liaison service at their hospital over a 6-month period. These patients were from 5 to 18 years of age and most had diagnoses of AN.

The authors suggest several contributing factors, including transition of their healthcare delivery methods to telehealth, increased parental knowledge of ED symptoms, and increased need for supervision of children at home.