Were eating disorders affected when isolation was ordered?
Few studies have yet examined the association between America’s COVID-19 lockdown and its effects on eating disorders. A team at the Australian National University recently learned that our pandemic lockdown clearly worsened the status of eating disorders.
Dr. Yunqi Gao and colleagues found that the lockdown environment led to increased anxiety and depression, changes in dietary habits and eventually produced worsening ED symptoms (J Public Health. 2022. doi. org/10.1007/s10389-022-1074-4). The researchers used a literature review to include all relevant articles published before the pandemic, from 2019 through April 2021; 12 articles fit the criteria.
Greater body image concern seen among women
During the lockdown, women and adolescents in general had more concern about body image and appearance, faced more difficulties in regulating eating, and were at greater risk of worsening ED symptoms during the lockdown. In general, the lockdown led to a worsening of eating disorders overall and to higher levels of anxiety and depressive symptoms in ED patients. The severity of ED symptoms then deceased to normal levels during the transition from lockdown to re-opening (J Affec Disord. 2021b. 285:77). One possible explanation was that some patients continued to receive virtual therapy during the lockdown. Negative elements that were in play were social isolation and loneliness, limited access to healthcare, dietary changes and food restrictions, the psychosocial impact, and negative emotions.
Further systematic reviews are needed to examine the impact of the lockdown on other continents, such as Asia, Africa, and South America, according to the authors.
A Letter to the Editor
A very pertinent “Letter to the Editor” to the Journal of the American Academy of Child and Adolescent Psychiatry (2022. 61:349) from Drs. Jace Reed and Katherine Ort at New York University Langone Health, New York, NY, pointed out the rise in eating disorders symptoms during COVID-19, and the impact upon treatment at their institution. According to the authors, health and economic effects were substantial among those with eating disorders. At their hospital, the child and adolescent consultation liaison service recorded a three-fold increase in consultations for restrictive EDs from September 1, 2019 to March 31, 2021. Patients included in the final analysis were from 5 to 18 years of age, all with a diagnosis of anorexia nervosa.
Factors that may have been involved in the increase are familiar from other studies: disruption in daily activities, including mealtimes, physical activity, sleep, effects of media, social isolation, emotional distress, and overall fear of contracting the virus.
The report gives us a view of the effects of the lockdown. As the authors note, it will be important to follow the role that the pandemic has played in EDs in the pediatric population. Continuing discussion will be needed to help increase the supply and access to specialized programs and services. The authors write that this will be helpful “to increase the supply and access to specialized programs and services to help bridge the gap between increased demand, low supply, and accessibility, which often leaves those in the most need with substandard care.”