Abstract
We evaluated the early impact of COVID-19 on people with self-reported eating disorders. Participants in the United States (US, N = 511) and the Netherlands (NL, N = 510), recruited through ongoing studies and social media, completed an online survey that included both quantitative measures and free-text responses assessing the impact of COVID-19 on situational circumstances, eating disorder symptoms, eating disorder treatment, and general well-being. Results revealed strong and wide-ranging effects on eating disorder concerns and illness behaviors that were consistent with eating disorder type. Participants with anorexia nervosa (US 62% of sample; NL 69%) reported increased restriction and fears about being able to find foods consistent with their meal plan. Individuals with bulimia nervosa and binge-eating disorder (US 30% of sample; NL 15%) reported increases in their binge-eating episodes and urges to binge. Respondents noted marked increases in anxiety since 2019 and reported greater concerns about the impact of COVID-19 on their mental health than physical health. Although many participants acknowledged and appreciated the transition to telehealth, limitations of this treatment modality for this population were raised. Individuals with past histories of eating disorders noted concerns about relapse related to COVID-19 circumstances. Encouragingly, respondents also noted positive effects including greater connection with family, more time for self-care, and motivation to recover. COVID-19 is associated with increased anxiety and poses specific disorder-related challenges for individuals with eating disorders that require attention by healthcare professionals and carers.
Highlights
We evaluated the early impact of COVID-19 on people with self-reported eating disorders
Participants reported concerns in a number of areas: worsening of the eating disorder due to a lack of structure (US 30%; NL 28%), increased time spent in a triggering environment (US 30%; NL 10%), access to food consistent with meal plan (US 32%; NL 3%), and having access to enough food (US 24%; NL 3%)
We describe the early impact of COVID-19 and treatment needs in patients with self-reported eating disorders in the United States (US) and NL
Summary
Participants from the United States (US) and the Netherlands (NL) were invited to take part in an online study. The online survey addressed concerns and challenges participants are facing with regard to their eating disorder and general mental health during the COVID-19 global pandemic. A 4-point Likert-scale asked participants to rate their level of concern about access to and affordability of food and treatment, and worsening of eating disorder symptoms due to a lack of structure, changes in the social support environment, and time spent living in a triggering environment. The survey assessed the impact of COVID-19 on specific eating disorder symptoms (e.g., “I have binged on food that I [or my family] have stockpiled”) These items were combined to create a mean impact score (Cronbach's α = .77). We assessed the different sections (effects of COVID-19 on eating disorder, eating disorder treatment, and general physical and mental wellbeing) by a descriptive analysis of the quantitative survey items. Given our goal of providing strictly descriptive results, we did not undertake formal efforts at establishing a coding scheme
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