Has COVID-19 Complicated Eating Disorder Treatment? An Examination of Comorbidities and Treatment Response Before and During the COVID-19 Pandemic.

Abstract

Objective: Recent evidence suggests psychosocial stressors stemming from coronavirus disease 2019 (COVID-19) exposure and public health recommendations and policies have exacerbated eating disorder symptoms. Consequentially, eating disorder acuity has increased during the COVID-19 pandemic. Currently, it is still unclear how the COVID-19 pandemic may be impacting individuals receiving treatment for eating disorders at higher levels of care. The purpose of this study was to examine the impact of COVID-19 on eating disorder symptoms and associated outcomes in a sample of individuals receiving eating disorder treatment compared to individuals receiving treatment in 2019. Methods: Blinded outcomes data from 272 adults who completed treatment at an eating disorder treatment center between April and October of 2019 (pre–COVID-19 group) and 2020 (COVID-19 group) were examined. Repeated measures analyses of variance with Bonferroni correction were used to examine differences in outcome variables and treatment response. Results: Fewer participants reported trauma in 2020, but symptoms were more severe when present. A significant interaction effect for treatment (eg, admission, discharge) and year (eg, pre–COVID-19, COVID-19) was found for eating disorder and trauma symptoms. Moreover, trauma symptom scores were higher in 2020 than in 2019. The interaction among year, trauma, and treatment was significant (F3,268 = 2.11, P = .027, η2 = 0.034), indicating that individuals with severe trauma in 2020 reported less eating disorder symptom score reduction. Conclusions: Results extend understanding of effects during the COVID-19 pandemic on treatment-seeking individuals with eating disorders. Clinical implications suggest that greater attention to trauma when screening eating disorder patients and selecting treatment approaches are needed, particularly during the COVID-19 pandemic.