Objectives This systematic review assessed the influence of the COVID‐19 pandemic and associated restrictions on body image, disordered eating (DE), and eating disorder outcomes. Methods After registration on PROSPERO, a search was conducted for papers published between December 1, 2019 and August 1, 2021, using the databases PsycINFO, PsycARTICLES, CINAHL Plus, AMED, MEDLINE, ERIC, EMBASE, Wiley, and ProQuest (dissertations and theses). Results Data from 75 qualitative, quantitative, and mixed‐methods studies were synthesized using a convergent integrated approach and presented narratively within four themes: (1) disruptions due to the COVID‐19 pandemic; (2) variability in the improvement or exacerbation of symptoms; (3) factors associated with body image and DE outcomes; (4) unique challenges for marginalized and underrepresented groups. Disruptions due to the pandemic included social and functional restrictions. Although most studies reported a worsening of concerns, some participants also reported symptom improvement or no change as a result of the pandemic. Factors associated with worse outcomes included psychological, individual, social, and eating disorder‐related variables. Individuals identifying as LGBTQ+ reported unique concerns during COVID‐19. Discussion There is large variability in individuals' responses to COVID‐19 and limited research exploring the effect of the pandemic on body image, DE, and eating disorder outcomes using longitudinal and experimental study designs. In addition, further research is required to investigate the effect of the COVID‐19 pandemic on body image and eating concerns among minoritized, racialized, underrepresented, or otherwise marginalized participants. Based on the findings of this review, we make recommendations for individuals, researchers, clinicians, and public health messaging. Public Significance This review of 75 studies highlights the widespread negative impacts that the COVID‐19 pandemic and associated restrictions have had on body image and disordered eating outcomes. It also identifies considerable variations in both the improvement and exacerbation of said outcomes that individuals, researchers, clinicians, and other public health professionals should be mindful of if we are to ensure that vulnerable people get the tailored support they require.

Objectives. This review assessed the impact of COVID-19 and restrictions related to the pandemic (e.g., social distancing and lockdown) on body image, disordered eating, and eating disorder outcomes. Method. After registration on PROSPERO, a systematic search was conducted for papers published between 1 December 2019 and 1 August 2021, using the databases PsycINFO, PsycARTICLES, CINAHL Plus, AMED, MEDLINE, ERIC, EMBASE, Wiley, and ProQuest. Results. A final sample of 74 reports, describing 75 studies, was included, and data from qualitative, quantitative, and mixed-methods studies were synthesized using a convergent integrated approach. Four themes were generated: (1) disruptions due to COVID-19; (2) variability in the improvement or exacerbation of symptoms; (3) risk and protective factors; and (4) unique challenges for marginalized and underrepresented groups. Findings across studies showed variation in individuals’ responses to, and experiences of, the current pandemic. Discussion. There is large variability in how individuals respond to COVID-19 and limited research exploring the effect of the pandemic on body image, disordered eating, and eating disorder outcomes using longitudinal and experimental study designs. Based on the findings of this review, we recommend that individuals reduce time spent on social media, maintain contact with family and friends, make time for self-care, and keep daily routines. Additionally, researchers should target more diverse participant samples and conduct longitudinal research on risk and protective factors of COVID-19 and long-term outcomes. Finally, clinicians should consider adopting flexible treatment practices, taking into account COVID-19 restrictions, patient preferences, and unique participant needs.

The COVID-19 pandemic lockdown restrictions posed unique challenges for people living with eating disorders (EDs), particularly relating to social isolation and changes in treatment access. However, less is known about the experience of lockdown for people ‘in recovery’ from EDs or disordered eating (DE) (i.e., with an ED/DE history). This study explored: (i) how people with a self-reported ED/DE history responded to and managed the experience of lockdown, specifically in relation to their recovery, and (ii) coping strategies for the management of recovery. Semi-structured interviews were conducted between June and August 2020 with 20 adults with a self-reported ED/DE history living in the UK. Data were analysed using inductive thematic analysis within a critical realist framework. Three overarching themes were identified: (1) Seeking safety and stability during a pandemic, (2) Lockdown prompting realisations about recovery, and (3) Exploring self-compassion as a more adaptive approach. While most participants experienced a resurgence in ED symptoms during lockdown, many reflected on the successful management of these as reinforcing their recovery. These findings have important implications for understanding ED recovery, in addition to informing interventions to better promote recovery during the COVID-19 pandemic and beyond.