Association between eating behavior and quarantine/confinement stressors during the coronavirus disease 2019 outbreak

Abstract

Background: Quarantine/confinement is an effective measure to face the Coronavirus disease 2019 (COVID-19). Consequently, in response to this stressful situation, people confined to their homes may change their everyday eating behavior. Therefore, the primary objective of this study is to evaluate the association between quarantine/ confinement stressors and eating behavior during the COVID-19 outbreak. The secondary objective is to compare the association of quarantine/confinement stressors and diet behavior between two groups of participants, those attending diet clinics and those not (general population). Method: A cross-sectional web-based online survey carried out between April 3 and 18, 2020, enrolled 407 participants from the Lebanese population. Eating Disorder Examination-Questionnaire (EDE-Q) were used to measure the behavioral features of eating disorders. Results: More than half of the sample (53.0%) abide by the home quarantine/confinement, 95.4% were living with someone in the quarantine/confinement, and 39.6% continued to work from home. Higher fear of COVID-19 was found in 182 (44.8%) participants, higher boredom in 200 (49.2%) participants, higher anger in 187 (46.3%), and higher anxiety in 197 (48.5%) participants. Higher fear of COVID-19 (Beta = 0.02), higher BMI (Beta = 0.05), and physical activity (Beta = 1.04) were significantly associated with a higher restraint score. Higher anxiety, higher fear of COVID-19, higher BMI, practicing physical exercise, and a higher number of adults living in the quarantine/ confinement were significantly associated with higher shape and weight concerns. Conclusion: Our results showed that the fear of COVID-19 was correlated with more eating restraint, weight, and shape concerns in the whole sample, but more specifically in the dietitian clients group. Public health control measures are needed to reduce the detrimental effects of psychological distress associated with quarantine/ confinement on eating behaviors during the COVID-19 outbreak.

Impact of the COVID-19 Pandemic on Disordered Eating Behavior: Qualitative Analysis of Social Media Posts

“…The objective of this analysis was to characterize the impact of the COVID-19 pandemic on disordered eating behavior using inductive, thematic analysis of ED-related Reddit forums. Consistent with previous investigations [ 7 - 12 , 24 , 25 , 30 ], our findings indicate that the COVID-19 pandemic and associated public health prevention measures negatively impacted the psychiatric health of most users. Users frequently sought comfort in a time of heighted emotional distress by engaging in ED behavior, which was exacerbated by abrupt and involuntary changes in daily routine, exposure to food shortages and panic buying, closure of exercise facilities, and reduced access to care and social support networks.…”

“…Specifically, Rodgers and colleagues [ 13 ] hypothesize that restriction may occur via reduced purchasing of specific food items and reluctance to leave home to purchase groceries given one’s fear of contagion. A positive association between fear of COVID-19, eating restraint, and concerns related to weight or shape emerged from an investigation among both the general population and individuals attending diet clinics for weight loss management [ 25 ]. Grocery shopping during the pandemic may prove difficult for those with disordered eating.…”

COVID-19 Lockdown and Self-Perceived Changes of Food Choice, Waste, Impulse Buying and Their Determinants in Italy: QuarantEat, a Cross-Sectional Study

“…These data are not surprising. In the literature, indeed, it is well known that during home confinement people tend to increase their food intake [ 10 , 11 ]. A quarter of the Italian population consumed more food and one third increased time spent cooking at home [ 12 ], while an Italian study showed that half of the sample felt anxious about their eating habits, consumed comfort food and were inclined to increase food intake to feel better [ 13 ].…”

Eating disorders during COVID-19 pandemic: the experience of Italian healthcare providers

“…Patients with ED are in fact considered highly fragile due to the associated psychiatric comorbidities and metabolic anomalies [2]. Such elevated vulnerability makes them particularly susceptible to stress [2,3]. The COVID-19 pandemic and the consequent lockdown have been a great element of stress which worsened dysfunctional behaviors among ED patients [3][4][5].…”

“…Such elevated vulnerability makes them particularly susceptible to stress [ 2 , 3 ]. The COVID-19 pandemic and the consequent lockdown have been a great element of stress which worsened dysfunctional behaviors among ED patients [ 3 – 5 ]. As reported by Termorshuizen and colleagues in a study conducted in the United States and Netherland, during the COVID-19 pandemic, restriction practices increased among patients with anorexia nervosa, while binge-eating episodes augmented among those with bulimia nervosa and binge eating disorders [ 4 ].…”