Perceptions and experiences with eating disorder treatment in the first year of COVID‐19: A longitudinal qualitative analysis

Abstract

Objective: The COVID-19 pandemic created significant challenges in accessing and receiving treatment for individuals with eating disorders (EDs). The purpose of this study is to explore perceptions of and experiences with ED treatment during the first year of the pandemic among individuals with past and self-reported EDs in the United States. Methods: Online surveys were administered to adults (N = 510) with a past or current self-reported ED at 13 timepoints between April 2020 and May 2021. Using longitudinal qualitative analysis, 5651 free-text responses were examined to capture experiences with ED treatment and generate inferences of change over time. Results: We categorized results into four sequential, temporal quarters and identified patterns that explained participants' perceptions of facilitators, barriers, and experiences with ED treatment over time: Quarter 1. Treatment Disruption and Reorienting Recovery; Quarter 2. Accumulating COVID-19 Stress and Virtual Treatment Woes; Quarter 3. A Continuation of Inadequate Care; and Quarter 4. Ongoing Adaptation and Adjustment to Uncertainty. Participant experiences were marked by numerous barriers to accessing care, challenges adjusting to virtual treatment, unmet treatment needs, and beginning acceptance of telehealth.Discussion: Our findings present a timeline to help evaluate challenges related to navigating the switch to virtual care which created significant disruption to ED recovery. Participants spent much of the first year trying to adjust to unemployment, loss

Perspectives on relapse prevention following intensive treatment of anorexia nervosa: A focus group study

“…The convenience and availability of telehealth were viewed as positive, consistent with other reports of the increasing acceptability and feasibility of remote treatment delivery methods (Gorrell et al, 2022; Graell et al, 2020; Raykos et al, 2021). The transition from in‐person to telehealth‐based treatment warrants careful planning for successful implementation (Goode et al, 2023). One participant expressed concern about the ability to be transparent and remain accountable when receiving therapy virtually because of the ego‐syntonic nature of the disorder.…”

An Analytical Review of the Causes of Eating Disorders in the COVID-19 Pandemic in Adolescents

“…Finally, both Goode [24] and Spigel [25] have shown that the COVID-19 pandemic has brought serious challenges to the recovery process of EDs because of access to healthcare resources. Admittedly, Spigel [25] did not demonstrate a statistically significant relationship between access to healthcare and more symptoms of ED in adolescents.…”

“…Some adolescents in EDs reported the availability of online treatments as high quality, and telehealth provided some opportunities to continue some of their treatments in the age of COVID-19 [25]. Online treatments also increase the safety and convenience of treatments, especially for those people who are unable or averse to meeting health professionals face-to-face [24]. However, individuals with EDs still reported challenges related to treatment during the first half of the COVID-19 pandemic [24].…”

“…Online treatments also increase the safety and convenience of treatments, especially for those people who are unable or averse to meeting health professionals face-to-face [24]. However, individuals with EDs still reported challenges related to treatment during the first half of the COVID-19 pandemic [24]. Although some individuals were able to accommodate online treatments, the decreased accessibility of ED-related treatments in the age of the COVID-19 pandemic still brought uninterrupted difficulties to people with EDs [24].…”

“…However, individuals with EDs still reported challenges related to treatment during the first half of the COVID-19 pandemic [24]. Although some individuals were able to accommodate online treatments, the decreased accessibility of ED-related treatments in the age of the COVID-19 pandemic still brought uninterrupted difficulties to people with EDs [24]. These challenges include treatment disruption, as evidenced by individuals who have experienced EDs being discharged from inpatient treatments prematurely and receiving restricted post-discharge support [15].…”