The effects of the COVID-19 pandemic on disordered eating symptoms in women: A 49-day, daily study before and during the outbreak in the United States.

Abstract

Longitudinal data are needed to examine effects of the COVID-19 pandemic on disordered eating. We capitalized on an ongoing, longitudinal study collecting daily data to examine changes in disordered eating symptoms in women across 49 days that spanned the time before and during the COVID-19 outbreak in the United States. Women from the Michigan State University Twin Registry (N = 402) completed daily questionnaires assessing a range of symptoms (e.g., binge eating, weight/shape concerns, liking/wanting of palatable food (PF) and whole foods, hunger). Dates of the first US COVID-19 case, first case in each participant's state, and onset of the initial stay-at-home orders (SHOs) were used to categorize women into those who completed all daily assessments prior to, during, or after these dates. We used mixed linear models and specification-curve analysis to examine between-person (i.e., differences between women assessed before vs during/after COVID-19) and within-person (i.e., changes in symptoms from days before to days after the dates) effects of the pandemic. Results showed significantly higher levels of binge-related pathology (e.g., odds of binge eating, liking/wanting of PF) in women who completed assessments during/after COVID-19 events, and significantly increased liking/wanting of PF in the days following the pandemic onset. By contrast, minimal between-or within-person differences were observed for other variables, including weight/shape concerns, compensatory behaviors, hunger, or liking/wanting whole foods. Overall, results suggest a specific effect of the pandemic on binge-related phenotypes in women. General Scientific SummaryThis study shows that the onset of the COVID-19 pandemic in the United States was associated with increased binge-eating pathology in women. The effects appear to be specific to binge eating and not present for other types of symptoms including body weight and shape concerns, compensatory behaviors, or overall levels of eating disorder symptoms.

A daily diary study of emotion regulation as a moderator of negative affect‐binge eating associations

“…Almost 1/3 of participants (31.8%) reported OBE at least once during the study. Though this proportion may seem relatively high for a non‐clinical sample, it is similar to the rate of OBEs in a previous longitudinal 45‐day population‐based study from our group (Klump et al, 2014; Mikhail et al, 2021), and could also reflect increased BE during COVID‐19 (Klump et al, in press). With respect to ER, DERS total scores were similar to published norms for women in the community (Gratz & Roemer, 2004) (mean = 75.82, SD = 21.49, range = 36–155).…”

Between- and within-person effects of stress on emotional eating in women: a longitudinal study over 49 days

“…EHE-BE spanned the onset of coronavirus disease 2019 (COVID-19), with 143 participants (30.2%) completing the study after the first US case. Though a prior study from our group found increased BE immediately after pandemic onset (Klump et al, in press ), there were no significant differences in between- or within-person associations between stress and EE pre- and post-COVID-19 (all p s >0.10; data not shown).…”

A cotwin control study of associations between financial hardship and binge eating phenotypes during COVID‐19

“…Analyses included 158 female twins (32 monozygotic twin pairs, 41 dizygotic twin pairs, and 12 individuals [4 from monozygotic pairs, 8 from dizygotic pairs] without cotwin data on financial stressors) ages 15–30 (mean = 22.13, SD = 3.71). All participants completed the study after the initial paper from our group examining increases in ED symptoms at the beginning of the pandemic (Klump et al, 2022 ). Because EHE‐BE focuses on the impact of combined oral contraceptives (COCs) on BE in women, eligibility criteria included: (1) member of a female same‐sex twin pair (as recorded on birth certificates/driver's licenses); (2) ≥1 twin taking COCs (participants not taking COCs required to have regular menstruation); (3) no pregnancy in the past year or lactation in the past 6 months; and (4) no history of genetic/medical conditions or current medications known to influence hormones/appetite/weight.…”

“…Analyses included 158 female twins (32 monozygotic twin pairs, 41 dizygotic twin pairs, and 12 individuals [4 from monozygotic pairs, 8 from dizygotic pairs] without cotwin data on financial stressors) ages 15-30 (mean = 22.13, SD = 3.71). All participants completed the study after the initial paper from our group examining increases in ED symptoms at the beginning of the pandemic (Klump et al, 2022).…”

“…In the current study, we used a longitudinal, cotwin control design to examine whether financial hardship measured over a 49‐day period was associated with dysregulated eating during COVID‐19. We focused on binge eating (BE) due to evidence that BE and related phenotypes may have increased more than other ED symptoms (e.g., dietary restraint, body dissatisfaction) in population‐based/community samples during the pandemic (De Pasquale et al, 2021 ; Klump et al, 2022 ; Ramalho et al, 2022 ). We examined a range of BE phenotypes, including clinically significant BE episodes as defined in the ICD‐11 (i.e., loss of control over eating during which a person perceives they have eaten too much regardless of the actual amount consumed; World Health Organization, 2019 ), dimensional BE symptoms (i.e., thoughts/urges/behaviors related to BE, such as fear of losing control over eating and eating large amounts in secret), and emotional eating (EE; i.e., eating in response to negative emotions, which is a strong correlate and predictor of clinical BE; Ricca et al, 2009 , 2012 ; Stice et al, 2002 ).…”