The impact of the COVID-19 pandemic on help-seeking behaviors in individuals suffering from eating disorders and their caregivers

Richardson, Clifford; Patton, Megan; Phillips, Suzanne; Paslakis, Georgios

doi:10.1016/j.genhosppsych.2020.10.006

Cited by 59 publications

(85 citation statements)

References 18 publications

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“…This is consistent with other studies of the impact of COVID-19 on patients with EDs. Rates of ED symptoms (e.g., dieting, excessive exercise, purging), anxiety, and depression among AYA populations with EDs have been consistently higher during the pandemic compared to other years, as evidenced by a significant increase in the number of helpline calls and online instant chats with their National ED Centre in Canada [ 22 ]. Termorshuizen et al (2020) found that AYA participants with AN reported increased restrictive eating and fear about finding foods to follow their meal plans while those with bulimia nervosa and binge eating disorder reported increased binge-eating behaviors [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

COVID-19 and eating disorder and mental health concerns in patients with eating disorders

et al. 2021

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Background The Coronavirus (COVID-19) pandemic dramatically transformed daily life for adolescents and young adults, altering social and physical environments. Previous research has shown such shifts in daily life to be especially challenging for people living with eating disorders (ED). However, the extent of this environmental change on ED symptoms and mental health (MH) has been relatively unexplored in patients with EDs. This study examines how young people with EDs feel the COVID-19 pandemic has affected their living environments as well as their ED and MH symptoms and motivation for ED recovery. Methods Participants were enrollees in the Registry of Eating Disorders and their Co-morbidities OVER time in Youth (RECOVERY) who responded to an additional survey (n = 89) in July 2020 to assess their perceptions of the impact of the COVID-19 pandemic. Participants reported on concerns of their ED worsening due to increased time living in a “triggering environment” due to the pandemic as well as perceived COVID-related changes in intrusive ED thoughts, depression, anxiety, isolation, and motivation to recover. Logistic regression models, adjusted for age and ED diagnosis, examined the association of triggering environment with ED and MH symptoms. Results The majority of respondents reported concern for worsening of their ED due to a “triggering environment” (63%). Most reported an increase in ED thoughts (74%), feelings of anxiety (77%), depression (73%), and isolation (80%) they perceived to be related to the pandemic. Nearly one-third reported decrease in motivation to recover (29%) they perceived to be related to the pandemic. After adjusting for age and ED diagnosis, participants who reported concern for worsening of their ED due to a triggering environment had nearly 18 times the odds of decreased motivation to recover (OR 18.1; 95% CI 3.37–97.4, p = 0.003) and nearly 24 times the odds of increased ED thoughts (OR 23.8; 95% CI 4.31–131.6, p < 0.001) compared to those who did not report concern for worsening of their ED due to a triggering environment. Conclusions Our findings demonstrate the perceived negative impact the COVID-19 pandemic has had on the self-reported ED and MH symptoms in patients with EDs, particularly in those who report concern for a negative environmental change. These results underscore the need for heightened monitoring of patients with EDs during the pandemic.

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Section: Discussionmentioning

confidence: 99%

COVID-19 and eating disorder and mental health concerns in patients with eating disorders

et al. 2021

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“…This is supported by data from Italy and Germany showing aggravation or reoccurrence of ED psychopathology in patients with anorexia nervosa and bulimia nervosa (Castellini et al., 2020; Schlegl, Maier et al., 2020; Schlegl, Meule et al., 2020). Likewise, an international online survey reveals worsening of ED symptoms in a self‐selected sample of people with a history of ED (Termorshuizen et al., 2020); and service‐utilization data from Canada indicates increased ED‐related help‐seeking behaviour (Richardson et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

Eating behaviour and symptom trajectories in patients with a history of binge eating disorder during COVID‐19 pandemic

Giel¹,

Schurr²,

Zipfel³

et al. 2021

Euro Eating Disorders Rev

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Objective A history of an eating disorder (ED) might constitute a risk for symptom deterioration and relapse during COVID‐19 pandemic. This longitudinal study investigates ED symptom trajectories until the first COVID‐19 lockdown in Spring 2020 in patients with a history of binge eating disorder (BED). Method Participants of the randomised‐controlled BED treatment trial IMPULS participated in a re‐assessment directly after the first COVID‐19 lockdown in Germany. We used expert‐rated clinical interviews and self‐report to investigate binge eating (BE) frequency, ED and general psychopathology, distress, emotion regulation and sense of coherence. Symptom trajectories were analysed for baseline when entering the trial, end of trial participation and the time point directly after lockdown. BE frequency was assessed on a recall basis for 4 weeks directly before lockdown and 4 weeks during lockdown. Results BE frequency, general ED pathology and depressive symptoms markedly increased after as compared to before the COVID‐19 outbreak. Individuals scoring high on reappraisal as emotion regulation strategy and sense of coherence scored lower on general ED pathology. Conclusion Individuals with a history of an ED are at risk for symptom deterioration and relapse during the pandemic. Intervention and service dissemination strategies are needed to support vulnerable groups throughout the pandemic.

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“…As a result of the COVID-19 pandemic, mental health care, including care for people with eating disorders, has had to rapidly transition to virtual delivery [ 1 – 3 ]. Reports indicate the exacerbation of symptoms for existing patients [ 4 – 6 ], and an increase in referrals to eating disorder services across age groups [ 7 ]. For children and adolescents specifically, the disruption to routines, social isolation, perceived lack of control and physical health anxieties have been linked to increased eating disordered cognitions and adverse mental health outcomes [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Is this the ‘new normal’? A mixed method investigation of young person, parent and clinician experience of online eating disorder treatment during the COVID-19 pandemic

et al. 2021

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Introduction Prior to the COVID-19 pandemic, research in virtual care for young people with eating disorders was preliminary and implementation rare. This study explored the experience of young people, parents and clinicians when therapy was transitioned to virtual provision as a result of the UK lockdown in March 2020. Methods A mixed-method approach was used in this study. Online questionnaires that included a mixture of rating (Likert scale) and free-text response questions were completed by 53 young people with any eating disorder, 75 parents and 23 clinicians. Questions focused on the experience of online treatment as well as the impact on engagement, perceived treatment efficacy and preferences around treatment mode in the future. Likert scale questions were analysed using a summary approach. Free-text responses were analysed qualitatively using reflexive thematic analysis. Results Responses to rating scale questions indicate satisfaction with treatment, good engagement and ability to manage technology. Young people who had transitioned care, rather than started care virtually in lockdown, rated therapy as less effective. However, individual accounts of experience were more varied. Reflexive thematic analysis of free-text responses identified key themes of 1) Making it work, 2) Home as a therapeutic space, and 3) Disrupted connection and 4) Into the future. Conclusions These results have implications for ongoing care during the pandemic and for future implementation of virtual care in the treatment of young people with eating disorders. Particular issues arising are the trade-off between accessibility and therapeutic engagement and depth and need for consideration of equal access to treatment in socially unequal societies.

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The impact of the COVID-19 pandemic on help-seeking behaviors in individuals suffering from eating disorders and their caregivers

Cited by 59 publications

References 18 publications

COVID-19 and eating disorder and mental health concerns in patients with eating disorders

COVID-19 and eating disorder and mental health concerns in patients with eating disorders

Eating behaviour and symptom trajectories in patients with a history of binge eating disorder during COVID‐19 pandemic

Is this the ‘new normal’? A mixed method investigation of young person, parent and clinician experience of online eating disorder treatment during the COVID-19 pandemic

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