A qualitative exploration of the impact of COVID-19 on individuals with eating disorders in the UK

Brown, Susan; Opitz, Marie-Christine; Peebles, A. Imogen; Sharpe, Helen; Duffy, Fiona; Newman, Emily

doi:10.1016/j.appet.2020.104977

Cited by 86 publications

(121 citation statements)

References 26 publications

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“…Reasons cited for this motivation included the convenience of tele-therapy, as well as concerns related to eating disorder symptoms and being at greater risk of contracting the virus. These findings are consistent with those from Brown et al (2020), who identified that many patients displayed an increased drive for recovery in response to the stressors experienced during COVID-19. During treatment, high levels of motivation can be harnessed to encourage behavior change and help patients achieve their recovery goals.…”

Section: Discussionsupporting

confidence: 90%

“…Eating disorder symptom improvement has been observed in a minority of cases (Branley-Bell & Talbot, 2020;Brown et al, 2020;Schlegl et al, 2020;Termorshuizen et al, 2020). In these studies, anywhere between 2% to 25% of patients cited positive outcomes associated with the pandemic (Branley-Bell & Talbot, 2020;Schlegl et al, 2020).…”

mentioning

confidence: 99%

“…In these studies, anywhere between 2% to 25% of patients cited positive outcomes associated with the pandemic (Branley-Bell & Talbot, 2020;Schlegl et al, 2020). Cited reasons for improvement of symptoms include increased social support, positive changes to daily routine and structure, and increased motivation for recovery (Branley-Bell & Talbot, 2020;Brown et al, 2020;Schlegl et al, 2020;Termorshuizen et al, 2020). The majority of participants in these studies at a diagnosis of anorexia nervous, or their specific eating disorder diagnosis was not known.…”

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confidence: 99%

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COVID-19 and binge eating: Patient perceptions of eating disorder symptoms, tele-therapy, and treatment implications

2021

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COVID-19 has been shown to detrimentally affect eating disorder symptoms, including increased dietary restriction and increased binge eating. However, research in this area is thus far limited. Additionally, as a result of the pandemic, many eating disorder treatments have converted to tele-health platforms, however, little is known about patient perceptions of this modality. The aim of the present, exploratory study was to qualitatively examine: (1) The impact of COVID-19 on binge eating spectrum disorder symptoms (2) Patient perceptions of tele-therapy, and (3) Ways to address COVID-19 in eating disorder treatment. Data were collected through one-on-one, semi-structured interviews (N = 11), conducted as part of a mid-program assessment for those undergoing individual, outpatient therapy for binge eating spectrum disorders. After thematic analysis, it was identified that patients reported both symptom deterioration and improvement during COVID-19. Factors surrounding social distancing and stay-at-home measures were found to both improve and worsen symptoms for different patients. Further, patients reported positive perceptions of tele-therapy, particularly appreciating the convenience of this modality. Finally, patients provided variable feedback on the incorporation of COVID-related concerns into their eating disorder treatment, with some participants wishing for this inclusion, and others viewing COVID-19 and their eating disorder as separate issues. Findings from the present study preliminarily identify ways in which binge eating spectrum disorder symptoms may have improved due to COVID-19 and indicate positive patient perceptions of tele-therapy. Our results may be used to inform the adaptation of future eating disorder treatment during COVID-19.

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Section: Discussionsupporting

confidence: 90%

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confidence: 99%

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confidence: 99%

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COVID-19 and binge eating: Patient perceptions of eating disorder symptoms, tele-therapy, and treatment implications

2021

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“…The findings of this analysis partially align with the hypotheses of Rodgers and colleagues [ 13 ], which posit that the COVID-19 pandemic worsens ED risk via limited access to care and social support networks, increased exposure to ED-specific media, and anxiety related to changing food quantity and quality. Reddit users included in this analysis frequently discussed the disruption to or cessation of ED treatment following the onset of the pandemic and struggled with limited access to both formal and informal support networks—a finding that supports the first hypothesis of Rodgers and colleagues [ 13 ] and expands on findings from a similar qualitative investigation conducted using a smaller sample of adults with self-reported ED [ 31 ]. Our findings also supported the third hypothesis of Rodgers and colleagues and suggested that changed food availability contributed to increased anxiety and ED behavior.…”

Section: Discussionsupporting

confidence: 59%

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

Nutley¹,

Falise²,

Henderson³

et al. 2021

JMIR Ment Health

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Background A growing body of evidence is suggesting a significant association between the COVID-19 pandemic and population-level mental health. Study findings suggest that individuals with a lifetime history of disordered eating behavior may be negatively affected by COVID-19–related anxiety, and prevention measures may disrupt daily functioning and limit access to treatment. However, data describing the influence of the COVID-19 pandemic on disordered eating behaviors are limited, and most findings focus on individuals in treatment settings. Objective The aim of this study is to characterize the experiences of Reddit users worldwide who post in eating disorder (ED)–related discussion forums describing the influence of the COVID-19 pandemic on their overall mental health and disordered eating behavior. Methods Data were collected from popular subreddits acknowledging EDs as their primary discussion topic. Unique discussion posts dated from January 1 to May 31, 2020 that referenced the COVID-19 pandemic were extracted and evaluated using inductive, thematic data analysis. Results Six primary themes were identified: change in ED symptoms, change in exercise routine, impact of quarantine on daily life, emotional well-being, help-seeking behavior, and associated risks and health outcomes. The majority of users reported that the COVID-19 pandemic and associated public health prevention measures negatively impacted their psychiatric health and contributed to increased disordered eating behaviors. Feelings of isolation, frustration, and anxiety were common. Many individuals used Reddit forums to share personal experiences, seek advice, and offer shared accountability. Conclusions Reddit discussion forums have provided a therapeutic community for individuals to share experiences and provide support for peers with ED during a period of increased psychiatric distress. Future research is needed to assess the impact of the COVID-19 pandemic on disordered eating behavior and to evaluate the role of social media discussion forums in mental health treatment, especially during periods of limited treatment access.

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“…While this change in environment may be supportive for some, for others it is potentially distressing. [20][21] Therefore, it is imperative to understand the role of these environmental disruptions on ED and mental health (MH)-related outcomes.…”

Section: Introductionmentioning

confidence: 99%

COVID-19’s Impact on Eating Disorder and Mental Health Concerns in Patients with Eating Disorders

Vitagliano

Jhe

Milliren

et al. 2021

Preprint

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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 the implications of the COVID-19 pandemic on ED and MH symptoms and motivation for ED recovery in adolescents/young adults. 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 the impact of the COVID-19 pandemic. Participants reported concerns of their ED worsening due to living in a “triggering environment” due to the pandemic as well as 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 MH and ED symptoms. Results The majority of respondents reported concern for “triggering environment” (63%), as well as increased ED thoughts (74%) and feelings of anxiety (77%), depression (73%), and isolation (80%) in response to the COVID-19 pandemic. Nearly one-third reported decrease in motivation to recover (29%). After adjusting for age and ED diagnosis, participants who reported 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 a triggering environment. Conclusions Our findings demonstrate the negative impact the COVID-19 pandemic has had on the self-reported MH and ED 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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A qualitative exploration of the impact of COVID-19 on individuals with eating disorders in the UK

Cited by 86 publications

References 26 publications

COVID-19 and binge eating: Patient perceptions of eating disorder symptoms, tele-therapy, and treatment implications

COVID-19 and binge eating: Patient perceptions of eating disorder symptoms, tele-therapy, and treatment implications

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

COVID-19’s Impact on Eating Disorder and Mental Health Concerns in Patients with Eating Disorders

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