A systematic scoping review of research on COVID‐19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field

Abstract

Objective Research investigating the effects of COVID‐19 on eating disorders is growing rapidly. A comprehensive evaluation of this literature is needed to identify key findings and evidence gaps to better inform policy decisions related to the management of eating disorders during and after this crisis. We conducted a systematic scoping review synthesizing and appraising this literature. Method Empirical research on COVID‐19 impacts on eating disorder severity, prevalence, and demand for treatment was searched. No sample restrictions were applied. Findings ( n = 70 studies) were synthesized across six themes: (a) suspected eating disorder cases during COVID‐19; (b) perceived pandemic impacts on symptoms; (c) symptom severity pre versus during the pandemic; (d) pandemic‐related correlates of symptom severity; (e) impacts on carers/parents; and (f) treatment experiences during COVID‐19. Results Pandemic impacts on rates of probable eating disorders, symptom deterioration, and general mental health varied substantially. Symptom escalation and mental health worsening during―and due to―the pandemic were commonly reported, and those most susceptible included confirmed eating disorder cases, at‐risk populations (young women, athletes, parent/carers), and individuals highly anxious or fearful of COVID‐19. Evidence emerged for increased demand for specialist eating disorder services during the pandemic. The forced transition to online treatment was challenging for many, yet telehealth alternatives seemed feasible and effective. Discussion Evidence for COVID‐19 effects is mostly limited to participant self‐report or retrospective recall, cross‐sectional and descriptive studies, and samples of convenience. Several novel pathways for future research that aim to better understand, monitor, and support those negatively affected by the pandemic are formulated.

Anorexia and Young Womens’ Personal Networks: Size, Structure, and Kinship

“…These studies have demonstrated that during COVID-19 pandemic people with eating disorders have experienced elevated feelings of stress, fear, and anxiety. At the same time, our study participants did not note any change in their relations with people in their personal networks contrary to some of the other studies of the perceived social support among people with eating disorders during COVID-19 pandemic ( Sideli et al, 2021 ; Linardon et al, 2022 ). Perhaps our participants were able to maintain relationships with people from their personal networks via digital technologies that is why they did not notice any changes in their social networks.…”

“…They associate these changes with lockdown restrictions. Women also reported that they felt more anxious about their current and future educational and career prospects, which corresponds with studies of emotional wellbeing during COVID-19 pandemic among people with eating disorders ( Sideli et al, 2021 ; Linardon et al, 2022 ). These studies have demonstrated that during COVID-19 pandemic people with eating disorders have experienced elevated feelings of stress, fear, and anxiety.…”

Changes in the prevalence and sociodemographic correlates of eating disorder symptoms from 2013 to 2020 among a large national sample of U.S. young adults: A repeated cross‐sectional study

“…Future research is needed to examine how the identified prevalence estimates align with estimates for behavioral ED symptoms and confirmed ED diagnoses. Finally, the COVID‐19 pandemic has negatively impacted individuals' ED symptoms (Linardon et al, 2022). Although this impact is likely minimal among the present sample, as few participants (7.27%) completed the HMS post‐COVID onset, the role of COVID‐19 in relation to college students' ED symptoms should be assessed in future studies.…”

Clinicians’ perspectives on supporting individuals with severe anorexia nervosa in specialist eating disorder intensive treatment settings during the COVID-19 pandemic

“…Clinicians from a range of professional backgrounds with varying lengths of experience in EDs participated, allowing for an array of perspectives to be considered. Although clinicians were all based in the UK, the results of this study may be applicable elsewhere, as the COVID-19 pandemic has impacted ED services across the globe and many have had to adopt similar ways of working (e.g., partial closures, virtual treatment delivery) [ 5 , 8 , 43 , 44 ]. All DP services adapted, rather than closed, which is not representative of the wider UK picture, although positively, it highlights the possibility of virtual intensive ED treatment.…”