Eating disorders during the COVID-19 pandemic: An overview of risks and recommendations for treatment and early intervention

Abstract

Individuals with eating disorders (EDs) are at significant risk for increases in symptomatology and diminished treatment access during the COVID-19 pandemic. Environmental precautions to limit coronavirus spread have affected food availability and access to healthy coping mechanisms, and have contributed to weight stigmatizing social media messages that may be uniquely harmful for those experiencing EDs. Additionally, changes in socialization and routine, stress, and experiences of trauma that are being experienced globally may be particularly deleterious to ED risk and recovery. This paper presents a brief review of the pertinent literature related to risk of EDs in the context of COVID-19 and offers suggestions for modifying intervention efforts to accommodate for the unique challenges individuals with EDs and providers may be experiencing in light of the ongoing public health crisis.

Eating disorder pathology and compulsive exercise during the COVID‐19 public health emergency: Examining risk associated with COVID‐19 anxiety and intolerance of uncertainty

“…Our findings are consistent with existing work documenting associations between trait intolerance of uncertainty, ED pathology, and compulsive exercise (Brown et al, 2017;Kesby et al, 2017;Scharmer et al, 2020). Results indicating that higher levels of COVID-19 anxiety and intolerance of uncertainty were associated with more severe ED pathology are also consistent with recent work evidencing COVID-19 increases in ED behaviors (e.g., Branley-Bell & Talbot, 2020;Phillipou et al, 2020) and publications predicting increases in ED risk associated with COVID-19 anxiety (e.g., Cooper et al, 2020;Rodgers et al, 2020). However, findings that neither COVID-19 anxiety nor COVID-19 intolerance of uncertainty were associated with compulsive exercise are surprising given established links between compulsive exercise and anxiety (Meyer et al, 2011) and intolerance of uncertainty (Scharmer et al, 2020).…”

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

“…The effects of the COVID-19 lockdown on individuals with an eating disorder could be broad ranging. While there may be potential for some protective consequences – e.g., reduced interpersonal triggers such as face-to-face body-based social comparisons ( Cooper et al, 2020 ), increased opportunity of support from loved ones ( Murphy, Calugi, Cooper, & Dalle Grave, 2020 ), or services embracing new technology in the delivery of psychological therapies ( Murphy et al, 2020 ) – the overwhelming concern within the field is the potential for severe, adverse impacts ( Weissman, Bauer, & Thomas, 2020 ). Initial small-scale pilot data from Spain indicates worsening of the mental health of individuals with an eating disorder including a deterioration in eating disorder symptomology for one third of respondents ( Fernández-Aranda et al, 2020 ).…”

“Now It's Just Old Habits and Misery”–Understanding the Impact of the Covid-19 Pandemic on People With Current or Life-Time Eating Disorders: A Qualitative Study

“…Responses to the pandemic at both the governmental and public level may make living with or recovery from an ED particularly challenging, and there has been much discussion about potential impacts on those with EDs (5)(6)(7)(8)(9). Hypothesized risk factors specific to these individuals include social isolation, changes in access to food, media messages around weight, limits on exercise, and reduced access to healthcare (10). High levels of worry, rumination and difficulties tolerating uncertainty, previously reported in those with EDs [e.g., (11)(12)(13)], may also play a role at a time when general population anxiety is higher (14).…”