Effects of COVID‐19 lockdown on eating disorders and obesity: A systematic review and meta‐analysis

Abstract

Objective: This systematic review and meta-analysis aimed to examine: the pooled prevalence of symptomatic behaviours and mental health deterioration amongst individuals with eating disorders (EDs) and obesity during the COVID-19 confinement. Moreover, we examined changes in EDs and distress before and during the confinement, and the association between psychosocial factors and EDs symptoms. Method: A systematic search was carried out in biomedical databases from January 2020 to January 2021. Both cross-sectional and longitudinal studies that used quantitative measures of ED symptoms and psychological distress during and after the COVID-19 confinement were included.Results: A total of 26 studies met inclusion criteria (n = 3399, 85.7% female). The pooled prevalence of symptomatic deterioration in EDs was 65% (95% CI [48,81], k = 10). The pooled prevalence of increased weight in obesity was 52% (95% CI [25,78], k = 4). More than half of the participants experienced depression and anxiety. Moreover, at least 75% of the individuals with EDs reported shape and eating concerns, and increased thinking about exercising. However, the pooled analyses of longitudinal studies showed no significant differences from pre-pandemic levels to the first lockdown phase in Body Mass Index and ED symptoms, whereas only few studies suggested increased distress, particularly among individuals with anorexia nervosa. Conclusions: The majority of individuals with EDs and obesity reported symptomatic worsening during the lockdown. However, further longitudinal studies are needed to identify vulnerable groups, as well as the long-term consequences of COVID-19.

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

“…These findings accord with broader trends of worsening mental health in the community from both cross‐sectional and longitudinal studies undertaken amidst COVID‐19 (Samji et al 2021 ; Vindegaard & Benros, 2020 ). While findings are also consistent with conclusion drawn from two earlier systematic reviews of COVID‐19 impacts on eating disorders (Miniati et al, 2021 ; Sideli et al, 2021 ), the present, updated review identified nearly four times as many eligible studies and highlighted much broader impacts of the pandemic on eating disturbances.…”

Telenutrition: Changes in Professional Practice and in the Nutritional Assessments of Italian Dietitian Nutritionists in the COVID-19 Era

“…Our results are in line with a survey conducted in other countries, where weight management was more common for freelance dietitians [ 17 ]. Numerous studies have shown that, during the COVID-19 lockdown, overweightness and obesity increased in all age groups [ 21 , 22 , 23 ]; therefore, the use of telenutrition for remote weight management was an excellent strategy for combating the increase in weight.…”

‘Feeling fat’ amid the COVID-19 pandemic: Examining the role of emotion dysregulation in the body displacement hypothesis

“…Individuals with pre-existing psychological conditions, including EDs, are especially impacted by the pandemic ( Belz et al, 2021 ; Favreau et al, 2021 ; Giel, Schurr, Zipfel, Junne, & Schag, 2021 ; Miller, Mehak, Trolio, & Racine, 2021 ). A meta-analysis found that 65% of individuals with EDs reported that their ED symptoms worsened during the pandemic ( Sideli et al, 2021 ). Further, binge eating increased during lockdown ( Cecchetto, Aiello, Gentili, Ionta, & Osimo, 2021 ), and alexithymia and emotion dysregulation were associated with increased emotional eating during the pandemic ( McAtamney, Mantzios, Egan, & Wallis, 2021 ).…”

“…As abovementioned, symptoms of virtually all psychological conditions have increased during the COVID-19 pandemic ( Davide et al, 2020 ; Giel et al, 2021 ; Necho, Tsehay, Birkie, Biset, & Tadesse, 2021 ; Sideli et al, 2021 ; Vindegaard & Benros, 2020 ), including those that are commonly comorbid with EDs such as anxiety, depression, and substance use disorder ( Agras, 2001 ). Further, emotion dysregulation is a transdiagnostic risk factor for psychopathology, with links to internalizing and externalizing disorders ( Aldao, 2012 ; Aldao & Nolen-Hoeksema, 2010 ; Fernandez, Jazaieri, & Gross, 2016 ).…”