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

Abstract

BACKGROUND A growing body of evidence suggests a significant association between the COVID-19 pandemic and population mental health. 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. Nevertheless, 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 To characterize the experiences of global Reddit users posting in eating disorder (ED)-related discussion forums, describing the influence of the COVID-19 pandemic on 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, 2020 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 COVID-19 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.