The COVID-19 pandemic and eating disorders in children, adolescents, and emerging adults: virtual care recommendations from the Canadian consensus panel during COVID-19 and beyond

Couturier, Jennifer; Pellegrini, Danielle; Miller, Catherine; Bhatnagar, Neera; Boachie, Ahmed; Bourret, Kerry; Brouwers, Melissa; Coelho, Jennifer S.; Dimitropoulos, Gina; Findlay, Sheri; Ford, Catherine; Geller, Josie; Grewal, Seena; Gusella, Joanne; Isserlin, Leanna; Jericho, Monique; Johnson, Natasha; Katzman, Debra K.; Kimber, Melissa; Lafrance, Adèle; Leclerc, Anick; Loewen, Rachel; Loewen, Techiya; McVey, Gail; Norris, Mark L.; Pilon, David; Preskow, Wendy; Spettigue, Wendy; Steinegger, Cathleen; Waite, Elizabeth; Webb, Cheryl

doi:10.1186/s40337-021-00394-9

Cited by 40 publications

(34 citation statements)

References 122 publications

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“…In addition, the loss of the usual daily structure often associated with a feeling of loss of control might have reinforced typical symptoms of AN, such as weight phobia and body shape concerns. The overall recommendation to intensify teleconsulting and telepsychotherapy for patients with mental illness might not be fully suitable for these patients [ 22 ] because an assessment of weight is no longer guaranteed. Helpful alternatives could involve better information for paediatricians and health care workers to be aware of a developing ED during a pandemic and to include regular weight control in routine visits to the paediatrician or general practitioner, such as regular medical checks, as legalized in Germany at the ages of 12–14 and 16–17 years.…”

Section: Discussionmentioning

confidence: 99%

Increase in admission rates and symptom severity of childhood and adolescent anorexia nervosa in Europe during the COVID-19 pandemic: data from specialized eating disorder units in different European countries

Gilsbach

Plana

Castro‐Fornieles

et al. 2022

Child Adolesc Psychiatry Ment Health

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Background The COVID-19 pandemic, associated with confinement and social isolation, seems to have impacted the course of many mental disorders in children and adolescents. An increase in hospital admission rates for juvenile anorexia nervosa (AN) has been documented in many regions of the world. However, data from Europe are scarce. Methods We asked clinicians in specialized eating disorder units in hospitals of maximum care in France, Germany, Italy, Spain, Sweden, and the Netherlands to report on (i) overall (inpatient and outpatient) and (ii) inpatient admission rates for adolescents with AN during 2019 and 2020. Additionally, a modified version of the COVID Isolation Eating Scale (CIES) was used to assess the child and adolescent psychiatrists’ estimations of a possible increase in symptom severity in children and adolescents with AN during the COVID-19 pandemic and to (iii) inquire about the contributing factors perceived by the caring professionals. Results Four out of six representatives of European hospitals described a higher rate of overall admissions during the pandemic. Three hospitals out of six reported an increase in inpatient admissions, and two centres had constant high numbers of admissions of both outpatients and inpatients. The clinicians perceived a higher symptom severity in 2020 than in 2019, especially involving more frequent use of social media, longer duration of exercising, and more restrictive eating. They supposed an increase in social media consumption, a perceived “loss of control”, and a lack of in-person assessments and weight controls as the main contributing factors for the deterioration in AN numbers and symptomatology. Conclusions The COVID-19 pandemic seems to have had a deep impact on symptom severity in AN, which is mirrored by a large increase in admission rates across Europe. An increase in exercise, social media consumption, a perceived “loss of control”, and a lack of face-to-face health care seem to have contributed to this development. Further investigation is required to identify which factors may lead to the increase in incidence and deterioration of childhood and adolescent AN. Possible preventive means for the future could include educating paediatricians and health care workers about AN, regular weight assessment, and home-based treatments.

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Section: Discussionmentioning

confidence: 99%

Increase in admission rates and symptom severity of childhood and adolescent anorexia nervosa in Europe during the COVID-19 pandemic: data from specialized eating disorder units in different European countries

Gilsbach

Plana

Castro‐Fornieles

et al. 2022

Child Adolesc Psychiatry Ment Health

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“…10,15,16 There has been a substantial increase in emergency department visits and hospitalizations for eating disorders. 17 The loss of access to school-based healthcare services, special services for children with disabilities, and nutritional programs has profoundly affected the most vulnerable of children. 18 Substantial disruptions to critical developmental milestones, including increase in speech delay, have been seen, and children have missed out on opportunities for skill development.…”

Section: Findings Value Of In-person Learningmentioning

confidence: 99%

School Operation for the 2021-2022 Academic Year in the Context of the COVID-19 Pandemic

Science¹,

Thampi²,

Bitnun³

et al. 2021

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In-person learning is essential for the learning and overall well-being of children and youth. Therefore, barring catastrophic circumstances, schools should remain open for in-person learning.The level of community COVID-19 burden should inform the degree of school-based measures: the provided framework should be implemented at the regional level by public health units, considering local vaccination coverage rate and metrics of COVID-19 disease severity and to a lesser extent, SARS-CoV-2 transmission rate.Permanent measures that support the ongoing operation of schools, irrespective of the COVID-19 pandemic, include vaccination of all eligible individuals, exclusion of sick students and staff, hand hygiene, adequate ventilation, and environmental cleaning.Temporary measures (e.g., masking, physical distancing, cohorting) implemented in response to changes in COVID-19 disease burden should take into consideration student age, grade, and vaccination status.Re-initiation and maintenance of extracurricular activities (e.g., music, sports, clubs) is an important component of return-to-school plans.

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“…The rise led to the first guidelines on virtual care of eating disorders in children, adolescents, and emerging adults, published in April 2021 and produced by a Canadian consensus panel as part of a project funded by the Canadian Institutes of Health Research 5. Couturier, lead author of the guidelines, acknowledged they were based on the small amount of available evidence, but said the need for guidance was acute given that “the eating disorder population is particularly vulnerable and at significant risk of death should they not receive appropriate care.”…”

Section: Embracing Technologymentioning

confidence: 99%

Eating disorders during the covid-19 pandemic

Feinmann¹

2021

BMJ

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A spike in people seeking treatment for eating disorders during the covid-19 pandemic has revealed their global nature and severity. Jane Feinmann reports from the International Conference on Eating Disorders Jane Feinmann freelance journalistThe story often starts in a positive way."At a consultation, kids tell us that when the pandemic started, they decided to eat healthier and begin exercising more," said Ellen Rome, head of adolescent medicine at Cleveland Clinic, Ohio, USA. That positive start is the prelude to a tragic turn, however. "Then an adult will pick up the story and say, 'The next thing we knew, she'd lost 10 kg'," said Rome. "Other kids tell us that without a schedule they started eating when they were stressed or bored and 'suddenly the weight balloons.'" Rome was speaking at the International Conference on Eating Disorders in June. There were first-hand accounts of the problems faced by severely ill patients during the pandemic, with the closure or restriction of in-patient services being a major factor. Carolyn, the Canadian mother of an adult with anorexia who relapsed in late 2019, described how she drove her daughter to the local emergency department over 10 times during the pandemic. "Each time, they discharged her as soon as she was stabilised," Carolyn told the conference, explaining that her daughter's relapse was continuing.And while much media coverage came from Europe and North America, the pandemic has shown that disordered eating is a global epidemic."The belief that eating disorders are confined to high income countries is a dangerous myth that perpetuates health disparities," says Cynthia Bulik, professor of eating disorders at the University of North Carolina. The picture is skewed, with the available literature coming from only a few affected countries, Ravi Rajkumar of the Jawaharlal Institute of Postgraduate Medical Education and Research in Pondicherry, India, told the conference.

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The COVID-19 pandemic and eating disorders in children, adolescents, and emerging adults: virtual care recommendations from the Canadian consensus panel during COVID-19 and beyond

Cited by 40 publications

References 122 publications

Increase in admission rates and symptom severity of childhood and adolescent anorexia nervosa in Europe during the COVID-19 pandemic: data from specialized eating disorder units in different European countries

Increase in admission rates and symptom severity of childhood and adolescent anorexia nervosa in Europe during the COVID-19 pandemic: data from specialized eating disorder units in different European countries

School Operation for the 2021-2022 Academic Year in the Context of the COVID-19 Pandemic

Eating disorders during the covid-19 pandemic

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