The Relationship Between Women’s Negative Body Image and Disordered Eating Behaviors During the COVID-19 Pandemic: A Cross-Sectional Study

Abstract

Recent studies have shed light on how the COVID-19 pandemic changed our lives, and most of them have documented its detrimental effect on eating habits. Until now, the effects of this global crisis on negative body image and its association with disordered eating behaviors remain largely understudied. This study aimed to investigate changes in frequency of disordered eating behaviors (i.e., restrictive eating, emotional eating, and overeating) and negative body image (i.e., shape and weight concern, and body dissatisfaction) among a community sample of women during the COVID-19 pandemic (October 2020–May 2021). Furthermore, we explored the possible relation between body image-related variables and changes in the frequency of disordered eating behaviors in the context of the pandemic. A total of 161 self-identified female participants enrolled in an online-based survey. Descriptive statistics showed that women did not report clinically significant levels of weight and body shape concerns, but participants reported being dissatisfied with their body. One sample Wilcoxon Signed Rank tests revealed a tendency toward an increasing of the frequency of all disordered eating behaviors during the COVID-19 pandemic. Multinomial logistic regressions showed that weight concerns predicted an overall increase in the frequency of restrictive eating behaviors, whereas higher body dissatisfaction was associated with a moderate self-perceived increase in the frequency of emotional eating. These results shed light on a risk pattern of phenomena in a non-clinical sample of women, as they represent the key risk factors for the development of eating disorders. Findings could have implications for designing and implementing prevention programs.

Exploring the impact of the COVID-19 pandemic on perceptual disturbances and dysfunctional eating attitudes and behaviors: A review of the literature

“…At that time, perceptual disturbances were already related to a body shape that does not conform to the image accepted by society, therefore under enormous pressure and constant criticism ( Bruch, 1974 ). Furthermore, perceptual disturbances are a well-established core of disordered eating behaviors and eating disorders ( Stice et al, 1996 , 1998 ; Cash and Deagle III, 1997 ; Burrows and Cooper, 2002 ; Stice, 2002 , 2022 ; Fairburn et al, 2003 ; Neumark-Sztainer et al, 2003 ; Levine and Piran, 2004 ; Glashouwer et al, 2019 ; Andersen and Swami, 2021 ; Corno et al, 2022 ).…”

“…On one hand, threats of food shortages and perceived body shape and weight gain could have given rise to restrictive eating behaviors associated to over/excessive exercising ( Schlegl et al, 2020 ; Termorshuizen et al, 2020 ; Nisticò et al, 2021 ; Miskovic-Wheatley et al, 2022 ). On the other hand, accumulation of food stored up and stay-at-home orders could have increased the risk of overeating and binge eating episodes ( Di Renzo et al, 2020 ; Scarmozzino and Visioli, 2020 ; Schlegl et al, 2020 ; Touyz et al, 2020 ; Weissman et al, 2020 ; Corno et al, 2022 ; Weissman and Hay, 2022 ). Furthermore, stress and emotional reactions to the pandemic situation could have contributed to dysfunctional eating attitudes.…”

“…Furthermore, stress and emotional reactions to the pandemic situation could have contributed to dysfunctional eating attitudes. For instance, emotional eating could have been adopted as a dysfunctional coping mechanism to overcome pandemic-related stress and negative emotions ( Ferrell et al, 2020 ; Madalı et al, 2021 ; Corno et al, 2022 ; Sanlier et al, 2022 ). Life during the COVID-19 crisis could have been particularly challenging for people living with severe eating disorders or with a history of eating disorders, leading to a deterioration of symptoms and relapses ( Fernández-Aranda et al, 2020 ; Touyz et al, 2020 ; Weissman et al, 2020 ; Linardon et al, 2021 ; Todisco and Donini, 2021 ; Devoe et al, 2022 ).…”

Body perceptions, occupations, eating attitudes, and behaviors emerged during the pandemic: An exploratory cluster analysis of eaters profiles

“…A re-emergence of EDs symptoms has also been reported in former EDs patients ( Castellini et al, 2020 ; Graell et al, 2020 ; Schlegl et al, 2020b ; Miskovic-Wheatley et al, 2022 ). Research results are also raising concerns for the general population, reporting a marked increase of disordered eating behaviors such as meal skipping, overeating, binge eating, restrictive eating, and emotional eating among individuals with no history of EDs (e.g., Ammar et al, 2020 ; Cheikh Ismail et al, 2020 ; Di Renzo et al, 2020 ; Flaudias et al, 2020 ; Phillipou et al, 2020 ; Choukas-Bradley et al, 2022 ; Corno et al, 2022 ; Ramalho et al, 2022 ). An increasing number of studies published since the COVID-19 outbreak establish both an increase and a plurality of eating disorders in clinical population and disordered eating behaviors in the general population, especially in women and girls ( Robertson et al, 2021 ; Schafer et al, 2022 ).…”

“…The increase in disordered eating behaviors during the COVID-19 pandemic could be associated with incongruent eating in response to emotional and external social signals, rather than a congruent response to interoceptive bodily signals and eating behaviors. For instance, boredom during lockdown periods could have promoted overeating as a dysfunctional strategy to escape monotony, and negative experiences related to the pandemic situation could give rise to restrained eating caused by a stress reaction that emulates the visceral cues related to satiety ( Crockett et al, 2015 ; Corno et al, 2022 ; Sanlier et al, 2022 ). Pandemic-related stress could have also led to eating as a coping mechanism to face mood changes and negative emotions ( Madali et al, 2021 ; Corno et al, 2022 ; Sanlier et al, 2022 ).…”