According to a study published in JAMA Pediatrics, cases of young people seeking care for eating disorders greatly increased in the months of the pandemic.
Eating disorders (EDs), such as anorexia nervosa and bulimia nervosa, impact a wide range of individuals. In the developmental stages of adolescent and young adulthood, EDs – especially restrictive ones – can have particularly negative impacts. Furthermore, EDs commonly co-occur with other mental health conditions which can influence the trajectory of illness. Individuals with EDs have greater mortality rates, partly due to increased suicidality.
EDs requires intensive specialist care, which is not often available in many settings. A rise in rates of anxiety and depression have been attributed to the COVID pandemic, as well as a worsening of ED. Possible reasons for this include uncertainty about the future, disruptions in daily routines, inconsistent access to food, more time spent in triggering environments, influence from the media, and changes in access to treatment.
Reports from hospitals indicated increasing numbers of diagnoses and hospital admissions for ED, but there was little geographically widespread data.
Therefore, the researchers set out to investigate trends in patient volume for inpatient medical hospitalisation as well as volume of patients seeking outpatient subspecialty care, both before and after the pandemic.
The researchers used an an observational case series design to compare changes in volume in inpatient and outpatient ED-related care at 15 sites between January 2018 and December 2021.
Before the COVID pandemic, the relative number of pooled inpatient ED admissions were increasing over time by 0.7% per month. After onset of the pandemic, there was a significant increase in admissions over time of 7.2% per month through April 2021, then a decrease of 3.6% per month through December 2021. Before the pandemic, relative outpatient ED assessment volume was stable over time, with an immediate 39.7% decline in April 2020. Thereafter, new assessments increased by 8.1% per month through April 2021, then decreased by 1.5% per month through December 2021. The nonhospital-based ED program did not demonstrate a significant increase in the absolute number of admissions after onset of the pandemic but did see a significant increase of 8.2 additional inquiries for care per month in the first year after onset of the pandemic.
“Given inadequate ED care availability prior to the pandemic, the increased postpandemic demand will likely outstrip available resources. Results highlight the need to address ED workforce and program capacity issues as well as improve ED prevention strategies.”