Eating disorders are a complex group of conditions associated with an abnormal preoccupation with food and bodyweight. The two most discussed eating disorders are Anorexia Nervosa, when one denies oneself food, and Bulimia Nervosa, which is associated with bouts of binge eating followed by purging. These disorders generally begin in adolescence or early adulthood and can lead to severe and sometimes fatal clinical outcomes if not addressed. Although the COVID-19 pandemic has been mitigated to a degree through aggressive public health measures and vaccination programs, the unforeseen consequences of the pandemic continue to emerge, especially in the mental health arena. Social isolation, stay-at-home orders, disruptions in much-needed psychiatric care, and other factors have led to increased rates of depression and anxiety. Early on, experts theorized that the COVID-19 pandemic would significantly impact those with eating disorders.
In October 2021, the results of a study evaluating hospital admission patterns in adolescents with eating disorders during the pandemic were published. Investigators reviewed charts of patients aged 10 to 23 years admitted to C.S. Mott Children’s Hospital in Ann Arbor, Michigan, between March 1, 2017, and March 31, 2021. Admission count before and after April 1, 2020, were compared. Investigators found that admission counts related to restrictive eating disorders increased significantly during the COVID-19 pandemic. The total number of hospital admissions was more than double the average number of admissions for the three prior years.
Although these results are limited to a single institution, findings are significant in that they support the growing observation that aggressive public health measures that have been required to reduce COVID-19 transmission have led to the worsening of a variety of mental health disorders. Adolescents are particularly vulnerable given the importance of routines and social functions that have been disrupted. Providers who manage adolescents with eating disorders and other mental health conditions should be prepared to respond to an increased demand for care. Primary care providers should be able to identify complications, signs of clinical deterioration, and indications for admission in adolescents with eating disorders.