The study shows that eating disorders among young people increased during the pandemic


Along with the many impacts of the Covid-19 pandemic on pediatric care, researchers have seen a significant increase in young adults seeking treatment for eating disorder behaviors.

In the United States, hospitalizations among young adults and adolescents with eating disorders rose at a rate of about 0.7 percent per month in the two years before the pandemic, according to a new study published Monday in the journal JAMA Pediatrics. But in 2020, the first year of the pandemic, this growth increased to an average of 7.2% per month.

From the spring of 2020 (when most of the Covid-19 restrictions/lockdowns were implemented) to the spring of 2021, the number of hospitalizations for eating disorders doubled. This number rose to a peak in April 2021.

“We were able to demonstrate that in several areas across the country, after the pandemic began, there were significant increases in patients with eating disorders, that this was not a one-off phenomenon,” said the study’s first author. Dr. Sydney Hartman-Munick, assistant professor of pediatrics at Chan Medical School in Massachusetts. “The results are consistent with what we felt working every day in our clinics and hospital.”

Individual hospitals reported a rise in eating disorder cases as a result of the pandemic, but this study was the first to show a nationwide impact, said Dr. Jason Nagata, assistant professor of pediatrics at the University of California, San Francisco. Nagata was not involved in the investigation.

The researchers tracked data from 14 “geographically diverse” hospital-based adolescent medicine programs and an outpatient eating disorder treatment program. Between 2018 and 2021, according to the study. The study showed an increase in the number of people seeking treatment, but could not say whether the pandemic caused it or whether the severity of cases was worse during the pandemic, Hartman-Munick said.

“Eating disorders have been and continue to be an important public health concern for adolescents and young adults,” she said. “Eating disorders can be severe, lifelong, and fatal, and recovery can take years even with timely and appropriate treatment.”

After the first year of the pandemic, the volume of new patients began to decline in 2021, but still remained at higher levels than before Covid-19.

“At the end of the study, they haven’t reached their pre-pandemic baseline, so the impact of the increase in volume may be felt for a long time,” Hartman-Munick said.

Hartman-Munick said there are many reasons the pandemic may be contributing to the increase in people seeking treatment for eating disorders.

It was a time of uncertainty, changes in daily routines, disruptions in food availability, health concerns and loss of control, he added.

The dramatic increase in numbers shows the need for more trained medical professionals to treat eating disorders, including mental health providers and dietitians with experience in eating disorders, she added.

“We need more capacity in eating disorder programs to accommodate more patients, and we need to expand resources for Medicaid patients who have the most treatment limitations,” Hartman-Munick said.

Primary care physicians need more guidance on the medical management of eating disorders, Nagata added.

Teens and young adults struggling with eating disorders need professional treatment, preferably with an interdisciplinary team that includes mental health, medical and nutrition providers, Nagata said.

“Eating disorders can lead to serious medical complications that affect the heart, brain, liver, kidneys and other organs,” he added.

It is important to know what to look for. These disorders can affect people of all genders, races, ethnicities, sexual orientations, ages, and body sizes.

“You can’t tell if someone has an eating disorder just by how they look,” Nagata said.

There’s a stereotype that only girls develop eating disorders, but boys can too, Nagata said. In boys, eating disorders often manifest as excessive exercise and an obsession with gaining muscle, sometimes with a focus on muscle-building supplements, he added. These cases are often under-reported and under-treated.

In general, warning signs for anyone with an eating disorder can include preoccupations with size, weight, food or exercise, which impairs a person’s quality of life, Nagata said. People with eating disorders can also withdraw from friends and routines.

“Other red flags include an individual fasting, significant caloric restriction, vomiting, or using laxatives or diet pills to lose weight,” he said.

Families should raise concerns with a health care provider if they see these signs, Nagata said. A professional can assess an eating disorder and direct families to resources they can use next, she added.

Parents, caregivers, and teens can call the Eating Disorders Association’s helpline (800-931-2237) for guidance.