Eating disorders increased during pandemic in female adolescents and adults

Emergency department (ED) visits and hospital admissions for eating disorders increased during the COVID-19 pandemic in adolescents aged 10–17 years, as did ED visits among young adults and older adults, according to new research published in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.221318.

Using ICES data, researchers compared observed and expected rates of ED visits and hospitalizations for eating disorders before (Jan. 1, 2017, to Feb. 29, 2020) and during the pandemic (Mar. 1, 2020, to Aug. 31, 2022) in adolescents (10–17 years), young adults (18–26 years), adults (27–40 years) and older adults (41–105 years).

Key findings:

• The observed rate of ED visits for eating disorders in adolescents in the 30 months after the start of the pandemic was 7.38 per 100 000, representing a 121% increase over the expected rate.
• The rate of ED visits among young adults increased 13% above expected to 2.79 per 100 000, but was near expected among adults aged 27–40 years.
• The rate of hospital admissions among adolescents increased 54% to 8.82 per 100 000, but was at expected or lower across all adult age groups.

"A combination of risk factors — including isolation, increased time on social media, extended time spent with family, decreased access to care and fear of infection — may contribute to an increased risk of development or exacerbation of an eating disorder," writes Dr. Alene Toulany, an adolescent medicine specialist at The Hospital for Sick Children (SickKids) and adjunct scientist at ICES, Toronto, Ontario, with coauthors.

Additional factors that may have contributed to the increase in eating disorders include concern about health and exercise with the closure of gyms and other opportunities for physical activity and household stress.

The authors recommend more investment in eating disorder programs for adolescents and adults, as well as continued research.

"Our findings reveal significant variations in the utilization of acute care services for eating disorders across different age groups. This highlights the need for a nuanced approach to allocating mental health resources and expanding system capacity and resources dedicated to both adolescent and adult eating disorder programs," says Dr. Toulany.

"Further research is needed to determine the degree to which the surge in acute presentations is attributable to new eating disorders or exacerbation of pre-existing eating disorders," the authors conclude.