How the pandemic impacted admissions for eating disorders

Connecting with others in a meaningful way, and experiencing a variety of activities with peers has been very difficult over the past 18 months, leading to mental health struggles for many. Additionally, the COVID-19 pandemic has altered health care utilization for non-COVID-19 reasons, with many elective surgeries being pushed back to a later time and many well-child visits that included routine vaccination didn’t occur. Initial data indicate that many adults and teenagers with eating disorders had worsening symptoms during this time. Investigators at C.S. Mott Children’s Hospital in Ann Arbor, Michigan, ran a study to determine whether the medical admission patterns for restrictive eating disorders in teenagers changed in comparison to the prepandemic numbers.¹

The investigators did a chart review of patients aged 10 to 23 years who were admitted to the hospital for restrictive eating disorders from March 2017 to March 2021. Restrictive eating disorders included avoidant or restrictive food intake disorder, anorexia nervosa, atypical anorexia nervosa, or unspecified eating disorders that were marked by some form of restriction. Nonrestrictive eating disorders were not included in the study because those patients were less likely to develop medical complications or malnutrition than those with restrictive disorders.

The investigators found that medical admissions linked to eating disorders had a significant increase during the pandemic. Overall, the total number of admissions (125) during the first 12 months of the pandemic, defined as April 1, 2020, through March 31, 2021) was more than double the average number (56) of admissions per year for the previous 3 years. The patient demographics were comparable before and during the pandemic, with one exception: patients admitted during the pandemic were less likely to have public insurance than patients admitted in the period before the pandemic.

Although the findings only include one institution, the investigators noted that they align with other studies on the subject. They noted that despite the pathogenesis of eating disorders still being a bit of mystery, that psychological factors and social influences play a role. Teenagers with low self-esteem or depressive symptoms are more likely to develop eating disorders and both of those factors worsened for many during the pandemic. The addition of disrupted exercise and eating routines may have aided the development of an eating disorder in teenagers who were at risk.

The investigators concluded that there was a significant increase in admissions linked to restrictive eating disorders during the pandemic. The investigators said that clinicians should be ready to provide care for restrictive eating disorders in teenagers as the pandemic continues.

Reference

1. Otto A, Jary J, Sturza J, et al. Medical admissions among adolescents with eating disorders during the COVID-19 pandemic. Pediatrics. September 10, 2021. Epub ahead of print. doi:10.1542/peds.2021-052201