International Journal of Eating Disorders

Volume 53, Issue 11 pp. 1780-1790

ORIGINAL ARTICLE

Early impact of COVID-19 on individuals with self-reported eating disorders: A survey of ~1,000 individuals in the United States and the Netherlands

Jet D. Termorshuizen MSc,

Jet D. Termorshuizen MSc

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands

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Hunna J. Watson PhD,

Hunna J. Watson PhD

orcid.org/0000-0001-8405-381X

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

School of Psychology, Curtin University, Perth, Western Australia, Australia

School of Paediatrics, Division of Medicine, The University of Western Australia, Perth, Western Australia, Australia

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Laura M. Thornton PhD,

Laura M. Thornton PhD

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Stina Borg MSc,

Stina Borg MSc

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

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Rachael E. Flatt MA,

Rachael E. Flatt MA

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Casey M. MacDermod BA,

Casey M. MacDermod BA

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Lauren E. Harper BS,

Lauren E. Harper BS

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Eric F. van Furth PhD,

Eric F. van Furth PhD

Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands

Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands

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Christine M. Peat PhD,

Christine M. Peat PhD

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Cynthia M. Bulik PhD,

Corresponding Author

Cynthia M. Bulik PhD

[email protected]

orcid.org/0000-0001-7772-3264

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Correspondence

Cynthia M. Bulik, Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7160, 101 Manning Drive, Chapel Hill, NC 27599-7160.

Email: [email protected]

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Jet D. Termorshuizen MSc,

Jet D. Termorshuizen MSc

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands

Search for more papers by this author

Hunna J. Watson PhD,

Hunna J. Watson PhD

orcid.org/0000-0001-8405-381X

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

School of Psychology, Curtin University, Perth, Western Australia, Australia

School of Paediatrics, Division of Medicine, The University of Western Australia, Perth, Western Australia, Australia

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Laura M. Thornton PhD,

Laura M. Thornton PhD

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Stina Borg MSc,

Stina Borg MSc

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

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Rachael E. Flatt MA,

Rachael E. Flatt MA

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Casey M. MacDermod BA,

Casey M. MacDermod BA

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Lauren E. Harper BS,

Lauren E. Harper BS

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Eric F. van Furth PhD,

Eric F. van Furth PhD

Rivierduinen Eating Disorders Ursula, Leiden, The Netherlands

Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands

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Christine M. Peat PhD,

Christine M. Peat PhD

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

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Cynthia M. Bulik PhD,

Corresponding Author

Cynthia M. Bulik PhD

[email protected]

orcid.org/0000-0001-7772-3264

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Correspondence

Cynthia M. Bulik, Department of Psychiatry, University of North Carolina at Chapel Hill, CB #7160, 101 Manning Drive, Chapel Hill, NC 27599-7160.

Email: [email protected]

Search for more papers by this author

First published: 28 July 2020

https://doi.org/10.1002/eat.23353

Citations: 197

Action Editor: Ruth Weissman

Eric F. van Furth, Christine M. Peat, and Cynthia M. Bulik contributed equally to this study.

Funding information: National Institute of Mental Health, Grant/Award Numbers: R01MH119084, R01MH120170; Substance Abuse and Mental Health Administration, Grant/Award Number: H79 SM081924; Vetenskapsrådet, Grant/Award Number: 538-2013-8864

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Abstract

Objective

We evaluated the early impact of COVID-19 on people with self-reported eating disorders.

Method

Participants in the United States (US, N = 511) and the Netherlands (NL, N = 510), recruited through ongoing studies and social media, completed an online survey that included both quantitative measures and free-text responses assessing the impact of COVID-19 on situational circumstances, eating disorder symptoms, eating disorder treatment, and general well-being.

Results

Results revealed strong and wide-ranging effects on eating disorder concerns and illness behaviors that were consistent with eating disorder type. Participants with anorexia nervosa (US 62% of sample; NL 69%) reported increased restriction and fears about being able to find foods consistent with their meal plan. Individuals with bulimia nervosa and binge-eating disorder (US 30% of sample; NL 15%) reported increases in their binge-eating episodes and urges to binge. Respondents noted marked increases in anxiety since 2019 and reported greater concerns about the impact of COVID-19 on their mental health than physical health. Although many participants acknowledged and appreciated the transition to telehealth, limitations of this treatment modality for this population were raised. Individuals with past histories of eating disorders noted concerns about relapse related to COVID-19 circumstances. Encouragingly, respondents also noted positive effects including greater connection with family, more time for self-care, and motivation to recover.

Discussions

COVID-19 is associated with increased anxiety and poses specific disorder-related challenges for individuals with eating disorders that require attention by healthcare professionals and carers.

CONFLICT OF INTEREST

C. M. B. reports: Shire (grant recipient, Scientific Advisory Board member); Idorsia (consultant); Pearson (author, royalty recipient); C. M. P. reports: Sunovion (Scientific Advisory Board member).

Open Research

DATA AVAILABILITY STATEMENT

Data availability: Data will be made available at the end of the 12-month follow-up period via the Open Science Framework.

Supporting Information

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Citing Literature

Volume53, Issue11

November 2020

Pages 1780-1790

Early impact of COVID-19 on individuals with self-reported eating disorders: A survey of ~1,000 individuals in the United States and the Netherlands

Abstract

Objective

Method

Results

Discussions

CONFLICT OF INTEREST

Open Research

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Early impact of COVID-19 on individuals with self-reported eating disorders: A survey of ~1,000 individuals in the United States and the Netherlands

Abstract

Objective

Method

Results

Discussions

CONFLICT OF INTEREST

Open Research

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

Citing Literature

References

Related

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley