Eating disorders in times of the COVID‐19 pandemic—Results from an online survey of patients with anorexia nervosa

• Published in: International Journal of Eating Disorders 2020-11, Vol.53 (11), p.1791-1800
• Main Authors: Schlegl, Sandra, Maier, Julia, Meule, Adrian, Voderholzer, Ulrich
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adolescent; Adult; Anorexia; anorexia nervosa; Anorexia Nervosa - psychology; Anorexia Nervosa - therapy; Anxiety - etiology; coping strategies; Coronavirus Infections; COVID-19; COVID‐19 pandemic; Cross-Sectional Studies; Depression - etiology; Eating disorders; Exercise - psychology; Female; Germany; Health Behavior; health care utilization; Health Services Accessibility; Health services utilization; Health Surveys; Humans; Mental Health; Middle Aged; Original; Pandemics; Patient Acceptance of Health Care; Pneumonia, Viral; Psychological aspects; Severity of Illness Index; Sickness Impact Profile; symptoms worsening; Young Adult
• ISSN: 0276-3478; 1098-108X
• DOI: 10.1002/eat.23374

Objective The COVID‐19 pandemic and the resulting public restrictions pose a psychological burden for humans worldwide and may be particularly detrimental for individuals with mental disorders. Therefore, the current study explored effects of the COVID‐19 pandemic on eating disorder (ED) symptoms and other psychological aspects in former inpatients with anorexia nervosa (AN). Method One‐hundred and fifty‐nine patients with AN—discharged from inpatient treatment in 2019—completed an online survey on contact history with COVID‐19, changes in ED symptoms and other psychological aspects, health care utilization, and strategies patients employed to cope during the pandemic. Results Approximately 70% of patients reported that eating, shape and weight concerns, drive for physical activity, loneliness, sadness, and inner restlessness increased during the pandemic. Access to in‐person psychotherapies and visits at the general practitioner (including weight checks) decreased by 37% and 46%, respectively. Videoconference therapy was used by 26% and telephone contacts by 35% of patients. Patients experienced daily routines, day planning and enjoyable activities as the most helpful among the most used coping strategies. Discussion The COVID‐19 pandemic poses great challenges to patients with AN. ED‐related thoughts and behaviors may be used as dysfunctional coping mechanisms to regain control over the current circumstances. E‐mental health interventions appear to be promising for supporting AN patients during these hard times. Furthermore, interventions addressing symptoms of depression and anxiety, as well as intolerance of uncertainty might help them manage their ED symptoms.