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Vavassori M, Donzelli G. Impact of COVID-19 restrictive measures during lockdown period on eating disorders: An umbrella review. Nutrition 2024; 124:112463. [PMID: 38749229 DOI: 10.1016/j.nut.2024.112463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 06/17/2024]
Abstract
The COVID-19 pandemic has sparked or amplified many mental health problems. The aim of this study was to compile evidence from existing systematic reviews to provide an overall assessment of the impact of social restrictions during the COVID-19 pandemic on people affected by eating disorders (EDs). PubMed and Scopus were searched up to August 16, 2023. Systematic reviews and meta-analyses were selected using the PRISMA 2020 statement. The quality assessment of the included studies was conducted using the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Eleven studies were included in this umbrella review. Six main categories emerged from the studies described in the review: dietary changes and psychopathological effects showed an overall worsening of symptomatology; in studies concerning the impact of isolation and restrictive measures, it was found that social distancing was associated with feelings of loneliness, anxiety, and depression; limited access to direct care was found and therapeutic changes were made; the influence of mass media negatively impacted people with ED; several studies reported positive findings regarding symptomatology; finally, studies regarding 'impact on vulnerable populations showed that vulnerable people are more at risk of reporting body image distortion and eating disorders. The COVID-19 pandemic has negatively impacted most of the population with ED leading to a worsening of specific symptomatology. In addition, this worsening of the condition may be caused by limited access to care and treatment, changes in routine, or to the negative influence of the media.
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Affiliation(s)
| | - Gabriele Donzelli
- Department of Pharmacy, University of Pisa, Pisa, Italy; Institute of Clinical Physiology of the National Research Council (CNR-IFC), Pisa, Italy
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Murphy-Morgan C, Brown R, Love C, Branley-Bell D. "Some distance between us": a UK mixed methods study exploring experiences of remote care for eating disorders during COVID-19. Front Psychiatry 2024; 15:1383080. [PMID: 38903648 PMCID: PMC11187335 DOI: 10.3389/fpsyt.2024.1383080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 05/20/2024] [Indexed: 06/22/2024] Open
Abstract
Introduction COVID-19 necessitated a rapid move from face-to-face services to remote care for eating disorders/eating distress (EDs). This study explores the advantages and challenges of remote care, identifying future implications for service provision. Remote care has been considered in the broadest of terms, including therapeutic care (e.g., Cognitive Behavioural Therapy, peer support, forums, one-to-one and group care options). Methods Using a mixed methods approach, data were collected from 211 people with lived experience of EDs (PWLE), with and without formal diagnosis. 27 participants took part in semi-structured interviews/workshops and a further 184 participants took part via an online survey. Participants reported on their ED status, the impact of the pandemic on symptoms, the benefits, and challenges of remote care (and type of support accessed), and any reasons for not accessing support. Participants were invited to make future care recommendations. Results ED symptoms were reported as worsening during the pandemic with contributing factors including isolation, lack of routine, negative emotions, and feeling like the external situation was outside of one's control. Remote care was positively attributed to increased flexibility and facilitation of social connection. Identified barriers to access included lack of awareness about support availability, digital access/literacy, and competing commitments. Further challenges included approaches being perceived as too clinical (e.g., ED information and support presented using clinical language and/or limited to support within medical care settings, without acknowledging the broader context of disordered eating), uncertainty around remote care quality, and concerns that remote platforms may facilitate masking of symptoms. Participants reported distress caused by online platforms where self-view is the default during video calls. They expressed a need for more holistic approaches to remote care, including: "real stories" of recovery, and hybrid (online and offline) options for greater flexibility and widening of access and choice. Participants also expressed a need for appropriate digital literacy training. Discussion Future recommendations emphasise user-centred holistic and hybrid approaches to ED remote support, with training to address digital literacy barriers and facilitate user control of platform functionalities (e.g., self-view). This study underscores the need for continued remote care with a focus on inclusivity and user empowerment.
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Affiliation(s)
- Claire Murphy-Morgan
- Department of Psychology, Northumbria University, Newcastle uponTyne, United Kingdom
| | - Richard Brown
- Department of Psychology, Northumbria University, Newcastle uponTyne, United Kingdom
| | - Charlotte Love
- School of Psychology, Newcastle University, Newcastle uponTyne, United Kingdom
| | - Dawn Branley-Bell
- Department of Psychology, Northumbria University, Newcastle uponTyne, United Kingdom
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Bracké K, Steegers C, van der Harst T, Pons R, Legerstee J, Dierckx B, de Nijs P, Bax-van Berkel M, van Elburg A, Hekkelaan M, Hokke J, de Jong-Zuidema H, Korthals Altes L, Lengton-van der Spil F, Luijkx J, Schuurmans F, Smeets C, van Wijk L, Woltering C, Vernooij M, Hillegers M, White T, Dieleman G. The implications of the COVID-19 pandemic on eating disorder features and comorbid psychopathology among adolescents with anorexia nervosa and matched controls: a comparative cohort design study. Eat Weight Disord 2024; 29:13. [PMID: 38347293 PMCID: PMC10861646 DOI: 10.1007/s40519-024-01640-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/28/2024] [Indexed: 02/15/2024] Open
Abstract
PURPOSE To examine implications of the COVID-19 pandemic on eating disorder (ED) features and psychopathology in female adolescents with anorexia nervosa (AN). METHOD In total 79 females with first-onset AN (aged 12-22 years) were included and were followed up across a period of 1 year. We assessed AN participants recruited pre-pandemic (n = 49) to those recruited peri-pandemic (n = 30). Pre- (n = 37) and peri-pandemic (n = 38) age-, and education-matched typically developing (TD) girls (n = 75) were used as a reference cohort. ED features and psychopathology were assessed at baseline. After 1 year of follow-up the association between pandemic timing and clinical course was assessed. Analyses of covariance were used to examine differences in ED features and psychopathology. RESULTS Peri-pandemic AN participants experienced less ED symptoms at baseline compared to pre-pandemic AN participants. In particular, they were less dissatisfied with their body shape, and experienced less interpersonal insecurity. In addition, the peri-pandemic AN group met fewer DSM-IV criteria for comorbid disorders, especially anxiety disorders. In contrast, peri-pandemic AN participants had a smaller BMI increase over time. In TD girls, there were no differences at baseline in ED features and psychopathology between the pre- and peri-pandemic group. CONCLUSION Overall, peri-pandemic AN participants were less severely ill, compared to pre-pandemic AN participants, which may be explained by less social pressure and peer contact, and a more protective parenting style during the pandemic. Conversely, peri-pandemic AN participants had a less favorable clinical course, which may be explained by reduced access to health care facilities during the pandemic. LEVEL OF EVIDENCE Level III: Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
- Katrien Bracké
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Cathelijne Steegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Tess van der Harst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Rozemarijn Pons
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Jeroen Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Bram Dierckx
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Pieter de Nijs
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | | | - Annemarie van Elburg
- Altrecht-Rintveld, Mental Health Care Organisation for Eating Disorders, Zeist, The Netherlands
| | - Marion Hekkelaan
- Department of Pediatrics, Het Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Joke Hokke
- Emergis-Ithaka, Mental Health Care Organisation for Child and Adolescent Psychiatry, Kloetinge, The Netherlands
| | - Hetty de Jong-Zuidema
- GGZ Delfland, Mental Health Care Organisation for Child and Adolescent Psychiatry, Delft, The Netherlands
| | - Lucas Korthals Altes
- LUMC-Curium, Mental Health Care Organisation for Child and Adolescent Psychiatry, Leiden, The Netherlands
| | - Farida Lengton-van der Spil
- Department for Eating Disorders, Emergis, Organisation for Mental Health and Well-Being, Goes, The Netherlands
| | - Judith Luijkx
- GGZ Westelijk Noord Brabant, Mental Health Care Organisation for Child and Adolescent Psychiatry, Roosendaal and Bergen Op Zoom, Bergen Op Zoom, The Netherlands
| | - Femke Schuurmans
- Department of Pediatrics, The Bravis Hospital, Bergen Op Zoom, The Netherlands
| | - Carien Smeets
- Department of Pediatrics, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Lia van Wijk
- Department of Pediatrics, Franciscus Gasthuis en Vlietland, Rotterdam, The Netherlands
| | - Claire Woltering
- Department of Pediatrics, Het Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - Meike Vernooij
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Manon Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
| | - Tonya White
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
- Section on Social and Cognitive Developmental Neuroscience, National Institutes of Mental Health, Bethesda, MD, USA
| | - Gwen Dieleman
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC-Sophia Children's Hospital, P.O. Box 2060, 3015 GD, Rotterdam, The Netherlands.
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Frances T, O'Neill K, Newman K. 'An extra fight I didn't ask for': A qualitative survey exploring the impact of calories on menus for people with experience of eating disorders. Br J Health Psychol 2024; 29:20-36. [PMID: 37518837 DOI: 10.1111/bjhp.12685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/21/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVES The UK government made it mandatory for large restaurants and cafes in England to display calorie labels on menus. Existing evidence identifies minimal potential for benefit, but significant potential for harm to those with eating disorders. To date, only one published study has directly explored the impact of this legislation on those with eating disorders. This study explores the impact of calorie labelling on menus on adults with experience of eating disorders in England. DESIGN A qualitative online survey was designed and distributed, and 399 adults with current or past experience/s of eating disorders completed the survey. METHODS Reflexive thematic analysis was used, informed by a critical realist approach. RESULTS Six themes were developed: (1) impacts on relationships, (2) exclusion and increased isolation, (3) restricted freedom, (4) dis/embodiment, (5) anger and frustration at the perpetuation of diet culture and (6) we are all responsible for ourselves. Most participants felt calorie labels on menus is detrimental to their eating disorder and/or recovery. People are navigating multiple opposing cultural narratives around health, bodies and eating disorder recovery that can put additional barriers in place to developing a relationship with food and body that they would like. CONCLUSIONS Calorie labelling on menus is likely to adversely impact those with eating disorders. Menus with calories should be available separately but should not be the first or only one provided. People with experience of eating disorders should be directly involved in the development of public health legislation and policy that is likely to affect them.
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Affiliation(s)
| | - Kel O'Neill
- Independent Counselling and Psychotherapy Practice, UK
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Murray F, Houghton S, Murphy F, Clancy E, Fortune D, McNicholas F. A Qualitative Exploration of Prominent Factors Contributing to the Aetiology of Child and Adolescent Eating Disorder Presentations during the COVID-19 Pandemic: The Perspectives of Patients, Parents and Clinicians. J Clin Med 2024; 13:615. [PMID: 38276121 PMCID: PMC10816259 DOI: 10.3390/jcm13020615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 01/27/2024] Open
Abstract
AIM The aim of this study was to explore the prominent factors that contributed to the development of child and adolescent eating disorder presentations during the COVID-19 pandemic. METHODS This was achieved through a qualitative analysis of interviews gathered from (1) adolescent patients diagnosed with an eating disorder (ED) during the COVID-19 pandemic (aged 13-18) (n = 4), (2) parents of patients attending an ED service (n = 7) and (3) clinicians working within a specialist child and adolescent ED support service (n = 7). Reflexive thematic analysis was used to analyse the data and establish the most prominent aetiological factors reported. RESULTS The most prominent aetiological factors reported were (1) the accumulation of risk factors; (2) seeking control amid increased anxiety, stress and uncertainty; (3) social isolation; (4) an increased focus on exercise and "healthy eating"; (5) increased social media use promoting unhelpful attention towards ED triggers; and (6) a lack of both awareness and support services. CONCLUSION During the COVID-19 pandemic, the quantity and severity of ED presentations increased. The current study uncovered six themes perceived by patients, parents and clinical staff that contributed to the aetiology of ED presentations during the COVID-19 pandemic. It is hoped that the insight gained through this research study into ED aetiology may act as a basis for further research and support ED awareness, prevention and intervention in the future.
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Affiliation(s)
- Finán Murray
- Department of Psychology, University of Limerick, V94 T9PX Limerick, Ireland
| | - Sharon Houghton
- Clinical Psychology Programme, Department of Psychology, University of Limerick, V94 T9PX Limerick, Ireland;
| | - Fay Murphy
- Lucena Clinic Child & Adolescent Mental Health Services, 59 Orwell Road, Rathgar, D06 HX93 Dublin, Ireland; (F.M.); (F.M.)
| | - Emma Clancy
- Lucena Clinic Child & Adolescent Mental Health Services, 59 Orwell Road, Rathgar, D06 HX93 Dublin, Ireland; (F.M.); (F.M.)
| | - Dónal Fortune
- Department of Psychology, University of Limerick, V94 T9PX Limerick, Ireland
| | - Fiona McNicholas
- Lucena Clinic Child & Adolescent Mental Health Services, 59 Orwell Road, Rathgar, D06 HX93 Dublin, Ireland; (F.M.); (F.M.)
- Children’s Health Ireland Crumlin, D12 N512 Dublin, Ireland
- School Medicine & Medical Sciences, University College Dublin, D04 V1W8 Dublin, Ireland
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Purvis F, Snowden J. Psychologically informed care of patients with anorexia nervosa on an acute medical ward. Nurs Stand 2024; 39:38-43. [PMID: 38152022 DOI: 10.7748/ns.2023.e12199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 12/29/2023]
Abstract
Anorexia nervosa is a challenging and highly distressing illness associated with significant and often debilitating symptoms that affect the person's physical and mental well-being, as well as their wider social networks. Although some patients can make important steps in their recovery in the community, many will become significantly unwell and require medical stabilisation and refeeding in an acute medical ward as a result of significant weight loss. This article describes some of the challenges experienced by adult nurses when caring for patients with anorexia nervosa on acute medical wards and explores how the patient's distress may manifest and complicate the recovery process. The article also discusses the principles of psychologically informed care and therapeutic interactions that nurses can use to promote recovery and ensure optimal practice.
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Affiliation(s)
- Francesca Purvis
- Department of Nursing, Midwifery and Health, School of Health Sciences, University of Southampton, Hampshire, England
| | - Jasmine Snowden
- Department of Nursing, Midwifery and Health, School of Health Sciences, University of Southampton, Hampshire, England
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7
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Martin S, Strodl E. The relationship between childhood trauma, eating behaviours, and the mediating role of metacognitive beliefs. Appetite 2023; 188:106975. [PMID: 37454578 DOI: 10.1016/j.appet.2023.106975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/18/2023]
Abstract
Disordered eating poses a significant risk to psychological and physical health. The experience of childhood trauma has been linked to the development of disordered eating behaviours, but the causal psychological mechanisms remain unclear. The metacognitive model holds promise as a potential framework for understanding the mediating psychological processes that explain how childhood trauma may lead to disordered eating. The purpose of this study was to examine the role of metacognitive beliefs mediating the relationship between childhood trauma and disordered eating behaviours. Adults from the Australian community (N = 461) completed an online self-report survey measuring childhood maltreatment (Childhood Trauma Questionnaire - Short Form), disordered eating behaviour (Three Factor Eating Questionnaire - Revised 21), and metacognitive beliefs (Metacognitive Questionnaire 30). Hierarchical multiple regression analyses revealed no independent associations between any forms of childhood maltreatment and cognitive restraint, while childhood emotional abuse was uniquely associated with uncontrolled eating and emotional eating. Through bootstrapping tests, the mediating effect between childhood trauma and uncontrolled and emotional eating consistently involved the metacognitive beliefs that thoughts are uncontrollable and dangerous. Future longitudinal research is required to confirm causal relationships.
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Affiliation(s)
- Sarah Martin
- School of Psychology and Counselling, Queensland University of Technology, Australia
| | - Esben Strodl
- School of Psychology and Counselling, Queensland University of Technology, Australia.
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Hunsicker M, Maloul E, Amanda K. G, Gilady D, Brownstone LM. Filling a gap: virtual clinician-led support groups for disordered eating. COUNSELLING PSYCHOLOGY QUARTERLY 2023. [DOI: 10.1080/09515070.2023.2192461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Teodoro MC, Conceição EM, Sinval J, de Lourdes M, Neufeld CB. Adaptation, confirmatory factor analysis, and psychometric properties of the Brazilian version of the Repetitive Eating Questionnaire. Int J Eat Disord 2023; 56:747-757. [PMID: 36965138 DOI: 10.1002/eat.23943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/27/2023]
Abstract
OBJECTIVE The Repetitive Eating Questionnaire (Rep(eat)-Q) is a brief self-report measure developed to assess grazing behavior-an understudied problematic eating behavior associated with eating disorder psychopathology and poor weight management. This study aimed to adapt and test the psychometric properties and factor structure of the Rep(eat)-Q in a Brazilian community sample. METHOD We used the International Test Commission guidelines for the adaptation of psychological measures between cultures. Participants were recruited from the community and on a university campus and completed a set of questionnaires including the Rep(eat)-Q, psychological measures, and sociodemographic data. RESULTS A total of 718 (86.4% female) completed the Rep(eat)-Q and were eligible for the confirmatory factor analysis (CFA). Only 542 completed the entire survey (Rep(eat)-Q and other psychological measures) and were eligible for the analysis of the validity evidence based on the relations to other variables. CFA revealed support for a two first-order model as originally proposed, however, a hierarchical (i.e., second-order) model is proposed. We found support for second-order scalar invariance across sex. Both first- and second-order internal consistency estimates presented very good evidence. Analysis (n = 542) revealed moderate to strong correlations (≥.58 to .77) between grazing (total score and subscales) and binge eating and other psychological measures, presenting good convergent evidence. DISCUSSION This study reports good psychometric properties of the Rep(eat)-Q for the Brazilian community sample. PUBLIC SIGNIFICANCE Grazing is a problematic eating behavior and the Rep(eat)-Q is one of the measures to assess grazing. The article aimed to adapt and test the psychometric properties of the Rep(eat)-Q in a Brazilian community sample. The results support a two-factor structure and suggest that the Rep(eat)-Q possesses good psychometric properties to be used with the Brazilian populations.
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Affiliation(s)
- Marília C Teodoro
- Psychology Department, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Eva M Conceição
- Psychology Department, Universidade do Minho-Braga, Braga, Portugal
| | - Jorge Sinval
- Business Research Unit (BRU-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
- Faculty of Philosophy, Sciences and Languages of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Evidence-Based Health, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- William James Center for Research, ISPA-Instituto Universitário, Lisbon, Portugal
| | - Marta de Lourdes
- Psychology Department, Universidade do Minho-Braga, Braga, Portugal
| | - Carmem B Neufeld
- Psychology Department, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
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Monthuy-Blanc J, Corno G, Abou Chabake S. Exploring the impact of the COVID-19 pandemic on perceptual disturbances and dysfunctional eating attitudes and behaviors: A review of the literature. Front Psychol 2023; 14:1139261. [PMID: 37008865 PMCID: PMC10050699 DOI: 10.3389/fpsyg.2023.1139261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
From the outbreak of the novel coronavirus 2019 (COVID-19) a new physical and social distancing environment has changed our lives and, more particularly, the way of perceiving oneself, as well as eating attitudes and behaviors. An increasing number of studies have highlighted a risky scenario in terms of negative perceptions of one’s body as well as disordered eating and eating disorder patterns in both clinical and general population. With regard to this postulate, this literature review posits two main concepts—perceptual disturbances and dysfunctional eating attitudes and behaviors—in the general and (sub-)clinical populations, to provide an understanding of these phenomena during the COVID-19 pandemic. The main objective of this article is to provide a comprehensive and critical review of published scientific literature about perceptual disturbances (i.e., negative body image, body image disturbances, low body esteem) and dysfunctional eating attitudes and behaviors, including disordered eating (e.g., restrictive eating, binge-eating episodes, overeating, emotional eating) and eating disorders features in community (i.e., general population) and clinical and sub-clinical samples worldwide during the COVID-19 pandemic. The PubMed, ScienceDirect, Ebsco, and Google Scholar databases were searched. The initial search produced 42 references. Scientific publications from March 2020 to April 2022 were included, and among the works compiled, only published research articles have been retained. Purely theoretical papers were also excluded. The final selection consisted of 21 studies, covering both community, clinical (i.e., eating disorder population), and sub-clinical samples. The details of the results are discussed taking into consideration the potential impact of changes in the way we perceive ourselves and interact with others (e.g., the popularity of videoconferencing and the over-use of social network sites due to social isolation) as well as changes in eating attitudes and behaviors, physical activity and exercise (e.g., as an emotional response to the insecurity generated by the pandemic context), in community and (sub-)clinical samples. The discussion sheds light on two outcomes: (1) a summary of findings with methodological considerations; (2) an intervention continuum to deal with the consequences of the COVID-19 pandemic; (3) and a final conclusion.
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Affiliation(s)
- Johana Monthuy-Blanc
- Loricorps Research Unit, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Department of Sciences of Education, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- *Correspondence: Johana Monthuy-Blanc,
| | - Giulia Corno
- Loricorps Research Unit, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Department of Psychology and Psychoeducation, Laboratory of Cyberpsychology, Université du Québec en Outaouais, Gatineau, QC, Canada
| | - Sara Abou Chabake
- Loricorps Research Unit, Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada
- Department of Psychology, LESPOIR Research Laboratory, Université de Montréal, Montréal, QC, Canada
- Department of Psychology, TRAJETS Research Laboratory, Université de Montréal, Montréal, QC, Canada
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Pegram G, Craddock N, Lewis-Smith H. "Like putting on an old pair of gloves" or "realising i am actually over it": a qualitative study exploring the impact of the COVID-19 pandemic lockdown restrictions on eating disorder recovery in the UK. CURRENT PSYCHOLOGY 2023:1-12. [PMID: 36845206 PMCID: PMC9944788 DOI: 10.1007/s12144-023-04353-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/17/2022] [Accepted: 01/31/2023] [Indexed: 02/24/2023]
Abstract
The COVID-19 pandemic lockdown restrictions posed unique challenges for people living with eating disorders (EDs), particularly relating to social isolation and changes in treatment access. However, less is known about the experience of lockdown for people 'in recovery' from EDs or disordered eating (DE) (i.e., with an ED/DE history). This study explored: (i) how people with a self-reported ED/DE history responded to and managed the experience of lockdown, specifically in relation to their recovery, and (ii) coping strategies for the management of recovery. Semi-structured interviews were conducted between June and August 2020 with 20 adults with a self-reported ED/DE history living in the UK. Data were analysed using inductive thematic analysis within a critical realist framework. Three overarching themes were identified: (1) Seeking safety and stability during a pandemic, (2) Lockdown prompting realisations about recovery, and (3) Exploring self-compassion as a more adaptive approach. While most participants experienced a resurgence in ED symptoms during lockdown, many reflected on the successful management of these as reinforcing their recovery. These findings have important implications for understanding ED recovery, in addition to informing interventions to better promote recovery during the COVID-19 pandemic and beyond. Supplementary information The online version contains supplementary material available at 10.1007/s12144-023-04353-2.
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Affiliation(s)
- Georgina Pegram
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, BS16 1QY Bristol, UK
| | - Nadia Craddock
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, BS16 1QY Bristol, UK
| | - Helena Lewis-Smith
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, BS16 1QY Bristol, UK
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12
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Brucki BM, Bagade T, Majeed T. A health impact assessment of gender inequities associated with psychological distress during COVID19 in Australia's most locked down state-Victoria. BMC Public Health 2023; 23:233. [PMID: 36732738 PMCID: PMC9894749 DOI: 10.1186/s12889-022-14356-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/29/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Since March 2020, when the COVID19 pandemic hit Australia, Victoria has been in lockdown six times for 264 days, making it the world's longest cumulative locked-down city. This Health Impact Assessment evaluated gender disparities, especially women's mental health, represented by increased levels of psychological distress during the lockdowns. METHODS A desk-based, retrospective Health Impact Assessment was undertaken to explore the health impacts of the lockdown public health directive with an equity focus, on the Victorian population, through reviewing available qualitative and quantitative published studies and grey literature. RESULTS Findings from the assessment suggest the lockdown policies generated and perpetuated avoidable inequities harming mental health demonstrated through increased psychological distress, particularly for women, through psychosocial determinants. CONCLUSION Ongoing research is needed to elucidate these inequities further. Governments implementing policies to suppress and mitigate COVID19 need to consider how to reduce harmful consequences of these strategies to avoid further generating inequities towards vulnerable groups within the population and increasing inequalities in the broader society.
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Affiliation(s)
- Belinda M Brucki
- School of Medicine & Public Health, College of Health Medicine & Wellbeing, University of Newcastle, Callaghan, NSW, Australia.
| | - Tanmay Bagade
- School of Medicine & Public Health, College of Health Medicine & Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Public Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Tazeen Majeed
- School of Medicine & Public Health, College of Health Medicine & Wellbeing, University of Newcastle, Callaghan, NSW, Australia
- Public Health Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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13
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Sheng R, Yang X, Zhou Y, Liu X, Xu W. COVID-19 and Eating Problems in Daily Life: The Mediating Roles of Stress, Negative Affect and Posttraumatic Stress Symptoms. Psychol Rep 2023; 126:34-51. [PMID: 34784823 PMCID: PMC9841454 DOI: 10.1177/00332941211045315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background The COVID-19 pandemic poses a challenge to individuals' mental health. People worldwide are experiencing increased stress, negative affect, and posttraumatic stress symptoms, which may lead to eating problems. The purpose of this study was to explore the impact of the perceived severity of COVID-19 on eating problems and the mediating effects of stress/negative affect/posttraumatic stress symptoms both at the personal level and interpersonal level. Methods: During the COVID-19 outbreak, a total of 108 college students were recruited to report their perceived severity of COVID-19, stress, negative affect, posttraumatic stress symptoms, and eating problems three times a day for seven consecutive days using Ecological Momentary Assessment. Results: State perceived severity of COVID-19 predicted fewer subsequent eating problems in daily life at the personal level. Both state negative affect and posttraumatic stress symptoms were positively associated with eating problems in daily life. At the interpersonal level, trait-like perceived severity of COVID-19, stress, negative affect, and posttraumatic stress symptoms were positively associated with overall eating problems. There were no mediating effects of stress/negative affect/posttraumatic stress symptoms on the relations between perceived severity of COVID-19 and eating problems at the personal/interpersonal level. Conclusions: The perceived severity of COVID-19, stress, negative affect, and posttraumatic stress symptoms might increase the risk of eating problems.
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Affiliation(s)
- Ruike Sheng
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Xiujie Yang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yuyang Zhou
- Department of Psychology, 5450Florida International University, Miami, Florida, United States
| | - Xiaoyan Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Wei Xu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China; School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China
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14
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Goode RW, Godoy SM, Wolfe H, Olson K, Agbozo B, Mueller A, Noem T, Malian H, Peat CM, Watson H, Thornton LM, Gwira R, Bulik CM. Perceptions and experiences with eating disorder treatment in the first year of COVID-19: A longitudinal qualitative analysis. Int J Eat Disord 2023; 56:247-256. [PMID: 36574733 PMCID: PMC9880652 DOI: 10.1002/eat.23888] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The COVID-19 pandemic created significant challenges in accessing and receiving treatment for individuals with eating disorders (EDs). The purpose of this study is to explore perceptions of and experiences with ED treatment during the first year of the pandemic among individuals with past and self-reported EDs in the United States. METHODS Online surveys were administered to adults (N = 510) with a past or current self-reported ED at 13 timepoints between April 2020 and May 2021. Using longitudinal qualitative analysis, 5651 free-text responses were examined to capture experiences with ED treatment and generate inferences of change over time. RESULTS We categorized results into four sequential, temporal quarters and identified patterns that explained participants' perceptions of facilitators, barriers, and experiences with ED treatment over time: Quarter 1. Treatment Disruption and Reorienting Recovery; Quarter 2. Accumulating COVID-19 Stress and Virtual Treatment Woes; Quarter 3. A Continuation of Inadequate Care; and Quarter 4. Ongoing Adaptation and Adjustment to Uncertainty. Participant experiences were marked by numerous barriers to accessing care, challenges adjusting to virtual treatment, unmet treatment needs, and beginning acceptance of telehealth. DISCUSSION Our findings present a timeline to help evaluate challenges related to navigating the switch to virtual care which created significant disruption to ED recovery. Participants spent much of the first year trying to adjust to unemployment, loss of insurance, and lack of access to in-person treatment. Future research should identify additional strategies to improve the receipt and experience of care for EDs. PUBLIC SIGNIFICANCE Our findings suggest that individuals with eating disorders were significantly challenged by accumulating COVID-19 stress, worsening symptomatology, and limited access to effective treatment during the first year of the pandemic. This knowledge can guide clinicians, treatment centers, and policy makers in addressing the behavioral health needs of individuals impacted by disordered eating amidst emergent public health crises.
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Affiliation(s)
- Rachel W. Goode
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Sarah M. Godoy
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hannah Wolfe
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Katie Olson
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Bridgette Agbozo
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Abigail Mueller
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Taylor Noem
- School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hannah Malian
- Department of Nutrition, Gillings School of Public HealthUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Christine M. Peat
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hunna Watson
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Discipline of Psychology, School of Population HealthCurtin UniversityPerthAustralia,Division of Paediatrics, School of MedicineThe University of Western AustraliaPerthAustralia
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Rebecca Gwira
- Department of Counseling and Psychological ServicesGeorgia State UniversityAtlantaGeorgiaUSA
| | - Cynthia M. Bulik
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
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15
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Thompson KA, Hedlund EL, Sun Q, Peat CM, Goode RW, Termorshuizen JD, Thornton LM, Borg S, van Furth EF, Birgegård A, Bulik CM, Watson HJ. Course and predictors of eating disorder symptoms, anxiety symptoms, and pandemic-related eating disorder concerns among adults with eating disorders during the first year of the COVID-19 pandemic. Int J Eat Disord 2023; 56:151-168. [PMID: 36508290 PMCID: PMC9877876 DOI: 10.1002/eat.23870] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 10/29/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The COVID-19 pandemic and public health mitigation measures have negatively impacted individuals with eating disorders (ED). We evaluated changes in and predictors of ED symptoms, pandemic-related ED concerns, and anxiety symptoms across the first 12 months of the COVID-19 pandemic among individuals with self-reported EDs in the United States (US), Sweden (SE), and the Netherlands (NL). METHOD Participants in the US (N = 510), SE (N = 982), and NL (N = 510) completed an online survey assessing ED symptoms (binge eating, restriction, compensatory behaviors, and anxiety about being unable to exercise), general anxiety symptoms, and pandemic-related ED concerns about accessing food, lack of structure and social support, being in a triggering environment, and food and treatment costs. In the US and NL, respondents completed surveys beginning April 2020 and continuing monthly for a year. In SE, respondents completed baseline surveys in May 2020, a six-month follow-up around December 2020, and a 12-month follow-up in May 2021. RESULTS Three patterns emerged: (1) a curvilinear course with the highest level of symptoms at baseline, declining through November 2020, and increasing through the rest of the year; (2) a linear declining course over time; and (3) a stable course with no changes. Worries about COVID-19 infection, lockdown, concerns about lack of structure and social support, and concerns about accessing food consistent with one's recovery meal plan predicted increases in ED symptoms. DISCUSSION ED symptoms tracked with pandemic-related concerns in people with EDs. Conceptualizing predictors of symptoms may inform therapy and public health resources that reduce the impact of pandemics on mental health. PUBLIC SIGNIFICANCE Our findings suggest that the COVID-19 pandemic had negative impacts on people with eating disorders, including amplification of mental health symptoms and stressors around peak periods of infection and COVID-19 restrictions. These findings inform medical providers, policy-makers, and community-based supports about the information and resource needs of this group to ensure efficient dissemination in future public health emergencies and during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Katherine A. Thompson
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Elin L. Hedlund
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Quan Sun
- Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Christine M. Peat
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Rachel W. Goode
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,School of Social WorkUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Jet D. Termorshuizen
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Rivierduinen Eating Disorders UrsulaLeidenthe Netherlands
| | - Laura M. Thornton
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Stina Borg
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Eric F. van Furth
- Rivierduinen Eating Disorders UrsulaLeidenthe Netherlands,Department of PsychiatryLeiden University Medical CenterLeidenthe Netherlands
| | - Andreas Birgegård
- Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Cynthia M. Bulik
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden,Department of NutritionUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Hunna J. Watson
- Department of PsychiatryUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA,Discipline of Psychology, School of Population HealthCurtin UniversityPerthAustralia,Division of Paediatrics, School of MedicineThe University of Western AustraliaPerthAustralia
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16
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Memon MA, Shaikh S, Mirza MZ, Obaid A, Muenjohn N, Ting H. Work-From-Home in the New Normal: A Phenomenological Inquiry into Employees' Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:48. [PMID: 36612370 PMCID: PMC9819185 DOI: 10.3390/ijerph20010048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has forced employees to adapt and adjust to the new normal in an unprecedented way. While some employees have been able to move to work-from-home (WFH) relatively easily, many find it challenging. Notwithstanding the magnitude of change, little is known about the determinants of WFH employees' mental health during COVID-19. This study therefore aims to explore (1) the salient factors that contribute to the mental health issues of WFH employees and (2) strategies to overcome WFH challenges. A qualitative approach using phenomenological inquiry was adopted. Forty-one employees who worked from home in Pakistan were sampled using the purposive and snowball sampling techniques. Data was collected via semi-structured interviews and analyzed using thematic analysis. Overall, employees believe that organizations offer inadequate support in both work-related and non-work-related matters. Five themes were elicited and coded as factors that contribute to mental health issues among WFH employees. Technical issues and system complexities, the absence of flexible working arrangements, distractions, a lack of communication, and inadequate social support were found to obstruct WFH and cause mental distress. Behavioral and cognitive coping strategies were also determined to tackle these mental issues. This study complements the human resource literature by exploring the factors that obstruct WFH and cause mental health issues in the context of the pandemic crisis. As mental well-being is more intricate than administrative arrangements, the study is useful for organizations to develop a feasible mechanism that facilitates the smooth execution of WFH for employees while ensuring their mental health is preserved. Using a phenomenological inquiry, the present study is one of the few to explore the factors that contribute to the mental health of WFH employees in the context of the pandemic crisis. Apart from its contribution to knowledge on human resource management and organizational behavior, it provides useful implications for managers, policymakers, and practitioners to manage WFH employees more effectively.
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Affiliation(s)
- Mumtaz Ali Memon
- NUST Business School, National University of Sciences and Technology, Islamabad 44000, Pakistan
| | - Saba Shaikh
- Department of Management Sciences, National University of Modern Languages Hyderabad Campus, Hyderabad 71000, Pakistan
| | - Muhammad Zeeshan Mirza
- NUST Business School, National University of Sciences and Technology, Islamabad 44000, Pakistan
| | - Asfia Obaid
- NUST Business School, National University of Sciences and Technology, Islamabad 44000, Pakistan
| | - Nuttawuth Muenjohn
- School of Management, College of Business and Law, RMIT University, Melbourne 3000, Australia
| | - Hiram Ting
- Department of Tourism and Commerce, UCSI University, Kuching 93000, Malaysia
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17
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A Multicenter Network Analysis Examining the Psychological Effects of the COVID-19 Pandemic on Patients with Eating Disorders versus Their Healthy Siblings. J Clin Med 2022; 11:jcm11237187. [PMID: 36498760 PMCID: PMC9736149 DOI: 10.3390/jcm11237187] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
(1) Background: The impact of the COVID-19 pandemic on individuals with eating disorders (EDs) has been recorded all over the world; the traumatic effects of COVID-19 have exacerbated specific and general psychopathologies in those with EDs. Comparing patients' and their healthy siblings' responses might help one evaluate whether there are significant differences between healthy individuals and those struggling with EDs in regard to posttraumatic psychological symptoms. (2) Methods: A sample of 141 ED patients and 99 healthy siblings were enrolled in this study in two different centers specializing in ED treatment. All participants completed the posttraumatic stress disorder (PTSD) checklist and an eating and general psychopathological self-report questionnaire. Network analysis was then applied to evaluate the differences between the populations. (3) Results: No significant differences emerged between the network structures despite the significant differences between patients and their healthy siblings in regard to posttraumatic symptoms, eating, and general psychopathology. (4) Conclusion: The complex nature of the interaction between environmental and personal factors should be evaluated further in individuals with EDs due to how they respond to traumatic events, which exacerbate patients' psychopathology.
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18
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Goode RW, Malian H, Samuel-Hodge C, Noem T, Coan D, Takgbajouah M, Bahena L, Bulik CM. The impact of COVID-19 on Black women who binge-eat: a qualitative study. Eat Weight Disord 2022; 27:3399-3407. [PMID: 36059023 PMCID: PMC9441135 DOI: 10.1007/s40519-022-01472-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/21/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Although studies have traced the impact of COVID-19 on those with eating disorders, little is known about the specific impact of the pandemic on Black American women who report disordered eating behaviors and are at risk for eating disorders. Thus, the purpose of this study is to investigate the impact of COVID-19 on Black women who binge-eat. METHODS We recruited a purposive sample during the first wave of COVID-19 from the southeastern United States. Participants identified as Black women, reported binge-eating episodes in the last 28 days, and agreed to participate in a semi-structured interview. Prior to the interview, participants were administered a socio-demographic survey and the Eating Disorder Examination-Questionnaire. Interviews were transcribed verbatim and analyzed independently using qualitative content analysis and open coding to identify relevant codes and themes. RESULTS On average, participants (N = 20) were 43.05 ± 16.2 years of age and reported 5.6 ± 5.7 binge-eating episodes in the last 28 days. We identified six themes to describe participants' experiences managing their eating behavior during COVID-19: (1) food as a coping strategy; (2) lack of control around food; (3) increased time in a triggering environment (e.g., being at home with an easy availability of food); (4) lack of structure and routine; (5) challenges with limited food availability; and (6) positive impact of the pandemic. CONCLUSION In this study, Black women reported challenges managing their eating behavior during COVID-19. Results could inform the development and tailoring of treatments for Black women reporting disordered eating behaviors. LEVEL OF EVIDENCE Level V, qualitative interviews.
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Affiliation(s)
- Rachel W Goode
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Hannah Malian
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Carmen Samuel-Hodge
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Taylor Noem
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Danielle Coan
- School of Social Work, North Carolina State University, Raleigh, NC, USA
| | | | - Lisette Bahena
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Cynthia M Bulik
- Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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19
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McLean CP, Utpala R, Sharp G. The impacts of COVID-19 on eating disorders and disordered eating: A mixed studies systematic review and implications. Front Psychol 2022; 13:926709. [PMID: 36148134 PMCID: PMC9487416 DOI: 10.3389/fpsyg.2022.926709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose The unique constraints to everyday life brought about by the COVID-19 pandemic have been suggested to negatively impact those with pre-existing mental health issues such as eating disorders. While individuals with eating disorders or disordered eating behaviors likely represent a vulnerable group to the COVID-19 pandemic, the impact of the pandemic is yet to be fully established. Methods We systematically examined the impact of the COVID-19 pandemic on eating disorders and disordered eating behaviors. We searched electronic databases MEDLINE, PsycINFO, CINAHL, and EMBASE for literature published until October 2021. Eligible studies were required to report on individuals with or without a diagnosed eating disorder or disordered eating behaviors who were exposed to the COVID-19 pandemic. Findings Seventy-two studies met eligibility criteria with the majority reporting an increase in eating disorder or disordered eating behaviors associated with the COVID-19 pandemic. Specifically, it appears children and adolescents and individuals with a diagnosed eating disorder may present vulnerable groups to the impacts of the COVID-19 pandemic. Discussion This mixed systematic review provides a timely insight into COVID-19 eating disorder literature and will assist in understanding possible future long-term impacts of the pandemic on eating disorder behaviors. It appears that the role of stress in the development and maintenance of eating disorders may have been intensified to cope with the uncertainty of the COVID-19 pandemic. Future research is needed among understudied and minority groups and to examine the long-term implications of the COVID-19 pandemic on eating disorders and disordered eating behaviors. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=284749, PROSPERO [CRD42021284749].
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Affiliation(s)
- Courtney P. McLean
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, VIC, Australia
- *Correspondence: Courtney P. McLean
| | | | - Gemma Sharp
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, VIC, Australia
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20
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Freizinger M, Jhe GB, Dahlberg SE, Pluhar E, Raffoul A, Slater W, Shrier LA. Binge-eating behaviors in adolescents and young adults during the COVID-19 pandemic. J Eat Disord 2022; 10:125. [PMID: 36002838 PMCID: PMC9399990 DOI: 10.1186/s40337-022-00650-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic and subsequent public health measures have resulted in a worsening of eating disorder symptoms and an increase in psychological distress. The present study examined symptoms and behaviors in adolescents and young adults with emotional eating, bingeing behaviors and binge eating disorder during the pandemic. Additionally, the study explored if individuals who experienced pandemic-related food availability and food affordability issues experienced increased binge-eating symptoms and negative feelings. METHOD Participants (n = 39) were a convenience sample who participated between November 2020 and January 2021 in a weight and lifestyle management program at an urban New England pediatric hospital. Participants completed online surveys that assessed (1) participant's exposure to COVID-19 related stress and binge-eating behaviors using the COVID-19 Exposure and Family Impact Survey-Adolescent and Young Adult Version (CEFIS-AYA) and the Binge Eating Scale (BES) respectively, (2) participants' and their families' ability to attain and afford food and its association with bingeing behaviors, and (3) the relationship between food availability and affordability and negative emotions. RESULTS Nearly half of all participants (48.7%) reported moderate to severe bingeing during the COVID-19 pandemic; those who experienced greater COVID-related stress reported more binge-eating behaviors (p = 0.03). There were no associations between indicators of food availability and affordability and binge eating or between food availability and affordability and negative feelings. CONCLUSIONS Higher pandemic-related stress was associated with more binge-eating behaviors among adolescents and young adults. These results underscore the need to monitor symptoms and provide treatment for these patients despite barriers to care imposed by the COVID-19 pandemic. Research and clinical care for adolescents and young adults with EDs must recognize and respond to pandemic effects across the weight and disordered eating spectrum.
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Affiliation(s)
- Melissa Freizinger
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA. .,Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. .,Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 333 Longwood Avenue, 5th Floor, Boston, MA, USA.
| | - Grace B Jhe
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Suzanne E Dahlberg
- Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.,Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Emily Pluhar
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Amanda Raffoul
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Wallis Slater
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Lydia A Shrier
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
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21
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Mills DJ, Petrovic J, Mettler J, Hamza CA, Heath NL. The good, the bad, and the mixed: Experiences during COVID-19 among an online sample of adults. PLoS One 2022; 17:e0269382. [PMID: 35749457 PMCID: PMC9231712 DOI: 10.1371/journal.pone.0269382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 05/19/2022] [Indexed: 11/29/2022] Open
Abstract
Studies have outlined the negative consequences of the COVID-19 pandemic to psychological health. However, the potential within-individual diversity of experiences during COVID-19, and how such experiences relate to indices of psychological distress and COVID-19-specific stressors, remains to be explored. A large online sample of American MTurk Workers (N = 3,731; Mage = 39.54 years, SD = 13.12; 51.70% female) completed short assessments of psychological distress, COVID-19-specific stressors (e.g., wage loss, death), and seven items assessing negative and positive COVID-19 experiences. Latent profile analyses were used to identify underlying profiles of COVID-19 experiences. A four-profile solution was retained representing profiles that were: (1) predominantly positive (n = 839; 22.49%), (2) predominantly negative (n = 849; 22.76%), (3) moderately mixed (n = 1,748; 46.85%), and (4) high mixed (n = 295; 7.91%). The predominantly positive profile was associated with lower psychological distress, whereas both the predominantly negative and high mixed profiles were associated with higher psychological distress. Interestingly, specific COVID-19 stressful events were associated with the high mixed profile. The present study challenges the narrative that the impacts of COVID-19 have been unilaterally negative. Future directions for research are proposed.
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Affiliation(s)
- Devin J. Mills
- Department of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, Texas, United States of America
- * E-mail:
| | - Julia Petrovic
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Jessica Mettler
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Chloe A. Hamza
- Department of Applied Psychology and Human Development, University of Toronto, Toronto, Canada
| | - Nancy L. Heath
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
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22
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Eating Disorders and Intimate Partner Violence: The Influence of Fear of Loneliness and Social Withdrawal. Nutrients 2022; 14:nu14132611. [PMID: 35807792 PMCID: PMC9268080 DOI: 10.3390/nu14132611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/16/2022] [Accepted: 06/20/2022] [Indexed: 02/04/2023] Open
Abstract
Eating disorders are vulnerability factors that increase the likelihood of intimate partner violence. However, the mechanisms underlying this relationship are unclear. Although eating disorders have been associated with increased perception and fear of loneliness, they have also been associated with increased social withdrawal resulting from decreased enjoyment of social situations and poorer social functioning. The purpose of the present study was to examine the mediating role of fear of loneliness in the relationship between the behavioural characteristics of eating disorders and intimate partner violence, as well as to explore the moderating role of social withdrawal in the relationship between fear of loneliness and intimate partner violence. The sample comprised 683 participants (78% female and 22% male) with a mean age of 21.14 years (SD = 2.72). The psychometric scales used were Eating Disorders Inventory (EDI 2), Emotional Dependency Questionnaire (EDQ), Coping Strategies Inventory (CSI) and the Violence Received, Exercised and Perceived in Youth and Adolescent Dating Relationships Scale (VREPS). The hypothesised model was tested by path analysis using maximum likelihood. The path analysis of the hypothesised model showed that inefficacy, fear of maturity, and impulsivity were the behavioural characteristics of eating disorders predominantly related to fear of loneliness. Fear of loneliness had no direct significant effect on any of the received violence variables. However, interaction effects indicated that there was a moderately significant effect of fear of loneliness on physical, psychological, and social violence received as a function of levels of social withdrawal. These findings show the need to take into account and work on fear of loneliness and social withdrawal among individuals with an eating disorder to decrease the likelihood of establishing violent intimate partner relationships. Improving interpersonal functioning and social support is key to recovery from eating disorders.
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Impacts of COVID-19 Sanitary Cues on Hedonic Appreciation of Foods. Foods 2022; 11:foods11121753. [PMID: 35741951 PMCID: PMC9222980 DOI: 10.3390/foods11121753] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/02/2022] [Accepted: 06/10/2022] [Indexed: 02/05/2023] Open
Abstract
The COVID-19 pandemic led to several lifestyle changes, including eating behavior. Herein, we aimed to evaluate how pandemic-related sanitary cues presented in food videos impact food appraisal and desire to eat, and their priming after-effects on subsequent food pictures presented without such cues. In two online sessions, separated by 4 to 7 days, participants watched either a Non-Pandemic or a Pandemic video of a woman eating, the latter containing sanitary elements adopted during the pandemic. The order of the videos was counterbalanced across participants over the two experimental sessions. Videos were followed by images of food from different categories. After observing both videos and each picture, participants were instructed to evaluate the visual aspect, expected smell and flavor, and rate their desire to eat. Our study demonstrated (1) higher hedonic responses to the Non-Pandemic compared to the Pandemic video, (2) a priming effect showing higher appreciation for sweet foods after the Non-Pandemic compared to the Pandemic video, (3) that food exposure gradually increases one's desire to eat, but such effects are impacted by pandemic sanitary cues, and (4) greater hedonic responses are given for sweet and high-calorie foods compared to salty and low-calorie ones, irrespective of pandemic priming. Finally, depression and anxiety symptoms were associated with lower smell evaluations only in the Pandemic condition.
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Managing disruption at a distance: Unequal experiences of people living with long-term conditions during the COVID-19 pandemic. Soc Sci Med 2022; 302:114963. [PMID: 35500314 PMCID: PMC8990438 DOI: 10.1016/j.socscimed.2022.114963] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/21/2022] [Accepted: 04/04/2022] [Indexed: 01/10/2023]
Abstract
The COVID-19 pandemic and 'lockdown' restrictions have affected people's health and wellbeing globally. Those who are clinically vulnerable to COVID-19 mortality due to living with long term conditions (LTCs) are at greater risk of negative impacts on their health and wellbeing, and of disruption in management of their LTCs. This study explores how people with LTCs managed their health and wellbeing under social distancing restrictions and self-isolation during the first wave of the COVID-19 pandemic, and examines why some people were more able to manage than others. Interviews were conducted between May and July 2020 with people (n = 44) living in North East England, who had one or more LTCs and were recruited via a social prescribing intervention. Data were analysed using a social constructivist thematic analysis. We present our analysis of the possibilities afforded to people to manage the impacts of lockdown on their health and wellbeing. We find that while some people deployed a range of capitals and/or etched out 'tactics' to make life 'habitable', others experienced 'zones of impossibility' requiring that they rely on contingent events or formal support. Our analysis highlights inequalities amongst people with LTCs, particularly regarding access to and deployment of important resources for health and wellbeing under COVID-19 social distancing restrictions, including outdoor space or greenspace, exercise and social connection. The study is novel in showing the mechanisms for coping with a significant period of disruption in the life-course whilst highlighting that although resilience was common in people with LTCs, this was sometimes at detrimental costs to themselves.
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Shah P, Hardy J, Birken M, Foye U, Rowan Olive R, Nyikavaranda P, Dare C, Stefanidou T, Schlief M, Pearce E, Lyons N, Machin K, Jeynes T, Chipp B, Chhapia A, Barber N, Gillard S, Pitman A, Simpson A, Johnson S, Lloyd-Evans B. What has changed in the experiences of people with mental health problems during the COVID-19 pandemic: a coproduced, qualitative interview study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1291-1303. [PMID: 35267053 PMCID: PMC8908744 DOI: 10.1007/s00127-022-02254-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/18/2022] [Indexed: 12/05/2022]
Abstract
PURPOSE We sought to understand how the experiences of people in the UK with pre-existing mental health conditions had developed during the course of the COVID-19 pandemic. METHODS In September-October 2020, we interviewed adults with mental health conditions pre-dating the pandemic, whom we had previously interviewed 3 months earlier. Participants had been recruited through online advertising and voluntary sector community organisations. Semi-structured qualitative interviews were conducted by telephone or video-conference by researchers with lived experience of mental health difficulties, and, following principles of thematic analysis, were analysed to explore changes over time in people's experience of the pandemic. RESULTS We interviewed 44 people, achieving diversity of demographic characteristics (73% female, 54% White British, aged 18-75) and a range of mental health conditions and service use among our sample. Three overarching themes were derived from interviews. The first theme "spectrum of adaptation" describes how participants reacted to reduced access to formal and informal support through personal coping responses or seeking new sources of help, with varying degrees of success. The second theme describes "accumulating pressures" from pandemic-related anxieties and sustained disruption to social contact and support, and to mental health treatment. The third theme "feeling overlooked" reflects participants' feeling of people with mental health conditions being ignored during the pandemic by policy-makers at all levels, which was compounded for people from ethnic minority communities or with physical health problems. CONCLUSION In line with previous research, our study highlights the need to support marginalised groups who are at risk of increased inequalities, and to maintain crucial mental and physical healthcare and social care for people with existing mental health conditions, notwithstanding challenges of the pandemic.
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Affiliation(s)
- Prisha Shah
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Jackie Hardy
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Mary Birken
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Una Foye
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, 18 DeCrespigny Park, London, SE5 8AF, UK
| | - Rachel Rowan Olive
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Patrick Nyikavaranda
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Ceri Dare
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Theodora Stefanidou
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Merle Schlief
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Eiluned Pearce
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Natasha Lyons
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Karen Machin
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Tamar Jeynes
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Beverley Chipp
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Anjie Chhapia
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Nick Barber
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Steven Gillard
- Centre for Mental Health Research, City, University of London, 1 Myddelton Street, London, EC1R 1UW, UK
| | - Alexandra Pitman
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Alan Simpson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, 18 DeCrespigny Park, London, SE5 8AF, UK
| | - Sonia Johnson
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK
| | - Brynmor Lloyd-Evans
- Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK.
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Kim R, Olpin E, Novilla LK, Crandall A. The Association of COVID-19 Stressors and Family Health on Overeating before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6174. [PMID: 35627710 PMCID: PMC9140506 DOI: 10.3390/ijerph19106174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/06/2022] [Accepted: 05/16/2022] [Indexed: 02/05/2023]
Abstract
Prior studies have examined how stress and the family environment affect overeating, but less is known about how COVID-19 stressors and family health may affect overeating during the COVID-19 pandemic. The research questions included: (1) Did COVID-19-related stressors increase the risk for overeating among adults in the United States? (2) Did family health protect against overeating during a pandemic? The sample included 443 participants aged 18 years and older living in the United States who were recruited via Amazon Mechanical Turk. Stata version 16 was used to analyze the data using multiple linear regression. The results indicate that one year into the pandemic, COVID-19 stressors were associated with increased overeating, even after adjusting for overeating before the pandemic. More family health resources were associated with less overeating. These results indicate that although COVID-19 stressors were associated with overeating, greater family health resources helped prevent overeating. Interventions and policies that aim to increase health resources for families may be particularly beneficial at preventing overeating and obesity in the face of long- and short-term stress.
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Affiliation(s)
| | | | | | - AliceAnn Crandall
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (R.K.); (E.O.); (L.K.N.)
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Özdil K, Küçük Öztürk G. “Burden that cannot be borne”: qualitative study of body dissatisfaction among women during the pandemic. Women Health 2022; 62:348-357. [DOI: 10.1080/03630242.2022.2072049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kamuran Özdil
- Aged Care Program, Health Services Vocational School, Nevsehir Haci Bektaş Veli University, Nevsehir, Turkey
| | - Gülhan Küçük Öztürk
- Department of Psychiatry Nursing, Nevşehir Hacı Bektaş Veli University Semra and Vefa Kucuk Faculty of Health Sciences, Nevşehir, Turkey
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J. Devoe D, Han A, Anderson A, Katzman DK, Patten SB, Soumbasis A, Flanagan J, Paslakis G, Vyver E, Marcoux G, Dimitropoulos G. The impact of the COVID-19 pandemic on eating disorders: A systematic review. Int J Eat Disord 2022; 56:5-25. [PMID: 35384016 PMCID: PMC9087369 DOI: 10.1002/eat.23704] [Citation(s) in RCA: 116] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE A growing body of evidence suggests that individuals with eating disorders (EDs) have experienced deteriorating symptoms, increased isolation, and an increase in hospital admissions as a result of the COVID-19 pandemic. Despite this, no systematic reviews have been conducted examining the COVID-19 and ED peer-reviewed literature. Therefore, this systematic review aimed to synthesize the impact of the COVID-19 pandemic on individuals with EDs. METHOD Database searches of the peer-reviewed literature were completed in the subsequent databases: CINAHL, Embase, MEDLINE, and PsycINFO (from November 2019 to October 20, 2021). All research reporting on the relationship between the COVID-19 pandemic on individuals with EDs were included. RESULTS Fifty-three studies met the inclusion criteria, including 36,485 individuals with EDs. The pooled hospital admissions across the studies demonstrated on average a 48% (pre = 591, post = 876, n = 10 studies) increase in admissions during the pandemic compared to previous pre-pandemic timepoints. In this review, 36% of studies (n = 19) documented increases in eating disorder symptoms during the pandemic, this increase in eating disorder symptoms were documented in AN, BED, BN, and OFSED patients. Studies also demonstrated increases in anxiety (n = 9) and depression (n = 8), however patterns of change appeared to be diagnostic and timing specific (e.g., lockdowns). DISCUSSION We found a large increase in the number of hospitalizations and an increase in ED symptoms, anxiety, depression, and changes to BMI in ED patients during the pandemic. However, these changes appeared to be diagnostic and timing specific. Many qualitative studies described deterioration in ED symptomatology due to decreased access to care and treatment, changes to routine and loss of structure, negative influence of the media, and social isolation. Future studies are needed to focus on pediatric populations, new ED diagnoses, and severity of illness at presentation. PUBLIC SIGNIFICANCE The scientific literature suggests that individuals with eating disorders have experienced deteriorating symptoms, increased isolation, and an increase in hospital admissions as a result of the COVID-19 pandemic. This study synthesized 53 articles and explored the impact of the COVID-19 pandemic on patients with eating disorders. We found increases in eating disorder symptoms during the pandemic; this increase in eating disorder symptoms was documented in patients with common eating disorders including anorexia nervosa, binge-eating disorder, bulimia nervosa, and other specified feeding and eating disorders. This review also demonstrated changes in body mass index (an index used to classify underweight, overweight, and obesity in adults) and increases in anxiety and depression during the pandemic compared to previous timepoints; patterns of change appeared to be related to timing of lockdowns. This review provides important information on the impact of COVID-19 on the physical and mental health of individuals with eating disorders.
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Affiliation(s)
- Daniel J. Devoe
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada,Department of PsychologyMount Royal UniversityCalgaryCanada
| | - Angela Han
- Division of Adolescent Medicine, Department of PediatricsThe Hospital for Sick Children, University of TorontoTorontoONCanada
| | - Alida Anderson
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada
| | - Debra K. Katzman
- Division of Adolescent Medicine, Department of PediatricsThe Hospital for Sick Children, University of TorontoTorontoONCanada
| | - Scott B. Patten
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada
| | - Andrea Soumbasis
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada
| | - Jordyn Flanagan
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and PsychotherapyRuhr‐University BochumLübbeckeGermany
| | | | | | - Gina Dimitropoulos
- Department of Psychiatry, Mathison Centre for Mental Health Research & EducationUniversity of CalgaryCalgaryABCanada,Faculty of Social WorkUniversity of CalgaryCalgaryABCanada
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Rapid Evidence Review of Community Engagement and Resources in the UK during the COVID-19 Pandemic: How Can Community Assets Redress Health Inequities? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074086. [PMID: 35409769 PMCID: PMC8998387 DOI: 10.3390/ijerph19074086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/14/2022] [Accepted: 03/24/2022] [Indexed: 12/14/2022]
Abstract
Community engagement, such as participating in arts, nature or leisurely activities, is positively associated with psychological and physiological wellbeing. Community-based engagement during the COVID-19 pandemic facilitated informal and local mutual aid between individuals. This rapid evidence review assesses the emergence of community-based arts, nature, music, theatre and other types of cultural engagement amongst UK communities in response to the COVID-19 pandemic. Here, we focus on all community engagement with a sub-focus on provisions accessed by and targeted towards vulnerable groups. Two hundred and fifty-six resources were included that had been created between February 2020 and January 2021. Resources were identified through Google Scholar, PubMed, Web of Science, MedRXic, PsycharXiv and searches for grey literature and items in the public domain. The majority reported services that had been adapted to become online, telephone-based or delivered at a distance from doorsteps. Several quality assessment frameworks were used to evaluate the quality of data. Whilst a number of peer-reviewed, grey literature and public domain articles were identified, less than half of the identified literature met quality thresholds. The pace of the response to the pandemic may have meant that robust evaluation procedures were not always in place.
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Schneider J, Pegram G, Gibson B, Talamonti D, Tinoco A, Craddock N, Matheson E, Forshaw M. A mixed-studies systematic review of the experiences of body image, disordered eating, and eating disorders during the COVID-19 pandemic. Int J Eat Disord 2022; 56:26-67. [PMID: 35322449 PMCID: PMC9087368 DOI: 10.1002/eat.23706] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/05/2022] [Accepted: 03/05/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES This systematic review assessed the influence of the COVID-19 pandemic and associated restrictions on body image, disordered eating (DE), and eating disorder outcomes. METHODS After registration on PROSPERO, a search was conducted for papers published between December 1, 2019 and August 1, 2021, using the databases PsycINFO, PsycARTICLES, CINAHL Plus, AMED, MEDLINE, ERIC, EMBASE, Wiley, and ProQuest (dissertations and theses). RESULTS Data from 75 qualitative, quantitative, and mixed-methods studies were synthesized using a convergent integrated approach and presented narratively within four themes: (1) disruptions due to the COVID-19 pandemic; (2) variability in the improvement or exacerbation of symptoms; (3) factors associated with body image and DE outcomes; (4) unique challenges for marginalized and underrepresented groups. Disruptions due to the pandemic included social and functional restrictions. Although most studies reported a worsening of concerns, some participants also reported symptom improvement or no change as a result of the pandemic. Factors associated with worse outcomes included psychological, individual, social, and eating disorder-related variables. Individuals identifying as LGBTQ+ reported unique concerns during COVID-19. DISCUSSION There is large variability in individuals' responses to COVID-19 and limited research exploring the effect of the pandemic on body image, DE, and eating disorder outcomes using longitudinal and experimental study designs. In addition, further research is required to investigate the effect of the COVID-19 pandemic on body image and eating concerns among minoritized, racialized, underrepresented, or otherwise marginalized participants. Based on the findings of this review, we make recommendations for individuals, researchers, clinicians, and public health messaging. PUBLIC SIGNIFICANCE This review of 75 studies highlights the widespread negative impacts that the COVID-19 pandemic and associated restrictions have had on body image and disordered eating outcomes. It also identifies considerable variations in both the improvement and exacerbation of said outcomes that individuals, researchers, clinicians, and other public health professionals should be mindful of if we are to ensure that vulnerable people get the tailored support they require.
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Affiliation(s)
- Jekaterina Schneider
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Georgina Pegram
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Benjamin Gibson
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Deborah Talamonti
- Research Centre and Centre EPICMontreal Heart InstituteMontrealQuebecCanada
| | - Aline Tinoco
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Nadia Craddock
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Emily Matheson
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Mark Forshaw
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
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Zhang W, Zou C, Sznajder KK, Cui C, Fu J, He S, Peng Q, Chen Q, Yang X. Panic, Psycho-Behavioral Responses, and Risk Perception in the Earliest Stage of the COVID-19 Pandemic in China. Front Med (Lausanne) 2022; 9:766842. [PMID: 35280909 PMCID: PMC8914041 DOI: 10.3389/fmed.2022.766842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/26/2022] [Indexed: 12/23/2022] Open
Abstract
Background Coronavirus Disease-19 (COVID-19), a rising global pandemic, has triggered psychological crises among the public. Panic, a severe symptom of mental disorders, is increasing in the public in China and it is urgent to provide research for intervention development. Objectives This study aimed to assess the prevalence of public panic in China during the earliest stage of the COVID-19 pandemic and to explore the associated psychological behavioral responses and public's risk perception of the pandemic. Methods A cross-sectional study using a web-based survey with convenience sampling was conducted with 2,484 participants nationally from February 11 to February 24, 2020 in China. A self-developed questionnaire was applied to assess the prevalence of public panic and its associated factors. Multivariable logistic regression analysis was applied to assess the risk and protective factors of public panic. Results There were 23.39% (581/2,484) of the participants who reported experiencing panic during the earliest stage of the COVID-19 pandemic. Taking temperature repeatedly, being nervous in a crowd, being suspicious of infection in the family, being worried about the future, and worries about high infectivity of the COVID-19, lack of effective therapies, and wide impact of the COVID-19 pandemic increased the odds of public panic. Whereas, avoiding gatherings during holidays was negatively associated with the odds of public panic. Conclusions Psycho-behavioral responses were closely associated with public panic during the earliest stage of the COVID-19 pandemic in China. Defusing excessive health-related worries, the guidance of appropriate self-protective behaviors, strengthening of health education in communities, and available treatment for mental disorders should be adopted to monitor the psychological responses and to guide the behaviors of the public.
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Affiliation(s)
- Weiyu Zhang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Changqing Zou
- Department of Humanities and Social Sciences, China Medical University, Shenyang, China
| | - Kristin K. Sznajder
- Department of Public Health, Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Can Cui
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Jiahui Fu
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Shan He
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Qinqi Peng
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Qiongli Chen
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
| | - Xiaoshi Yang
- Department of Social Medicine, College of Health Management, China Medical University, Shenyang, China
- *Correspondence: Xiaoshi Yang
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Covid-19 Coping Survey: an In-depth Qualitative Analysis of Free-Text Responses from People With and Without Existing Health Conditions in the UK. Int J Behav Med 2022; 29:743-751. [PMID: 35132540 PMCID: PMC8821867 DOI: 10.1007/s12529-022-10055-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2021] [Indexed: 11/20/2022]
Abstract
Background There is currently a lack of qualitative research exploring how cognitive and emotional reactions to the threat of SARS-CoV-2 affected the health behaviours of people living with and without pre-existing mental and physical health conditions. We aimed to investigate how the threat of SARS-CoV-2 influenced the thoughts, feelings and health behaviours of people with and without pre-existing health conditions in the UK. Methods A cross-sectional online survey of UK adults (aged 18 and over). Free-text responses were analysed using a qualitative framework approach guided by the Common-Sense Model of Self-Regulation. Results Of the 9110 respondents, 2763 participants provided at least one free-text response. Three main themes were derived from the data. Theme one, locus of control, reports on the extent to which people felt in control during the first wave of the pandemic. Theme two, emotional impact, conveys how individuals felt and how people’s personal circumstances made them more vulnerable to experiencing negative emotions during the pandemic. Theme three, coping strategies, describes common health-protective and health-threatening behaviours performed by individuals, as well as the importance of social connectedness, the social context and the need for collective action during the first national lockdown. Conclusion Complex psychological interventions including behaviour change are required to mitigate the psychological burden of the SARS-CoV-2 pandemic and increase autonomy in people with and without pre-existing conditions during this highly uncertain time. Behavioural scientists can support governments and public health agencies to develop evidence-based communication and behaviour change strategies that support people to address unhelpful beliefs and emotions and strengthen coping abilities as the UK moves through and beyond the SARS-CoV-2 pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s12529-022-10055-z.
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Takakura S, Toda K, Yamashita M, Kitajima T, Suematsu T, Yokoyama H, Asou CS, Hata T, Sudo N. Potential impact of the COVID-19 pandemic on japanese patients with eating disorders -a cross-sectional study. Biopsychosoc Med 2022; 16:2. [PMID: 34991681 PMCID: PMC8733913 DOI: 10.1186/s13030-021-00232-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2023] Open
Abstract
Background The COVID-19 pandemic and associated lockdown had a considerable impact on eating disorders (EDs). We evaluated the clinical features of Japanese ED patients before and after the first COVID-19 outbreak-related state of emergency (April 7, 2020). Methods We studied 148 patients who were divided into two groups based on when they arrived at our clinic: before (Before group: n = 86) or after (After group: n = 62) the start of the first state of emergency. All patients completed the Japanese versions of the Eating Disorder Inventory (EDI) and Parental Bonding Instrument (PBI). Results The After group was substantially younger than the Before group (p = .0187). Regardless of the ED type, patients who developed an ED during the first state of emergency tended to be significantly younger than those who developed one before. Differences in EDI characteristics were observed between the two groups. The PBI care subscale was notably higher (p = .0177) in the After group. The PBI maternal care subscale was the only statistically significant factor associated with age (β = -0.35, p < .0001). Conclusions Home confinement associated with the COVID-19 pandemic and the ensuing increase in parent-child closeness may have influenced the decreased age of ED patients at their initial consultation. Treatment interventions should consider the differences in the clinical features of EDs.
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Affiliation(s)
- Shu Takakura
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan. .,Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.
| | - Kenta Toda
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.,Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
| | - Makoto Yamashita
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.,Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan
| | - Tomoko Kitajima
- Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan
| | - Takafumi Suematsu
- Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
| | - Hiroaki Yokoyama
- Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
| | - Chie Suzuyama Asou
- Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
| | - Tomokazu Hata
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.,Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan.,Fukuoka Prefectural Support Base Hospital for Eating Disorders, Fukuoka, Japan.,Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
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Gobin KC, Mills JS, McComb SE. The Effects of the COVID-19 Pandemic Lockdown on Eating, Body Image, and Social Media Habits Among Women With and Without Symptoms of Orthorexia Nervosa. Front Psychol 2022; 12:716998. [PMID: 34975611 PMCID: PMC8714632 DOI: 10.3389/fpsyg.2021.716998] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 11/10/2021] [Indexed: 01/14/2023] Open
Abstract
The COVID-19 pandemic is negatively impacting people's mental health worldwide. The current study examined the effects of COVID-19 lockdown on adult women's eating, body image, and social media habits. Furthermore, we compared individuals with and without signs of orthorexia nervosa, a proposed eating disorder. Participants were 143 women, aged 17-73 years (M = 25.85, SD = 8.12), recruited during a COVID-19 lockdown in Canada from May-June 2020. Participants completed self-report questionnaires on their eating, body image, and social media habits during the pandemic. The Eating Habits Questionnaire (EHQ) assessed symptoms of orthorexia nervosa. Compared to the period prior to lockdown, women with higher total orthorexia nervosa scores reported eating a lot more than usual, feeling greater pressure to diet and lose weight, thinking about food more often than usual, experiencing greater weight gain, and perceiving more pressure from social media specifically to lose weight and to exercise, compared to their healthy counterparts. We examined associations between individual EHQ subscales and perceived changes to eating and weight. Women who scored high on EHQ-Problems reported seeing more weight loss content on their social media than those who reported fewer orthorexia nervosa symptoms. Conversely, those who scored low on EHQ-Feelings reported feeling a lot less pressure to lose weight, somewhat less or a lot less pressure to lose weight or to exercise from social media specifically, and trended toward less laxative use during lockdown, compared to those who scored higher on orthorexia nervosa. And those who scored low on EHQ-Knowledge reported feeling somewhat less or a lot less pressure to lose weight than those who reported more orthorexia nervosa symptoms. Together, the findings suggest that women with symptoms of orthorexia nervosa are experiencing an exacerbation of disordered eating thoughts and behaviors during COVID-19, and that social media may be a contributing factor.
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Affiliation(s)
- Keisha C Gobin
- Department of Psychology, York University, Toronto, ON, Canada
| | | | - Sarah E McComb
- Department of Psychology, York University, Toronto, ON, Canada
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Medium-term and peri-lockdown course of psychosocial burden during the ongoing COVID-19 pandemic: a longitudinal study on patients with pre-existing mental disorders. Eur Arch Psychiatry Clin Neurosci 2022; 272:757-771. [PMID: 34825249 PMCID: PMC8614217 DOI: 10.1007/s00406-021-01351-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/08/2021] [Indexed: 12/16/2022]
Abstract
While the COVID-19 pandemic continues, patients with pre-existing mental disorders are increasingly recognized as a risk group for adverse outcomes. However, data are conflicting and cover only short time spans so far. Here, we investigate the medium-term and peri-lockdown-related changes of mental health outcomes in such patients in a longitudinal study. A cohort of 159 patients comprising all major mental disorders (ICD-10 F0-F9) were interviewed twice with the Goettingen psychosocial Burden and Symptom Inventory (Goe-BSI) to evaluate psychosocial burden, psychiatric symptoms and resilience at the end of the first (April/May 2020) and the second lockdown in Germany (November/December 2020). For the primary outcome "psychosocial burden" ratings also comprised retrospective pre-pandemic (early 2020) and very early states during the pandemic (March 2020). For all diagnostic groups, psychosocial burden varied significantly over time (p < 0.001) with an increase from the pre-pandemic to the initial phase (p < 0.001), followed by a steady decrease across both lockdowns, normalizing in November/December 2020. Female gender, high adjustment disorder symptom load at baseline and psychiatric comorbidities were risk factors for higher levels and an unfavorable course of psychosocial burden. Most psychiatric symptoms changed minimally, while resilience decreased over time (p = 0.044 and p = 0.037). The longitudinal course of psychosocial burden indicates an initial stress response, followed by a return to pre-pandemic levels even under recurrent lockdown conditions, mimicking symptoms of an adjustment disorder. Strategies for proactive, specific and continuous treatment have to address resilience capacities before their depletion in the pandemic aftermath, especially for patients with additional risk factors.
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Albano G, Bonfanti RC, Gullo S, Salerno L, Lo Coco G. The psychological impact of COVID-19 on people suffering from dysfunctional eating behaviours: a linguistic analysis of the contents shared in an online community during the lockdown. RESEARCH IN PSYCHOTHERAPY (MILANO) 2021; 24:557. [PMID: 35047429 PMCID: PMC8715260 DOI: 10.4081/ripppo.2021.557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 09/08/2021] [Indexed: 12/15/2022]
Abstract
The coronavirus disease 2019 (COVID-19) spread several months ago from China and it is now a global pandemic. The experience of lockdown has been an undesirable condition for people with mental health problems, including eating disorders. The present study has the aim of understanding the impact of the first wave of the COVID-19 pandemic on people with selfreported disordered eating behaviours. A linguistic analysis was carried out with regard to the online posts and comments published by 1971 individuals (86% women) in a Facebook online community focusing on EDs during the lockdown. A total of 244 posts and 3603 comments were collected during the 56 days of lockdown (from the 10th of March until the 4th of May 2020) in Italy and were analysed by Linguistic Inquiry and Word Count (LIWC) software. The results showed that words related to peer support decreased in posts over time, and that anxiety and anger increased in the published comments. Moreover, greater feelings of negativity and anxiety were found in posts and comments throughout the COVID-19 pandemic, as well as lesser use of words related to positive emotions. Thematic qualitative analysis revealed eight themes that described the main subjective components of ED symptomatology and distress during the first COVID-19 lockdown. The current findings can help in delivering tailored treatments to people with eating disorders during the COVID-19 pandemic.
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Affiliation(s)
- Gaia Albano
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Rubinia Celeste Bonfanti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Salvatore Gullo
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Laura Salerno
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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Mannino G, Salerno L, Bonfanti RC, Albano G, Lo Coco G. The impact of Facebook use on self-reported eating disorders during the COVID-19 lockdown. BMC Psychiatry 2021; 21:611. [PMID: 34876064 PMCID: PMC8651245 DOI: 10.1186/s12888-021-03628-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/02/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The social isolation due to the COVID-19-related lockdown has had an impact on social media consumption around the world. This study examines the relationship between fear of COVID-19, Facebook use and disordered eating. METHODS Structural Equation Modeling was used to analyse two-wave survey data (T0: Italian first lockdown; T1: after two months) during the pandemic. Young adults with self-reported dysfunctional eating behaviors (N = 115; 91.3% females; mean age = 28.60 ± 7.31) were recruited to complete an online survey at T0; 66 participants (92.4% females; mean age = 28.85 ± 7.85) completed the survey at T1. They were assessed on Facebook use, dysfunctional eating cognitions, and fear of COVID-19. RESULTS Participants' disordered eating cognitions increased during the pandemic. At T0, higher fear of COVID-19 was positively associated to time spent on Facebook, which in turn predicted disordered eating cognitions at T1. Moreover, maladaptive Facebook use mediated the relationship between daily time on Facebook and Shape concerns. CONCLUSIONS The findings of this study suggest an influence of dysfunctional Facebook use in increasing disordered eating cognitions during the pandemic.
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Affiliation(s)
| | - Laura Salerno
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy.
| | - Rubinia Celeste Bonfanti
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy
| | - Gaia Albano
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy
| | - Gianluca Lo Coco
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Viale delle Scienze, Edificio 15, 90128, Palermo, Italy
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Antwi J, Appiah B, Oluwakuse B, Abu BAZ. The Nutrition-COVID-19 Interplay: a Review. Curr Nutr Rep 2021; 10:364-374. [PMID: 34837637 PMCID: PMC8627159 DOI: 10.1007/s13668-021-00380-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2021] [Indexed: 02/08/2023]
Abstract
Purpose of Review Nutritional status is affected by the COVID-19 pandemic, directly or indirectly. Even with the recent rollout of the coronavirus disease 2019 (COVID-19) vaccines and availability of medicines such as remdesivir, and monoclonal antibodies, host nutritional status is pivotal in the fight against the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and outcomes. The purpose of this review is to discuss the effects of COVID-19-related lockdown on lifestyle behaviors, and the nutritional consequences, and the direct sequelae of the infection on nutrition including potential nutritional interventions. Recent Findings The COVID-19-related lockdown imposed radical changes in lifestyle behaviors with considerable short-term and long-term health and nutritional consequences including weight gain and obesity and increased cardiometabolic risk, consistently linked to worsened prognosis. The extent of the impact was dependent on food insecurity, overall stress and disordered eating, physical inactivity, and exposure to COVID-19-related nutrition information sources. COVID-19 could directly induce inflammatory responses and poor nutrient intake and absorption leading to undernutrition with micronutrient deficiencies, which impairs immune system function with subsequent amplified risk of infection and disease severity. Nutrition interventions through nutrition support, dietary supplementation, and home remedies such as use of zinc, selenium, vitamin D, and omega-3 fatty acids showed the most significant promise to mitigate the course of COVID-19 infection and improve survival rates. Summary The nutrition-COVID-19 relationship and related dietary changes mimic a vicious cycle of the double burden of malnutrition, both obesity and undernutrition with micronutrient deficiencies, which promote infection, disease progression, and potential death.
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Affiliation(s)
- Janet Antwi
- Department of Agriculture, Nutrition and Human Ecology, Prairie View A&M University, Prairie View, TX, USA.
| | - Bernard Appiah
- Department of Public Health, Syracuse University, Syracuse, NY, USA
| | - Busayo Oluwakuse
- Department of Agriculture, Nutrition and Human Ecology, Prairie View A&M University, Prairie View, TX, USA
| | - Brenda A Z Abu
- Wegmans School of Health and Nutrition, College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY, USA
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McKenna-Plumley PE, Graham-Wisener L, Berry E, Groarke JM. Connection, constraint, and coping: A qualitative study of experiences of loneliness during the COVID-19 lockdown in the UK. PLoS One 2021; 16:e0258344. [PMID: 34644328 PMCID: PMC8513854 DOI: 10.1371/journal.pone.0258344] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/24/2021] [Indexed: 01/02/2023] Open
Abstract
The COVID-19 pandemic has necessitated physical distancing which is expected to continue in some form for the foreseeable future. Physical distancing policies have increased reliance on digital forms of social connection and there are widespread concerns about social isolation and mental health in this context. This qualitative study sought to understand how loneliness was experienced during physical distancing in the initial national UK COVID-19 lockdown. Eight individuals who reported feeling lonely during the initial lockdown were interviewed in May 2020. Interviews were analysed using reflexive thematic analysis. Four main themes were identified: (1) Loss of in-person interaction causing loneliness, (2) Constrained freedom, (3) Challenging emotions, and (4) Coping with loneliness. The loss of in-person interaction contributed to feelings of loneliness and digital interaction was viewed as an insufficient alternative. Social freedom could be constrained by distancing policies and by social contacts, contributing to strained personal relationships and feelings of frustration as part of loneliness. Fluctuations in mood and difficult emotions were experienced alongside loneliness, and distraction and seeking reconnection were commonly reported methods of coping, although they were less accessible. These findings indicate that physical distancing measures can impact loneliness due to the limitations they impose on in-person social contact and the perceived insufficiency of digital contact as a substitute.
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Affiliation(s)
- Phoebe E. McKenna-Plumley
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
- * E-mail:
| | - Lisa Graham-Wisener
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Emma Berry
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
| | - Jenny M. Groarke
- Centre for Improving Health-Related Quality of Life, School of Psychology, Queen’s University Belfast, Belfast, United Kingdom
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Miniati M, Marzetti F, Palagini L, Marazziti D, Orrù G, Conversano C, Gemignani A. Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review. Front Psychol 2021; 12:663376. [PMID: 34658992 PMCID: PMC8511307 DOI: 10.3389/fpsyg.2021.663376] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 08/26/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Several data suggest that coronavirus disease 2019 (COVID-19) pandemic may exacerbate or trigger eating disorders (EDs). The aim of this paper was to summarize current literature studies on COVID pandemic and EDs. Methods: Literature search, study selection, methods, and quality evaluation were performed according to the preferred reporting items for systematic review and meta-analyses (PRISMA) guidelines. Results: A systematic search allowed the initial selection of 172 papers; 21 (12.2%) papers were eligible and included in the review. In selected studies, a total number of 29,108 subjects were enrolled (range: 10-11,391; mean/SD: 1,386 ± 2,800), 6,216 were men (21.4%), 22,703 were women (77.9%), and 189 (0.7%) were gender fluid or not declared. The mean age/SD of subjects was 30.2 ± 7.7. About 12 studies (57.1%) were online surveys, 4 (19.0%) were retrospective studies, 2 (9.5%) were qualitative studies, 2 (9.5%) were longitudinal cohort studies, and 1 was a social media survey (4.8%). Their analysis revealed five main findings: (1) changes in the routines of physical activities were related to the worsening of preoccupation on weight/body shape; (2) food access limitation during pandemic represented the risk factors for both triggering and exacerbating EDs; (3) restriction in healthcare facilities contributed to increase anxiety levels and to modify treatment compliance; (4) social isolation was related to the exacerbation of symptoms in patients with EDs who are home-confined with family members; and (5) conflicts and difficulties in relationships with "no way out" were the maintenance factors for ED symptoms, especially in adolescents and young adults. Conclusion: The COVID-19 pandemic had a negative impact on EDs that might be triggered by the exceptional conditions derived from COVID-19-related stress in predisposed subjects. Patients who were already affected by EDs experienced the worsening of their clinical conditions and related quality of life (QoL).
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Affiliation(s)
- Mario Miniati
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Francesca Marzetti
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Laura Palagini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Graziella Orrù
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
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Emotional eating in times of coronavirus disease 2019. Nutrition 2021; 93:111438. [PMID: 34535371 PMCID: PMC8318665 DOI: 10.1016/j.nut.2021.111438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/28/2021] [Accepted: 07/21/2021] [Indexed: 11/24/2022]
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Hansen SJ, Stephan A, Menkes DB. The impact of COVID-19 on eating disorder referrals and admissions in Waikato, New Zealand. J Eat Disord 2021; 9:105. [PMID: 34454600 PMCID: PMC8397868 DOI: 10.1186/s40337-021-00462-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/18/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Several countries have reported increased demand for eating disorder services during the COVID-19 pandemic, particularly for adolescents. Within New Zealand, anecdotal and media reports suggest similar changes but are limited in scope and detail. We assessed eating disorder service demand in the Waikato district in relation to the COVID-19 pandemic. METHODS We retrospectively analysed records of eating disorder admissions and referrals for both children (< 18 years) and adults (≥ 18 years) during 2019 and 2020 in the Waikato, a mixed urban-rural province in northern New Zealand (population 435,000). We analysed medical admission and outpatient referral rates, and referral acuity, in relation to the COVID-19 pandemic using Welch's t- and chi-square tests. RESULTS 106 medical admissions met inclusion criteria (n = 37 in 2019; 69 in 2020). Admissions for eating disorders increased markedly following nationwide lockdown in March 2020 (RR = 1.7, p = 0.01), largely driven by increases in adult admissions (RR 2.0, p = 0.005). The proportion of 'new patient' admissions showed comparable increases for both children (RR = 2.0, p = 0.02) and adults (RR = 2.3, p = 0.03). Following lockdown, outpatient referrals increased in acuity (RR = 1.8, p = 0.047) and volume (RR = 1.6, p = 0.076) for children but not for adults. CONCLUSIONS Our study confirms a pandemic-related increase in demand for eating disorder services in the Waikato region of New Zealand, consistent with findings reported overseas. We observed contrasting increases in admissions for adults and outpatient referrals for children, exacerbating resource constraints for already stretched services and compromising provision of timely care. The COVID-19 pandemic has been linked to increased numbers and worsening severity of eating disorders in several settings. In New Zealand, similar trends have been noted anecdotally. We assessed clinical records to calculate rates of eating disorder-related hospital admissions and outpatient referrals during 2019 and 2020. We found significant increases in hospital admissions related to COVID-19, particularly for adults, and greater proportions of both children and adults having a first-ever eating disorder-related admission. In outpatient services, young people were referred more frequently during the pandemic and were more physically unwell when referred. These results indicate increased demand for eating disorder services as a result of the pandemic and complement findings reported overseas.
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Affiliation(s)
- Sara J Hansen
- University of Auckland, Waikato Clinical Campus, Private Bag 3200, Hamilton, New Zealand.
| | - Alice Stephan
- Waikato District Health Board, Hamilton, New Zealand
| | - David B Menkes
- University of Auckland, Waikato Clinical Campus, Private Bag 3200, Hamilton, New Zealand.,Waikato District Health Board, Hamilton, New Zealand
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Favreau M, Hillert A, Osen B, Gärtner T, Hunatschek S, Riese M, Hewera K, Voderholzer U. Psychological consequences and differential impact of the COVID-19 pandemic in patients with mental disorders. Psychiatry Res 2021; 302:114045. [PMID: 34126461 PMCID: PMC8180351 DOI: 10.1016/j.psychres.2021.114045] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/30/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE People with mental disorders might be differentially affected by the COVID-19 pandemic. The aim of the current study was to evaluate the impact of the pandemic on patients with various psychiatric disorders who were admitted to inpatient treatment. METHODS Five-hundred thirty-eight inpatients with mental disorders participated in a survey about psychological consequences of the pandemic between March-December 2020. We examined the perceived burden by restrictions and worries, changes in health care utilization, and helpfulness of coping strategies. RESULTS More than 50% reported any worsening of symptoms, 40% stated increased need of therapeutic support. High rates of symptom deterioration were observed for depressive symptoms (>55%), anxiety (>40%), and sleeping behavior (>40%). Treatment impairment was stated by 27.9%. Patients with anxiety disorders were less affected by contact restrictions compared with eating disorders and depression. Patients with anorexia nervosa and post-traumatic stress disorder experienced higher helpfulness by daily structuring than patients with depression. DISCUSSION About half of our sample of psychiatric patients experienced symptom deterioration due to the pandemic and about one quarter reported impairment of treatment modalities. Especially patients with eating disorders and depressive disorders were more frequently affected. The results indicate a needed improvement of treatment options during a pandemic.
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Affiliation(s)
- Matthias Favreau
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Schoen Clinic Roseneck, Prien am Chiemsee, Germany.
| | | | | | | | | | | | - Karina Hewera
- Schoen Clinic Bad Staffelstein, Bad Staffelstein, Germany
| | - Ulrich Voderholzer
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany,Schoen Clinic Roseneck, Prien am Chiemsee, Germany,Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg, Germany
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Parsons H, Murphy B, Malone D, Holme I. Review of Ireland's First Year of the COVID-19 Pandemic Impact on People Affected by Eating Disorders: 'Behind Every Screen There Was a Family Supporting a Person with an Eating Disorder'. J Clin Med 2021; 10:3385. [PMID: 34362170 PMCID: PMC8347427 DOI: 10.3390/jcm10153385] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/29/2021] [Accepted: 07/29/2021] [Indexed: 01/14/2023] Open
Abstract
Irish society went into one of the most stringent lockdowns in March 2020 due to the COVID-19 pandemic, and barring a few weeks, remains highly restricted at time of writing. This has produced a wide range of challenges for those affected by eating disorders, as well as treatment services and Bodywhys, The Eating Disorders Association of Ireland. Current research indicates that COVID-19 has impacted across three key areas-the experience of those with an eating disorder, the experience of service provision, and the impact on the family situation. Drawing on monitoring and evaluation data gathered by Bodywhys, this paper details the challenges faced by those affected by eating disorders in Ireland and how the organisation responded to these challenges, providing support in various forms to people with eating disorders and their families.
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Affiliation(s)
- Harriet Parsons
- Bodywhys, The Eating Disorders Association of Ireland, P.O. Box 105, Blackrock, Co Dublin, Ireland; (B.M.); (D.M.)
| | - Barry Murphy
- Bodywhys, The Eating Disorders Association of Ireland, P.O. Box 105, Blackrock, Co Dublin, Ireland; (B.M.); (D.M.)
| | - Deirbhile Malone
- Bodywhys, The Eating Disorders Association of Ireland, P.O. Box 105, Blackrock, Co Dublin, Ireland; (B.M.); (D.M.)
| | - Ingrid Holme
- School of Sociology, University College Dublin, Dublin, Ireland;
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Vitagliano JA, Jhe G, Milliren CE, Lin JA, Spigel R, Freizinger M, Woods ER, Forman SF, Richmond TK. COVID-19 and eating disorder and mental health concerns in patients with eating disorders. J Eat Disord 2021; 9:80. [PMID: 34215340 PMCID: PMC8253465 DOI: 10.1186/s40337-021-00437-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/21/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The Coronavirus (COVID-19) pandemic dramatically transformed daily life for adolescents and young adults, altering social and physical environments. Previous research has shown such shifts in daily life to be especially challenging for people living with eating disorders (ED). However, the extent of this environmental change on ED symptoms and mental health (MH) has been relatively unexplored in patients with EDs. This study examines how young people with EDs feel the COVID-19 pandemic has affected their living environments as well as their ED and MH symptoms and motivation for ED recovery. METHODS Participants were enrollees in the Registry of Eating Disorders and their Co-morbidities OVER time in Youth (RECOVERY) who responded to an additional survey (n = 89) in July 2020 to assess their perceptions of the impact of the COVID-19 pandemic. Participants reported on concerns of their ED worsening due to increased time living in a "triggering environment" due to the pandemic as well as perceived COVID-related changes in intrusive ED thoughts, depression, anxiety, isolation, and motivation to recover. Logistic regression models, adjusted for age and ED diagnosis, examined the association of triggering environment with ED and MH symptoms. RESULTS The majority of respondents reported concern for worsening of their ED due to a "triggering environment" (63%). Most reported an increase in ED thoughts (74%), feelings of anxiety (77%), depression (73%), and isolation (80%) they perceived to be related to the pandemic. Nearly one-third reported decrease in motivation to recover (29%) they perceived to be related to the pandemic. After adjusting for age and ED diagnosis, participants who reported concern for worsening of their ED due to a triggering environment had nearly 18 times the odds of decreased motivation to recover (OR 18.1; 95% CI 3.37-97.4, p = 0.003) and nearly 24 times the odds of increased ED thoughts (OR 23.8; 95% CI 4.31-131.6, p < 0.001) compared to those who did not report concern for worsening of their ED due to a triggering environment. CONCLUSIONS Our findings demonstrate the perceived negative impact the COVID-19 pandemic has had on the self-reported ED and MH symptoms in patients with EDs, particularly in those who report concern for a negative environmental change. These results underscore the need for heightened monitoring of patients with EDs during the pandemic.
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Affiliation(s)
- Julia A Vitagliano
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA.
| | - Grace Jhe
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA.,Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, 02115, MA, USA
| | - Carly E Milliren
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA.,Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA
| | - Jessica A Lin
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA.,Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, 02115, MA, USA
| | - Rebecca Spigel
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA
| | - Melissa Freizinger
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA.,Department of Psychiatry, Harvard Medical School, 25 Shattuck Street, Boston, 02115, MA, USA
| | - Elizabeth R Woods
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA.,Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, 02115, MA, USA
| | - Sara F Forman
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA.,Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, 02115, MA, USA
| | - Tracy K Richmond
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, 02115, MA, USA.,Department of Pediatrics, Harvard Medical School, 25 Shattuck Street, Boston, 02115, MA, USA
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Simone M, Emery RL, Hazzard VM, Eisenberg ME, Larson N, Neumark‐Sztainer D. Disordered eating in a population-based sample of young adults during the COVID-19 outbreak. Int J Eat Disord 2021; 54:1189-1201. [PMID: 33720460 PMCID: PMC8250323 DOI: 10.1002/eat.23505] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 03/02/2021] [Accepted: 03/02/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The present study aimed to describe the experience of, and factors associated with, disordered eating in a population-based sample of emerging adults during the COVID-19 outbreak. METHOD Participants in the EAT 2010-2018 (Eating and Activity over Time) study were invited to complete the C-EAT (COVID-19 EAT) survey in April-May 2020. There were 720 respondents to the survey (age: 24.7 ± 2.0 years). Psychological distress, stress, stress management, financial difficulties, and food insecurity during the COVID-19 pandemic were examined as cross-sectional correlates of disordered eating in 2020. Open-ended questions assessed the perceived impact of the pandemic on eating behaviors. RESULTS Low stress management was significantly associated with a higher count of extreme unhealthy weight control behaviors (UWCBs). Food insecurity, higher depressive symptoms, and financial difficulties were significantly associated with a higher count of less extreme UWCBs. Higher stress and depressive symptoms were significantly associated with greater odds of binge eating. Six themes pertaining to disordered eating during the pandemic emerged: (a) mindless eating and snacking; (b) increased food consumption; (c) generalized decrease in appetite or dietary intake; (d) eating to cope; (e) pandemic-related reductions in dietary intake; and (f) re-emergence or marked increase in eating disorder symptoms. DISCUSSION Psychological distress, stress management, financial difficulties, and abrupt schedule changes may have contributed to disordered eating during the COVID-19 pandemic. Interventions that target stress management, depressive symptoms, and financial strain and provide tools to develop a routine may be particularly effective for emerging adults at risk of developing disordered eating during public health crises.
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Affiliation(s)
- Melissa Simone
- Department of Psychiatry & Behavioral SciencesUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA,Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Rebecca L. Emery
- Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | | | - Marla E. Eisenberg
- Department of PediatricsUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Dianne Neumark‐Sztainer
- Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
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Zhou Y, Wade TD. The impact of COVID-19 on body-dissatisfied female university students. Int J Eat Disord 2021; 54:1283-1288. [PMID: 33851442 PMCID: PMC8250175 DOI: 10.1002/eat.23521] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE This study investigated the impact of COVID-19 on young women's disordered eating and their responses to online interventions to reduce disordered eating. METHOD University students at risk of developing an eating disorder (N = 100) were randomly assigned to either receiving an online intervention to reduce disordered eating or not. Forty-one participants entered the study from September 2019 to March 2020 (pre-COVID) and 59 after physical distancing was introduced due to COVID pandemic (during COVID). Online assessments were conducted at baseline and 1-week follow up. RESULTS There was a significant increase in weight concerns, disordered eating, and negative affect among participants entering the trial during COVID compared to pre-COVID. The increases in the first two variables remained when adjusting for baseline negative affect. No significant interactions between time, condition and COVID status were observed. DISCUSSION Young women experienced increased levels of disordered eating after the onset of COVID. While no interactions with COVID were detected, changes to within-group effect sizes for disordered eating more than doubled for both online interventions and assessment from pre-COVID to during COVID, suggesting any attention to issues related to disordered eating in the context of reduced social contact may be beneficial.
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Affiliation(s)
- Yuan Zhou
- College of Education Psychology & Social Work, Flinders UniversityAdelaideSouth AustraliaAustralia
| | - Tracey D. Wade
- College of Education Psychology & Social Work, Flinders UniversityAdelaideSouth AustraliaAustralia
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Mahmoud AB, Hack-Polay D, Fuxman L, Nicoletti M. The Janus-faced effects of COVID-19 perceptions on family healthy eating behavior: Parent's negative experience as a mediator and gender as a moderator. Scand J Psychol 2021; 62:586-595. [PMID: 34057230 PMCID: PMC8242485 DOI: 10.1111/sjop.12742] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 03/22/2021] [Accepted: 04/21/2021] [Indexed: 12/16/2022]
Abstract
This research examines the effects of COVID‐19 perceptions and negative experiences during the pandemic time on parental healthy eating behavior and whether these relationships interact with a parent’s gender. We ran a survey of parents who had at least one child aged 3 to 17 years old living in the United Kingdom. We received 384 valid responses, which were analysed via a variance‐based structural equation modeling approach to test our hypotheses. The results revealed that COVID‐19 perceptions effects were Janus‐faced. While they indirectly and negatively impact healthy eating behavior mediated by triggering negative experiences during the pandemic, COVID‐19 perceptions, however, directly get parents, especially fathers, more engaged into healthy eating behavior – making COVID‐19 perceptions total effects positive on healthy eating behavior. This explorative model is novel in the sense that it is the first of its kind to cast light on how parental healthy eating behavior can be shaped in pandemic time. The research is particularly timely due to the uncertain times in which the research is situated, that is, the worldwide pandemic (also termed COVID‐19); the paper highlights how family eating practices can undergo dramatic shifts during acute crises.
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Ben Hassen T, El Bilali H, Allahyari MS, Berjan S, Fotina O. Food purchase and eating behavior during the COVID-19 pandemic: A cross-sectional survey of Russian adults. Appetite 2021; 165:105309. [PMID: 34015307 DOI: 10.1016/j.appet.2021.105309] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/06/2021] [Accepted: 05/07/2021] [Indexed: 02/08/2023]
Abstract
The Russian government took strong containment measures to prevent the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with rigid hygiene protocols and restrictions on daily living, such as social distancing and closing businesses and schools. While these measures were crucial to stop the diffusion of SARS-CoV-2, numerous voices highlighted their disorderly psychological, social, and economic impacts on food consumption behavior and lifestyle. Therefore, this paper aims to understand how consumers' food-related habits in Russia have shifted due to the COVID-19 pandemic and potential problems and opportunities this might bring for the Russian food system. The study is based on an online cross-sectional survey using a structured questionnaire administered in Russian through the Survey Monkey platform. A total of 1297 valid answers was collected. The results reveal that diet and food shopping, preparation, and use have been widely affected. Indeed, the survey results suggested (i) a change in the modality of acquiring food, consumers reduced the number of shopping trips and buying more on each trip to minimize store visits; (ii) a surge of stockpiling of non-perishable food items; (iii) a shift toward healthier diets; (iv) an increase in culinary capabilities; (v) a decrease of food waste. The results are expected to inform current emergency plans as well as long-term food-related strategies in Russia.
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Affiliation(s)
- Tarek Ben Hassen
- Department of International Affairs, College of Arts and Sciences, Qatar University, Doha, 2713, Qatar.
| | - Hamid El Bilali
- International Centre for Advanced Mediterranean Agronomic Studies (CIHEAM-Bari), Via Ceglie 9, 70010, Valenzano (Bari), Italy.
| | - Mohammad S Allahyari
- Department of Agricultural Management, Rasht Branch, Islamic Azad University, Rasht, 41476-54919, Iran; North-West University, Faculty of Economic and Management Sciences, Private Bag X2046, Internal box 575, Mmabatho, 2735, South Africa.
| | - Sinisa Berjan
- Department of Agroeconomy and Rural Development, Faculty of Agriculture, University of East Sarajevo, Lukavica (East Sarajevo), Bosnia and Herzegovina.
| | - Oksana Fotina
- International Relations Center, Perm State Agro-Technological University, Perm, Russia.
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50
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Dietary Habits before and during the COVID-19 Epidemic in Selected European Countries. Nutrients 2021; 13:nu13051690. [PMID: 34065655 PMCID: PMC8156782 DOI: 10.3390/nu13051690] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/15/2021] [Accepted: 05/13/2021] [Indexed: 12/11/2022] Open
Abstract
During the so-called “second wave of the pandemic” in Europe, the authors conducted a cross-sectional online survey that aimed to examine changes in dietary habits and associated practices, as well as physical activity during the COVID-19 pandemic and before the onset of lockdowns in three European countries: Poland, Austria and the United Kingdom. Methods: The online observational study, both prospective and retrospective, conducted with the use of social media for the distribution of an anonymous online questionnaire, was completed from 1 October to 30 October 2020, during the second wave of the pandemic in Europe. The study encompassed a total of 1071 adults from Poland (n = 407), Austria (n = 353) and the United Kingdom (n = 311). Results: The results of this study indicate that the COVID-19 confinement period influenced eating behavior and the level of physical activity in a group of adult residents of Poland, Austria and the United Kingdom. The general shopping frequency decreased, regardless of the place and manner. However, there was an increased interest in online grocery shopping. The resulting data revealed an increased frequency of the daily consumption of food products such as dairy, grains, fats, vegetables and sweets (p < 0.05). A rise in the frequency of purchasing frozen goods and food with long shelf life has also been observed. The changed workplace and working conditions or unemployment probably affected a perceptible rise in alcohol consumption (p = 0.02). In turn, physical activity levels markedly decreased, which reflected the body mass changes. Conclusion: The dietary habits in the studied countries have changed as a result of the pandemic situation. They contribute to the aggravation of the problem of excess body weight and its health consequences.
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