Longitudinal experiences and impact of the COVID-19 pandemic among people with past or current eating disorders in Sweden

Objective

To document the impact of the COVI-19 pandemic on the health and well-being of individuals with past and current eating disorders in Sweden.

Method

We re-contacted participants from two previous Swedish studies who had a known lifetime history of an eating disorder. Participants completed an online questionnaire about their health and functioning at baseline early in the pandemic (Wave 1; N=982) and six months later (Wave 2); N=646).

Results

Three important patterns emerged: 1) higher current eating disorder symptom levels were associated with greater anxiety, worry, and pandemic-related eating disorder symptom increase; 2) patterns were fairly stable across time, although a concerning number who reported being symptom-free at Wave 1 reported re-emergence of symptoms at Wave 2; and only a minority of participants with current eating disorders were in treatment, and of those who were in treatment, many reported fewer treatment sessions than pre-pandemic and decreased quality of care.

Conclusions

The COVID-19 pandemic is posing serious health challenges for individuals with eating disorders, whether currently symptomatic or in remission. We encourage health service providers and patient advocates to be alert to the needs of individuals with eating disorders and to take active measures to ensure access to appropriate evidence-based care both during and following the pandemic.

Significant Outcomes and Limitations

• Individuals with eating disorders symptoms or current active disorder report higher adverse impact of COVID-19 on their mental health

• Even individuals who were symptom-free early in the pandemic reported a resurgence of eating disorder symptoms

• A large proportion of symptomatic individuals were not in treatment for their eating disorder, services should be aware and access to evidence-based care should be ensured across Sweden

• Limitations included the use of a convenience sample with atypical diagnostic distribution, and a low initial response rate, possibly introducing bias and limiting generalisability.

Data Availability Statement

Fully anonymized data are available from the corresponding author upon request.