Eating Disorders Spectrum during COVID Pandemic: a systematic review

Background

Several data suggest that COVID-19 pandemic might exacerbate or trigger Eating Disorders (EDs). The aim of this paper was to summarize present literature on COVID pandemic and EDs.

Methods

Literature search, study selection, methods, and quality evaluation were performed following PRISMA Guidelines.

Results

The systematic search permitted the identification of 91 studies; 21 papers were eligible and included in the review. Nine papers (42.9%) evaluated the effect of pandemic and associated protective and risk factors in EDs patients, ten (47.6%) explored the prevalence of disturbed eating behaviours and risk factors for exacerbating EDs in the general population, and the remaining two (9.5%) were qualitative studies describing the impact of lockdown and quarantine on EDs patients.

Their analysis revealed five main findings: 1) changes in physical activities routines were related to a worsening of preoccupation on weight/body shape; 2) food access limitation during pandemic represented a risk factors for both triggering and exacerbating EDs; 3) restriction in healthcare facilities contributed to increase anxiety levels and modifies treatment compliance; 4) social isolation was related to symptoms’ exacerbation in EDs patients who are home-confined with family members; 5) conflicts and difficulties in relationships with ‘no way out’ were maintenance factors for EDs symptoms, especially in adolescents and young adults.

Conclusion

COVID-19 pandemic had a negative impact on EDs that might be triggered or worsened by the exceptional conditions deriving from COVID-19-related stress in predisposed subjects. Patients already affected by EDs experienced a worsening of their clinical conditions and related quality of life.