By Iana Niknezhad, Ocean Lakes High School, Virginia Beach, Virginia, USA
Eating disorders—such as anorexia, binge eating, restriction, and bulimia—have had significant effects on adolescents and adults after the onset of the COVID-19 pandemic in April of 2020. In fact, these disorders have been shown to cause critical long-term impacts on the lives of people that have them, such as depression, anxiety, hormonal imbalances, body distortion, and mental suffering. In recent times, a significant rise in cases after the COVID-19 pandemic has shown to impact people worldwide. The onset of the pandemic, along with a rise in social media use– which often promotes ideologies for certain body types–have increased the number of cases worldwide. Indeed, the COVID-19 pandemic, acting as a catalyst for this increase, has played a role in creating a statistically significant rise in eating disorder cases that continue to prevail today.
Eating disorders are mental illnesses caused by many factors such as genetics, the external environment, social influence, and socioeconomic status that can affect just about anyone (Barakat et al., 2023). These serious and widespread disorders, which can be fatal and costly, may cause long term impacts such as disability, electrolyte imbalances, and bradycardia (Hundemedr et al. 2022). In fact, in the United States, approximately 10% of the population has experienced an eating disorder over their lifetime (Hartman-Munick et al. 2022). Although around for a long time, eating disorders have had increasingly detrimental effects on adults and adolescents in recent years after the onset of the COVID-19 pandemic.
In a study conducted by the National Eating Disorder Quality Improvement Collaborative (NEDQIC), the effect of COVID-19 on the cases of inpatient and outpatient eating disorders in 15 US sites showed significant results. Before the onset of COVID-19 (January 1, 2018-March 31, 2020), eating disorder inpatient admissions were increasing at 0.7% monthly. In contrast, after the onset of the pandemic (April 2020), this percentage escalated to 7.2% (Hartman-Munick et al., 2022). Additionally, in another study analyzing the volume of patients searching for inpatient and emergency care in hospitals, the volume of patients increased from 1.50 visits per month to 12.9 since April of 2020 (Milliren et al. 2022). Although the volume of patients seeking such care for eating disorders decreased the second year post COVID-19 onset, it has not returned to pre COVID-19 levels. In fact, across 38 different hospitals, 27 months before pandemic onset there were a total of 2793 patient visits pertaining to eating disorders, which has increased by over 185% to 5217 cases 27 months post outbreak. Notably, a higher proportion of those patient visits were from adolescents aged 14-17, with a higher number being diagnosed with anorexia nervosa.
The growing concern with eating disorders is not unique to the United States. Worldwide, the ‘burden of eating disorders’ was shown to be more prevalent in higher-income countries. However, it has now been shown that South and East Asia are displaying a higher risk towards a ‘burden of eating disorders’. In addition, the pandemic has had extreme impacts on people of all ages with higher risk of eating disorders in different regions such as Europe, Australia, and North America (Zipfel et al., 2022). For instance, in New Zealand, eating disorders were identified to be a prevalent issue in a variety of age groups including adolescents, young adults, and middle aged adults (Cleland et al., 2023).
There have been several possible explanations for the significant statistical increase in eating disorder cases during COVID-19. Changes such as disturbances in daily routines of individuals, along with an emphasis on exercise, may have caused individuals to experience struggles with body image and weight. These disturbances to daily routines may negatively impact emotional support systems, sleeping patterns, and eating habits, causing more risk of eating disorder behavior (Rodgers et al., 2020). To compound this issue, the pervasiveness of social media has continued to exacerbate the influence of eating disorders. With the rise of social media use worldwide, there has been an influx of endorsements promoting eating disorders and an emphasis on so-called “diet culture”. Eating disorders, like anorexia, which are built off distorted views of the body, have shown a correlation to depression and mental suffering (Ciwoniuk et al., 2023). Such views could be attributed to public messages praising thin ideology worldwide, creating unhealthy motivations for ‘thinness’. As a matter of fact, in a study where female participants with no previous history of eating disorders were exposed to idealized body images on the internet for a week, caloric intake dropped by 20% (Barakat et al., 2023). In addition, this viewing of content has caused not only great caloric reduction in females, but also body dissatisfaction in males. In essence, eating disorders have significantly influenced societies ideals, behavior, and perspective to be prone to eating disorders.
With the recent global prevalence of eating disorders in adults and adolescence post the COVID-19 pandemic, it is crucial we continue to study possible treatments and areas of research regarding long term effects on younger and older individuals. In the end, these disorders can have many short and long term health implications on our generations that are vital to address and prevent.