The COVID-19 pandemic and youth with anorexia nervosa: A retrospective comparative cohort design.

OBJECTIVE: There is a growing body of literature suggesting the novel coronavirus pandemic (COVID-19) negatively impacts mental health in individuals self-reporting an eating disorder (ED); however, limited pediatric data is available about the impact COVID-19 has had on youth with EDs, specifically Anorexia Nervosa (AN). Our study uses a cross-sectional design to explore differences in ED symptoms between adolescents diagnosed with AN during the COVID-19 pandemic compared to a retrospective cohort of adolescents for whom these measures were previously collected, prior to the pandemic. METHOD: We report cross-sectional data assessing differences between AN behaviors and cognitions during the COVID-19 pandemic compared to a retrospective cohort (n = 25 per cohort) assessed before the pandemic. RESULTS: Results suggest that individuals with a first-time diagnosis of AN during the pandemic had lower percent expected body weight, and more compulsive exercise behaviors. CONCLUSIONS: These data support existing pediatric findings in exercise and body weight differences in adolescents with AN before and during the pandemic. Findings may be helpful in informing considerations for providers treating ED patients amidst and after the pandemic. PUBLIC SIGNIFICANCE: This manuscript compares a retrospective cohort of adolescents diagnosed with AN prior to the pandemic to a cohort of adolescents diagnosed with AN during the pandemic. Results report that adolescents diagnosed with AN during the pandemic have lower weights and increased compensatory exercise behavior compared to adolescents diagnosed with AN before the pandemic despite no difference in length of illness. Findings may be helpful in informing considerations for providers treating ED patients amidst and after the pandemic.

Effect of telehealth implementation on an adolescent metabolic and bariatric surgery program.

BACKGROUND: Pediatric severe obesity is a worldwide health concern. Treatment with metabolic and bariatric surgery can reduce morbidity and mortality. The COVID-19 pandemic not only has had a significant effect on rates of pediatric obesity but also has necessitated a rapid transition to virtual medicine. OBJECTIVE: We aimed to identify and examine adolescent metabolic and bariatric surgery patient participation rates through our program's virtual telehealth programming as compared with prepandemic traditional in-person clinic appointments. SETTING: This study took place at an academic pediatric quaternary care center. METHODS: We evaluated 92 adolescent patients with a total of 2442 unique encounters between January 2018 and July 2021. RESULTS: The rate of attendance was found to be greater for telehealth visits (83.1%) than for in-person appointments (70.5%) for all clinics regardless of appointment type (preoperative versus postoperative). Cancellation rates were lower for telehealth visits (9.9%) than for in-person appointments (22.5%). CONCLUSION: This study provides evidence that telehealth can be implemented successfully in an adolescent metabolic and bariatric surgery program and can improve attendance rates for all provider and appointment subtypes.

Family-based treatment via videoconference: Clinical recommendations for treatment providers during COVID-19 and beyond.

The necessity to employ distance-based methods to deliver on-going eating disorder care due to the novel coronavirus (COVID-19) pandemic represents a dramatic and urgent shift in treatment delivery. Yet, TeleHealth treatments for eating disorders in youth have not been adequately researched or rigorously tested. Based on clinical experience within our clinic and research programs, we aim to highlight the common challenges clinicians may encounter in providing family-based treatment (FBT) via TeleHealth for children and adolescents with anorexia nervosa and bulimia nervosa. We also discuss possible solutions and offer practical considerations for providers delivering FBT in this format. Additional research in TeleHealth treatment for eating disorders in youth may lead to improved access, efficiency, and effectiveness of FBT delivered via videoconferencing.