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1.
Nutrients ; 14(1)2021 Dec 27.
Article in English | MEDLINE | ID: covidwho-1580550

ABSTRACT

BACKGROUND: The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. AIMS: (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. METHODS: The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). RESULTS: Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. CONCLUSIONS: The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients.


Subject(s)
COVID-19/prevention & control , COVID-19/psychology , Feeding and Eating Disorders/psychology , Quarantine/psychology , Social Isolation/psychology , Adolescent , Adult , Asia , Child , Europe , Female , Humans , Internationality , Longitudinal Studies , Male , SARS-CoV-2 , Young Adult
2.
Nutrients ; 14(1)2021 Dec 31.
Article in English | MEDLINE | ID: covidwho-1580544

ABSTRACT

There are many ways to regulate emotions. People use both adaptive (e.g., regulation by music) and maladaptive (e.g., regulation by food) strategies to do this. We hypothesized that participants with a high level of food-based regulatory strategies and a low level of music-based regulatory strategies (a group with the least adaptive form of emotion regulation) would have significantly greater levels of unhealthy eating behaviours, depression, anxiety and stress, as well as a significantly lower level of healthy eating behaviours than those with a low level of food-based regulatory strategies and a high level of music-based regulatory strategies (a group with the greatest adaptive form of emotion regulation). Participants (N = 410; Mage = 31.77, SD = 13.53) completed: the Brief Music in Mood Regulation Scale, the Emotional Overeating Questionnaire, the Healthy and Unhealthy Eating Behavior Scale, the Depression, Anxiety and Stress Scale and a socio-demographic survey. The four clusters were identified: (a) Cluster 1 (N = 148): low food-based regulatory strategies and high music-based regulatory strategies; (b) Cluster 2 (N = 42): high food-based regulatory strategies and high music-based regulatory strategies; (c) Cluster 3 (N = 70): high food-based regulatory strategies and low music-based regulatory strategies; (d) Cluster 4 (N = 150): low food-based regulatory strategies and low music-based regulatory strategies. Overall, our outcomes partially support our hypothesis, as higher levels of unhealthy eating behaviours, depression, anxiety and stress were observed in participants with high food-based and low music-based regulatory strategies as compared with adults with low food-based and high music-based regulatory strategies. To sum up, the results obtained indicate that during the COVID-19 pandemic the group of people regulating their emotional state and unhealthy eating predominantly with food is potentially characterized by worse functioning than the group of people regulating with music. Therefore, it can be concluded that people who regulate their functioning using food should be included in preventive measures by specialists. During the visit, psychologists and primary care physicians can ask patients about their daily strategies and based on this information specialists can estimate the potential risk of developing high levels of stress and anxiety, depressive disorders and unhealthy eating habits and provide specific (match) intervention.


Subject(s)
Anxiety Disorders/therapy , COVID-19/psychology , Depressive Disorder/therapy , Diet, Healthy/statistics & numerical data , Feeding and Eating Disorders/therapy , Music/psychology , Stress, Psychological/therapy , Adolescent , Adult , Aged , Anxiety Disorders/complications , Anxiety Disorders/psychology , Cluster Analysis , Depressive Disorder/complications , Depressive Disorder/psychology , Emotional Regulation , Feeding and Eating Disorders/complications , Feeding and Eating Disorders/psychology , Female , Humans , Male , Middle Aged , Patient Acuity , SARS-CoV-2 , Stress, Psychological/complications , Stress, Psychological/psychology , Surveys and Questionnaires , Young Adult
3.
Nutrients ; 13(10)2021 Sep 28.
Article in English | MEDLINE | ID: covidwho-1444280

ABSTRACT

The COVID-19 pandemic has caused stress as well as modified physical activity and eating habits among university students. The objectives were to identify the changes in body mass index (BMI) and eating disorders among university students between 2009 and 2021. Between 2009 and 2021, five repeated cross-sectional studies were conducted among university students who filled in an anonymous online self-questionnaire. Age, gender, and BMI were recorded, and the SCOFF questionnaire was used for ED screening which, in combination with BMI, allows to identify the four broad categories of ED with the Expali algorithm. With the five studies, 8981 university students were included in total. Obesity steadily increased between 2009 and 2021, for both men and women. The prevalence of ED was stable between 2009 and 2018 and significantly increased from 31.8% in 2018 to 51.8% in 2021 for women (p trend < 0.0001), and from 13.0% in 2009 to 31.3% in 2021 for men (p trend < 0.0001). All types of ED increased significantly between 2009 and 2021, except for restrictive ED among men. These results indicate for the first time a significant increase in ED prevalence among students since the COVID-19 pandemic. Initiatives to reinforce early screening of ED to implement targeted interventions in the student population are urgently needed.


Subject(s)
COVID-19/psychology , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/psychology , Students/psychology , Adult , Cross-Sectional Studies , Female , France/epidemiology , Humans , Male , Pandemics , Prevalence , SARS-CoV-2 , Students/statistics & numerical data , Surveys and Questionnaires , Universities , Young Adult
4.
J Med Internet Res ; 23(7): e28346, 2021 07 08.
Article in English | MEDLINE | ID: covidwho-1314516

ABSTRACT

BACKGROUND: COVID-19 has affected individuals with lived experience of eating disorders (EDs), with many reporting higher psychological distress, higher prevalence of ED symptoms, and compensatory behaviors. The COVID-19 pandemic and the health and safety measures taken to contain its spread also disrupted routines and reduced access to familiar coping mechanisms, social support networks, and health care services. Social media and the ED communities on social media platforms have been an important source of support for individuals with EDs in the past. So far, it is unknown how discussions in online ED communities changed as offline support networks were disrupted and people spent more time at home in the first months of the COVID-19 pandemic. OBJECTIVE: The aim of this study is to identify changes in language content and style in an online ED community during the initial onset of the COVID-19 pandemic. METHODS: We extracted posts and their comments from the ED community on the social media website Reddit and concatenated them to comment threads. To analyze these threads, we applied top-down and bottom-up language analysis methods based on topic modeling with latent Dirichlet allocation and 13 indicators from the Linguistic Inquiry and Word Count program, respectively. Threads were split into prepandemic (before March 11, 2020) and midpandemic (after March 11, 2020) groups. Standardized mean differences were calculated to estimate change between pre- and midpandemic threads. RESULTS: A total of 17,715 threads (n=8772, 49.5% prepandemic threads; n=8943, 50.5% midpandemic threads) were extracted from the ED community and analyzed. The final topic model contained 21 topics. CIs excluding zero were found for standardized mean differences of 15 topics and 9 Linguistic Inquiry and Word Count categories covering themes such as ED symptoms, mental health, treatment for EDs, cognitive processing, social life, and emotions. CONCLUSIONS: Although we observed a reduction in discussions about ED symptoms, an increase in mental health and treatment-related topics was observed at the same time. This points to a change in the focus of the ED community from promoting potentially harmful weight loss methods to bringing attention to mental health and treatments for EDs. These results together with heightened cognitive processing, increased social references, and reduced inhibition of negative emotions detected in discussions indicate a shift in the ED community toward a pro-recovery orientation.


Subject(s)
COVID-19/epidemiology , Feeding and Eating Disorders/psychology , Language , Pandemics , Social Media , Social Support , Emotions , Feeding and Eating Disorders/physiopathology , Humans , Latent Class Analysis , Linguistics , Mental Health , Psychological Distress , SARS-CoV-2 , Weight Loss
6.
Nutrients ; 13(4)2021 Apr 20.
Article in English | MEDLINE | ID: covidwho-1194695

ABSTRACT

To limit the spread of the novel coronavirus (COVID-19), many countries have introduced mandated lockdown or social distancing measures. Although these measures may be successful against COVID-19 transmission, the pandemic and attendant restrictions are a source of chronic and severe stress and anxiety which may contribute to the emergence or worsening of symptoms of eating disorders and the development of negative body image. Therefore, in this study, we aimed to: (1) classify different conditions associated with COVID-19-related stress, COVID-19-related anxiety, and weight status; and (2) analyze and compare the severity of dimensions typically related to eating disorders symptomatology and body image in individuals with different COVID-19-related stress, COVID-19-related anxiety, and weight status. Polish women (N = 671, Mage = 32.50 ± 11.38) completed measures of COVID-19-related stress and anxiety along with body dissatisfaction, drive for thinness, and bulimia symptomatology subscales of the Eating Disorders Inventory, and the appearance evaluation, overweight preoccupation, and body areas satisfaction subscales of the Multidimensional Body-Self Relations Questionnaire. The following four clusters were identified through cluster analysis: (a) Cluster 1 (N = 269), healthy body weight and low COVID-related stress (M = 3.06) and anxiety (M = 2.96); (b) Cluster 2 (N = 154), healthy body weight and high COVID-related stress (M = 5.43) and anxiety (M = 5.29); (c) Cluster 3 (N = 127), excess body weight and high COVID-related stress (M = 5.23) and anxiety (M = 5.35); (d) Cluster 4 (N = 121), excess body weight and low COVID-related stress (M = 2.69) and anxiety (M = 2.83). Our results showed that Clusters 3 and 4 had significantly greater body dissatisfaction and lower appearance evaluation and body areas satisfaction than Clusters 1 and 2. Cluster 3 also had a significantly higher level of drive for thinness, bulimia, and overweight preoccupation than Clusters 1 and 2. These preliminary findings may mean that the COVID-19 pandemic and attendant anxiety and stress caused by the pandemic are exacerbating symptoms of eating disorders and negative body image, with women with excess weight particularly at risk.


Subject(s)
Anxiety/epidemiology , Body Image/psychology , COVID-19/psychology , Feeding and Eating Disorders/epidemiology , Stress, Psychological/epidemiology , Adult , Anorexia Nervosa/epidemiology , Anxiety/psychology , Body Mass Index , Body Weight , Bulimia/epidemiology , COVID-19/epidemiology , Cluster Analysis , Communicable Disease Control , Feeding and Eating Disorders/psychology , Female , Humans , Poland/epidemiology , SARS-CoV-2 , Stress, Psychological/psychology , Surveys and Questionnaires , Young Adult
8.
BMJ Open Qual ; 10(2)2021 04.
Article in English | MEDLINE | ID: covidwho-1169878

ABSTRACT

BACKGROUND: Mealtimes occur six times a day on eating disorder (ED) inpatient units and are a mainstay of treatment for EDs. However, these are often distressing and anxiety provoking times for patients and staff. A product of patients' distress is an increase in ED behaviours specific to mealtimes. The aim of this quality improvement project was to decrease the number of ED behaviours at mealtimes in the dining room through the implementation of initiatives identified through diagnostic work. METHODS: The Model for Improvement was used as the systematic approach for this project. Baseline assessment included observations in the dining room, gathering of qualitative feedback from staff and patients and the development of an ED behaviours form used by patients and staff. The first change idea of a host role in the dining room was introduced, and the impact was assessed. RESULTS: The introduction of the host role has reduced the average number of ED behaviours per patient in the dining room by 35%. Postintervention feedback demonstrated that the introduction of the host role tackled the disorganisation and chaotic feeling in the dining room which in turn has reduced distress and anxiety for patients and staff. CONCLUSIONS: This paper shows the realities of a quality improvement (QI) project on an ED inpatient unit during the COVID-19 pandemic. The results are positive for changes made; however, a large challenge, as described has been staff engagement.


Subject(s)
COVID-19 , Feeding and Eating Disorders/psychology , Food Service, Hospital/standards , Meals/psychology , Quality Improvement , Adult , Anxiety/psychology , Behavior Observation Techniques , Feeding and Eating Disorders/therapy , Female , Humans , Inpatients/psychology , Male , Personnel, Hospital/psychology , Qualitative Research , SARS-CoV-2 , Stress, Psychological/psychology
9.
Nutrients ; 13(4)2021 Mar 29.
Article in English | MEDLINE | ID: covidwho-1159895

ABSTRACT

BACKGROUND: In older people with psychoneurological diseases, COVID-19 infection may be associated with a risk of developing or exacerbating dysphagia. The aim of the present study was to examine the relationship between eating/swallowing function and COVID-19 infection. METHODS: Subjects were 44 inpatients with confirmed COVID-19 infection being treated for schizophrenia in a psychiatric ward. Eating function was assessed using the Food Intake Level Scale (FILS) before and after infection. We also evaluated age, comorbidities, COVID-19 hospital stay, obesity index, weight loss rate, and chlorpromazine equivalent. RESULTS: Subjects had a mean age of 68.86 years. Pre-infection, 20 subjects had a FILS score of 7-9 (presence of eating/swallowing disorder) and 24 subjects had a score of 10 (normal). Eating function after infection resolution showed decreasing FILS score compared to that before infection in 14 subjects (74.14 years). Six subjects (79.3 years) transitioned from oral feeding to parenteral feeding. A ≥ 10% weight loss during infection treatment was significantly associated with decreased eating function and a transition to parenteral feeding. Chlorpromazine equivalents, comorbidities, and number of days of hospitalization showed no associations with decreased eating function. CONCLUSIONS: Preventing malnutrition during treatment for COVID-19 infection is important for improving post-infection life prognosis and maintaining quality of life (QOL).


Subject(s)
COVID-19/complications , Deglutition Disorders/etiology , Feeding and Eating Disorders/etiology , Schizophrenia/complications , Weight Loss , Aged , COVID-19/physiopathology , COVID-19/psychology , Deglutition Disorders/physiopathology , Deglutition Disorders/psychology , Eating/physiology , Eating/psychology , Feeding and Eating Disorders/physiopathology , Feeding and Eating Disorders/psychology , Female , Humans , Male , Middle Aged , Nutritional Status , Schizophrenia/virology
10.
J Alzheimers Dis ; 80(2): 533-537, 2021.
Article in English | MEDLINE | ID: covidwho-1073321

ABSTRACT

We explored the experience from caregivers of people with dementia (PwD) during mandatory confinement due to the COVID-19 pandemic in Spain. An online survey, which studied the perceptions of the main problems and consequences experienced during confinement, was answered by 106 family caregivers of PwD. Results showed that family caregivers of PwD experienced psychological problems, like anxiety, mood, sleep, or eating disorders during confinement and felt less supported when they had to handle challenging behaviors or offer meaningful activities. An innovative multi-tiered supportive approach is needed which considers a post-pandemic reality and ensures the continuity of quality care for PwD and their family careers.


Subject(s)
Alzheimer Disease/psychology , Alzheimer Disease/therapy , COVID-19/psychology , Caregivers/psychology , Needs Assessment , Adaptation, Psychological , Aged , Aged, 80 and over , Anxiety Disorders/psychology , Anxiety Disorders/therapy , COVID-19/prevention & control , Feeding and Eating Disorders/psychology , Feeding and Eating Disorders/therapy , Female , Humans , Male , Middle Aged , Mood Disorders/psychology , Mood Disorders/therapy , Sleep Wake Disorders/psychology , Sleep Wake Disorders/therapy , Social Isolation , Social Support , Spain
11.
Encephale ; 46(3S): S43-S52, 2020 Jun.
Article in French | MEDLINE | ID: covidwho-1065048

ABSTRACT

The psychological effects of isolation have already been described in the literature (polar expeditions, submarines, prison). Nevertheless, the scale of confinement implemented during the COVID-19 pandemic is unprecedented. In addition to reviewing the published studies, we need to anticipate the psychological problems that could arise during or at a distance from confinement. We have gone beyond the COVID-19 literature in order to examine the implications of the known consequences of confinement, like boredom, social isolation, stress, or sleep deprivation. Anxiety, post-traumatic stress disorder, depression, suicidal or addictive behaviours, domestic violence are described effects of confinement, but the mechanisms of emergence of these disorders and their interrelationships remain to be studied. For example, what are the mechanisms of emergence of post-traumatic stress disorders in the context of confinement? We also remind the reader of points of vigilance to be kept in mind with regard to eating disorders and hallucinations. Hallucinations are curiously ignored in the literature on confinement, whereas a vast literature links social isolation and hallucinations. Due to the broad psychopathological consequences, we have to look for these various symptoms to manage them. We quickly summarize the diagnostic and therapeutic approaches already in place, such as telemedicine, which is undergoing rapid development during the COVID-19 crisis.


Subject(s)
Betacoronavirus , Coronavirus Infections , Pandemics , Patient Isolation/psychology , Pneumonia, Viral , Social Isolation/psychology , Adult , Anxiety Disorders/etiology , Anxiety Disorders/psychology , Behavior, Addictive/etiology , Behavior, Addictive/psychology , Boredom , COVID-19 , Child , Child Abuse , Coronavirus Infections/psychology , Delivery of Health Care , Depression/etiology , Depression/psychology , Domestic Violence/psychology , Feeding and Eating Disorders/etiology , Feeding and Eating Disorders/psychology , France , Hallucinations/etiology , Hallucinations/psychology , Health Services Accessibility , Humans , Mental Health Services/organization & administration , Pneumonia, Viral/psychology , SARS-CoV-2 , Sleep Wake Disorders/etiology , Sleep Wake Disorders/psychology , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/psychology , Suicide/psychology , Telemedicine
12.
Nutrients ; 12(10)2020 Sep 24.
Article in English | MEDLINE | ID: covidwho-982806

ABSTRACT

Emotional eating (EE) is prevalent among women and is associated with obesity. The coronavirus 2019 (COVID-19) pandemic and mandatory quarantine increased the risk of mental symptoms and, inferentially, emotional eating (EE). We investigated the EE prevalence and predictors during this pandemic. Overall, 638 women, ages 18-39, completed an online survey incorporating the Emotional Eating Scale, Perceived Stress Scale, Generalized Anxiety Disorder-7 Scale, Patient Health Questionnaire-9, Pittsburgh Sleep Quality Index, and Global Physical Activity Questionnaire. We asked about nutrition and collected data on weight, height, and pandemic responses. Most respondents (47.2%) reported low EE; 40.4% were "moderate" and 12.4% "high" emotional eaters; 42.8% reported depression, 27% anxiety, 71% moderate stress, and 12.5% severe stress. The main EE indicators/predictors were fat intake (ß = 0.192, p = 0.004), number of meals (ß = 0.187, p < 0.001), sugar consumption (ß = 0.150, p < 0.001), body mass index (ß = 0.149, p < 0.001), stress (ß = 0.143, p = 0.004), energy intake (ß = 0.134, p = 0.04), and fast food intake frequency (ß = 0.111, p < 0.01). EE score correlated negatively with increased family income (ß = -0.081, p = 0.049). Higher stress correlated with worse sleep, less sleep, and less physical activity. Emotional eating is common among young Saudi women during the pandemic. We recommend healthy food choices and increased physical activity to improve sleep and mitigate stress.


Subject(s)
Coronavirus Infections/prevention & control , Diet, Healthy/psychology , Emotions , Feeding and Eating Disorders/epidemiology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Quarantine/psychology , Adolescent , Adult , Anxiety/epidemiology , Anxiety/psychology , Betacoronavirus , COVID-19 , Diet Surveys , Eating/psychology , Feeding Behavior/psychology , Feeding and Eating Disorders/psychology , Female , Humans , Prevalence , Risk Factors , SARS-CoV-2 , Saudi Arabia/epidemiology , Stress, Psychological/epidemiology , Stress, Psychological/psychology , Young Adult
13.
Gen Hosp Psychiatry ; 67: 136-140, 2020.
Article in English | MEDLINE | ID: covidwho-893777

ABSTRACT

OBJECTIVE: To describe the impact of the COVID-19 pandemic on help-seeking behaviors among individuals with eating disorders and caregivers. METHODS: We analyzed service utilization data from the National Eating Disorder Information Centre (NEDIC). We compared the number of contacts and symptom frequency between the pandemic period and previous years. RESULTS: NEDIC was contacted 609 times during March 1-April 30, 2020 (72.1% individuals affected by disordered eating, 20.4% caregivers). The number of total contacts significantly increased from 2018 to 2019 and 2018 to 2020 (X2(3) = 50.34, p < .001). Among affected individuals (80.4% women), the number of contacts during the pandemic period was significantly higher (n = 439; X2(2) = 92.74, p < .001) compared to 2018 (n = 197) and 2019 (n = 312). There were higher rates of eating disorder symptoms, anxiety, and depression in 2020 compared to previous years. Thematic analysis of instant chats from the pandemic year revealed four emerging themes: 1) lack of access to treatment, 2) worsening of symptoms, 3) feeling out of control, and 4) need for support. CONCLUSION: These findings point toward the impact of COVID-19 in individuals affected by disordered eating and hold implications for service delivery during times of crises.


Subject(s)
COVID-19 , Caregivers/statistics & numerical data , Facilities and Services Utilization/statistics & numerical data , Feeding and Eating Disorders , Health Services Accessibility/statistics & numerical data , Patient Acceptance of Health Care/statistics & numerical data , Adolescent , Adult , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/physiopathology , Feeding and Eating Disorders/psychology , Feeding and Eating Disorders/therapy , Female , Humans , Internal-External Control , Internet-Based Intervention/statistics & numerical data , Male , Middle Aged , Psychotherapy/statistics & numerical data , Social Support , Symptom Flare Up , Young Adult
14.
Int J Eat Disord ; 53(12): 2049-2054, 2020 12.
Article in English | MEDLINE | ID: covidwho-886969

ABSTRACT

OBJECTIVE: COVID-19 has led to disruptions in daily living and increased uncertainty about physical, financial, social, and psychological consequences, which may contribute to anxiety, eating disorder (ED) pathology, and compulsive exercise. Individual factors, such as intolerance of uncertainty, may impact risk for ED pathology and CE in response to COVID-19 anxiety. The current study examined associations between COVID-19 anxiety, trait intolerance of uncertainty, and COVID-19 intolerance of uncertainty and ED pathology and compulsive exercise. METHOD: Undergraduate participants (N = 295) completed a series of online questionnaires between March and April of 2020. RESULTS: COVID-19 anxiety and intolerance of uncertainty were associated with ED pathology, but not compulsive exercise. Additionally, both trait and COVID-19 intolerance of uncertainty moderated associations between COVID-19 anxiety and compulsive exercise and ED pathology. COVID-19 anxiety was more strongly related to compulsive exercise and ED pathology for individuals with lower intolerance of uncertainty. DISCUSSION: COVID-19 anxiety may increase risk for ED pathology and may be specifically important in determining risk for ED pathology and compulsive exercise among individuals with lower intolerance of uncertainty. These results contribute to a growing body of research aimed at understanding the mental health consequences of the COVID-19 and suggest that individual factors (e.g., anxiety and intolerance of uncertainty) are important in determining risk for ED pathology and compulsive exercise in the context of the pandemic.


Subject(s)
Anxiety/psychology , COVID-19/psychology , Compulsive Exercise/psychology , Feeding and Eating Disorders/psychology , Uncertainty , Adult , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/virology , Feeding and Eating Disorders/epidemiology , Female , Humans , Male , Mental Health , Pandemics , SARS-CoV-2/isolation & purification , Students/statistics & numerical data , Surveys and Questionnaires , United States/epidemiology , Universities/statistics & numerical data , Young Adult
15.
J Behav Addict ; 9(3): 826-835, 2020 Oct 12.
Article in English | MEDLINE | ID: covidwho-796245

ABSTRACT

BACKGROUND AND AIMS: Since mid-March 2020, over 3 billion people have been confined as a result of the COVID-19 pandemic. Problematic eating behaviors are likely to be impacted by the pandemic through multiple pathways. This study examined the relationships between stress related to lockdown measures and binge eating and dietary restriction in a population of French students during the first week of confinement. METHODS: A sample of undergraduate students (N = 5,738) completed an online questionnaire 7 days after lockdown measures were introduced. The survey comprised variables related to lockdown measures and the COVID-19-pandemic, mood, stress, body image, binge eating and dietary restriction during the past 7 days, as well as intent to binge eat and restrict in the following 15 days. RESULTS: Stress related to the lockdown was associated with greater likelihood of binge eating and dietary restriction over the past week and intentions to binge eat and restrict over the next 15 days. Greater exposure to COVID-19-related media was associated with increased eating restriction over the past week. Binge eating and restriction (past and intentions) were associated with established risk factors, including female gender, low impulse regulation, high body dissatisfaction, and having a concurrent probable eating disorder. DISCUSSION AND CONCLUSION: The higher the stress related to the first week of confinement, the higher the risk of problematic eating behaviors among students, particularly those characterized by eating-related concerns. Screening for risk factors and providing targeted interventions might help decrease problematic eating behaviors among those who are most vulnerable.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/psychology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Quarantine/psychology , Students/psychology , Adult , COVID-19 , Female , France/epidemiology , Humans , Male , Pandemics , SARS-CoV-2 , Students/statistics & numerical data , Surveys and Questionnaires , Young Adult
16.
Ann Behav Med ; 54(10): 738-746, 2020 10 01.
Article in English | MEDLINE | ID: covidwho-752259

ABSTRACT

BACKGROUND: Weight stigma is common for people with obesity and harmful to health. Links between obesity and complications from COVID-19 have been identified, but it is unknown whether weight stigma poses adverse health implications during this pandemic. PURPOSE: We examined longitudinal associations between prepandemic experiences of weight stigma and eating behaviors, psychological distress, and physical activity during the COVID-19 pandemic in a diverse sample of emerging adults. METHODS: Participants (N = 584, 64% female, mean age = 24.6 ± 2.0 years, mean body mass index [BMI] = 28.2) in the COVID-19 Eating and Activity over Time (C-EAT) study were cohort members of the population-based longitudinal study EAT 2010-2018. Weight stigma reported by participants in 2018 was examined as a predictor of binge eating, eating to cope, physical activity, depressive symptoms, and stress during COVID-19. Data were collected via online surveys during the U.S. outbreak of COVID-19 in 2020. RESULTS: Prepandemic experiences of weight stigma predicted higher levels of depressive symptoms (ß = 0.15, p < .001), stress (ß = 0.15, p = .001), eating as a coping strategy (ß = 0.16, p < .001), and an increased likelihood of binge eating (odds ratio = 2.88, p < .001) among young adults during the COVID-19 pandemic but were unrelated to physical activity. Although associations remained after accounting for demographic characteristics and BMI, the magnitude of longitudinal associations was attenuated after adjusting for prior levels of the outcome variables. CONCLUSIONS: Young adults who have experienced weight stigma may have increased vulnerability to distress and maladaptive eating during this pandemic. Public health messaging could be improved to support people of diverse body sizes and reduce the harmful consequences of weight stigma.


Subject(s)
Body Weight , Coronavirus Infections/psychology , Feeding and Eating Disorders/psychology , Pneumonia, Viral/psychology , Psychological Distress , Social Stigma , Betacoronavirus , COVID-19 , Exercise/psychology , Female , Humans , Longitudinal Studies , Male , Obesity/psychology , Pandemics , SARS-CoV-2 , Young Adult
17.
Int J Eat Disord ; 53(11): 1855-1862, 2020 11.
Article in English | MEDLINE | ID: covidwho-734194

ABSTRACT

OBJECTIVE: the aim of this longitudinal study was to evaluate the impact of COVID-19 epidemic on Eating Disorders (EDs) patients, considering the role of pre-existing vulnerabilities. METHOD: 74 patients with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) and 97 healthy controls (HCs) were evaluated before lockdown (T1) and during lockdown (T2). Patients were also evaluated at the beginning of treatment (T0). Questionnaires were collected to assess psychopathology, childhood trauma, attachment style, and COVID-19-related post-traumatic symptoms. RESULTS: A different trend between patients and HCs was observed only for pathological eating behaviors. Patients experienced increased compensatory exercise during lockdown; BN patients also exacerbated binge eating. Lockdown interfered with treatment outcomes: the descending trend of ED-specific psychopathology was interrupted during the epidemic in BN patients. Previously remitted patients showed re-exacerbation of binge eating after lockdown. Household arguments and fear for the safety of loved ones predicted increased symptoms during the lockdown. BN patients reported more severe COVID-19-related post-traumatic symptomatology than AN and HCs, and these symptoms were predicted by childhood trauma and insecure attachment. DISCUSSION: COVID-19 epidemic significantly impacted on EDs, both in terms of post-traumatic symptomatology and interference with the recovery process. Individuals with early trauma or insecure attachment were particularly vulnerable.


Subject(s)
Coronavirus Infections/prevention & control , Feeding and Eating Disorders/psychology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Quarantine/psychology , Adolescent , Adult , COVID-19 , Case-Control Studies , Exercise/psychology , Feeding Behavior/psychology , Feeding and Eating Disorders/therapy , Female , Humans , Italy , Longitudinal Studies , Middle Aged , Object Attachment , Psychological Trauma/psychology , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/psychology , Surveys and Questionnaires , Young Adult
18.
Int J Eat Disord ; 53(11): 1780-1790, 2020 11.
Article in English | MEDLINE | ID: covidwho-680161

ABSTRACT

OBJECTIVE: We evaluated the early impact of COVID-19 on people with self-reported eating disorders. METHOD: Participants in the United States (US, N = 511) and the Netherlands (NL, N = 510), recruited through ongoing studies and social media, completed an online survey that included both quantitative measures and free-text responses assessing the impact of COVID-19 on situational circumstances, eating disorder symptoms, eating disorder treatment, and general well-being. RESULTS: Results revealed strong and wide-ranging effects on eating disorder concerns and illness behaviors that were consistent with eating disorder type. Participants with anorexia nervosa (US 62% of sample; NL 69%) reported increased restriction and fears about being able to find foods consistent with their meal plan. Individuals with bulimia nervosa and binge-eating disorder (US 30% of sample; NL 15%) reported increases in their binge-eating episodes and urges to binge. Respondents noted marked increases in anxiety since 2019 and reported greater concerns about the impact of COVID-19 on their mental health than physical health. Although many participants acknowledged and appreciated the transition to telehealth, limitations of this treatment modality for this population were raised. Individuals with past histories of eating disorders noted concerns about relapse related to COVID-19 circumstances. Encouragingly, respondents also noted positive effects including greater connection with family, more time for self-care, and motivation to recover. DISCUSSIONS: COVID-19 is associated with increased anxiety and poses specific disorder-related challenges for individuals with eating disorders that require attention by healthcare professionals and carers.


Subject(s)
Coronavirus Infections , Feeding and Eating Disorders/psychology , Health Status Indicators , Pandemics , Pneumonia, Viral , Adolescent , Adult , Anxiety/epidemiology , Anxiety/etiology , COVID-19 , Feeding and Eating Disorders/therapy , Female , Health Behavior , Health Services Accessibility , Humans , Male , Mental Health , Middle Aged , Needs Assessment , Netherlands , Self Report , Telemedicine , United States , Young Adult
19.
Int J Eat Disord ; 53(7): 1166-1170, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-457140

ABSTRACT

The current COVID-19 pandemic has created a global context likely to increase eating disorder (ED) risk and symptoms, decrease factors that protect against EDs, and exacerbate barriers to care. Three pathways exist by which this pandemic may exacerbate ED risk. One, the disruptions to daily routines and constraints to outdoor activities may increase weight and shape concerns, and negatively impact eating, exercise, and sleeping patterns, which may in turn increase ED risk and symptoms. Relatedly, the pandemic and accompanying social restrictions may deprive individuals of social support and adaptive coping strategies, thereby potentially elevating ED risk and symptoms by removing protective factors. Two, increased exposure to ED-specific or anxiety-provoking media, as well as increased reliance on video conferencing, may increase ED risk and symptoms. Three, fears of contagion may increase ED symptoms specifically related to health concerns, or by the pursuit of restrictive diets focused on increasing immunity. In addition, elevated rates of stress and negative affect due to the pandemic and social isolation may also contribute to increasing risk. Evaluating and assessing these factors are key to better understanding the impact of the pandemic on ED risk and recovery and to inform resource dissemination and targets.


Subject(s)
Coronavirus Infections/prevention & control , Exercise/psychology , Feeding Behavior/psychology , Feeding and Eating Disorders/psychology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Quarantine/psychology , Adaptation, Psychological , Betacoronavirus , COVID-19 , Coronavirus Infections/psychology , Fear , Female , Humans , Male , Pneumonia, Viral/psychology , Risk Factors , SARS-CoV-2
20.
Int J Eat Disord ; 53(7): 1158-1165, 2020 07.
Article in English | MEDLINE | ID: covidwho-457188

ABSTRACT

OBJECTIVE: Emerging evidence suggests that the coronavirus (COVID-19) pandemic may be negatively impacting mental health. The impact on eating and exercise behaviors is, however, currently unknown. This study aimed to identify changes in eating and exercise behaviors in an Australian sample among individuals with an eating disorder, and the general population, amidst the COVID-19 pandemic outbreak. METHOD: A total of 5,469 participants, 180 of whom self-reported an eating disorder history, completed questions relating to changes in eating and exercise behaviors since the emergence of the pandemic, as part of the COLLATE (COvid-19 and you: mentaL heaLth in AusTralia now survEy) project; a national survey launched in Australia on April 1, 2020. RESULTS: In the eating disorders group, increased restricting, binge eating, purging, and exercise behaviors were found. In the general population, both increased restricting and binge eating behaviors were reported; however, respondents reported less exercise relative to before the pandemic. DISCUSSION: The findings have important implications for providing greater monitoring and support for eating disorder patients during the COVID-19 pandemic. In addition, the mental and physical health impacts of changed eating and exercise behaviors in the general population need to be acknowledged and monitored for potential long-term consequences.


Subject(s)
Coronavirus Infections/prevention & control , Exercise/psychology , Feeding Behavior/psychology , Feeding and Eating Disorders/psychology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Quarantine/psychology , Adult , Australia/epidemiology , Betacoronavirus , COVID-19 , Coronavirus Infections/psychology , Feeding and Eating Disorders/epidemiology , Female , Humans , Male , Mental Health , Pneumonia, Viral/psychology , SARS-CoV-2 , Self Report
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