The COVID-19 pandemic saw a significant increase in adolescents and young adults with eating disorders being admitted to inpatient treatment and outpatient programs, according to a recent study by Sydney M. Hartman-Munick, MD’15, assistant professor of pediatrics.
Dr. Hartman-Munick said that while the volume of patients with eating disorders among 15 sites nationwide peaked in April 2021, monthly admissions are still above what they were before the pandemic.
The study was published Nov. 7 in JAMA Pediatrics.
“I think the tough thing about eating disorders is it can take years to recover,” said Hartman-Munick. “If you have a whole bunch of patients with new onset eating disorders and they’re going to take years to recover, we’re really going to feel it for so long.”
Researchers used an observational case series design looking at changes in volume in inpatient and outpatient eating-disorder-related care across 14 hospital-based programs and one non-hospital-based program. They compared monthly patient volume between January 2018 and December 2021.
Before the COVID-19 pandemic was declared in March 2020, inpatient admissions related to eating disorders increased across sites by 0.7 percent per month. After onset of the pandemic, inpatient admissions increased to 7.2 percent per month through April 2021. They then decreased by 3.6 percent per month through December 2021.
Outpatient eating disorder assessments were stable prior to the pandemic but new assessments increased by 8.1 percent per month between May 2020 and April 2021. They then decreased by 1.5 percent per month through December 2021.
Hartman-Munick said that although this study didn’t look at reasons for the jump in admissions, other researchers have cited the following: uncertainty about the future resulting in feeling loss of control; people abruptly losing their treatment team and having difficulty accessing or adapting to telehealth care; individuals worried about where their next meal was coming from, with fear of going to the grocery store or other health concerns; and some people—such as college students—returning to potentially triggering environments when they suddenly had to move home.
“The pandemic has been a universally traumatizing event for pretty much everybody and we know that in the setting of trauma, eating disorders tend to be pretty common,” Hartman-Munick said.
Hartman-Munick said the need for primary care providers to be aware of eating disorders and offer access to screening and treatment has become even more important after the turbulent last few years.
“The frustrating and fascinating thing about eating disorders is they really don’t discriminate,” said Hartman-Munick. “We see eating disorders across every race, ethnicity, every gender identity and sexual orientation. We see eating disorders among people who have difficulties with food insecurity.”
She found in her previous research that LGBTQ+ young adults experienced more difficulty in receiving screening and diagnosis because “people just don’t think of it” in these populations.
Hartman-Munick, who works in adolescent medicine at UMass Memorial Health, is working on building a comprehensive outpatient eating disorders program which would provide services beyond traditional medical care, such as support groups.
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