COVID-19 pandemic triggers eating disorders in children

The COVID-19 pandemic has spiked an increase in eating disorders due to increased internal distress, binge-eating episodes and other factors. 

Eating disorders typically arise from an increase in internal distress, which could be a result of food insecurity, childhood trauma, abuse, gender role concerns or stressful life events. 

“Evidence that is emerging would suggest that the pandemic itself is acting as a significant trigger," said Dr. Mark Norris, a physician in the Division of Adolescent Medicine at the Children’s Hospital of Eastern Ontario. 

The American Academy of Child & Adolescent Psychiatry found that as many as 10 in 100 young women suffer from an eating disorder. The two most frequent ones are anorexia nervosa and bulimia.

During the pandemic, adolescents engaged in more solitary activities, which may have led to the development of harmful habits, such as poor eating patterns, as a coping mechanism to isolation.

“Much of what we hear from youth speaks to social isolation or social malnutrition,” Norris said.  

Norris and other specialists said they were worried that the pandemic would trigger youth and adults in recovery to relapse from known eating disorders, but they were surprised to find many new cases as well. 

According to the Journal of Eating Disorders, a study by Dr. Norris found that patients were not only reporting lower weight but also higher levels of functional impairment. They were also more likely to require hospital admission.

Eating disorders can negatively affect the entire digestive system and lead to electrolyte and chemical imbalances in the body that affect major organ functions. These imbalances, along with cardiac arrest, can kill without warning. 

A study from the journal Current Opinion in Psychiatry estimated that over 3.3 million healthy life-years are lost to eating disorders.

Norris’ study also found that when patients were asked what they thought prompted their illness, 40% of children reported the effects of the pandemic. 

Norris said he saw similar trends across Canada and the U.S. during the summer and fall of 2020 and contacted Dr. David Little, a family physician and clinical informaticist at Epic Health Research Network, to see if Little’s electronic medical records corroborated with his findings.

“What's really interesting is that when we looked at other mental health diagnoses — anxiety, depression and even suicide attempts — we saw slight increases,” Little said. “But nothing nearly as dramatic as the 30 percent increase in adolescent girls being hospitalized for anorexia and other eating disorders.”

Norris said the family of patients should externalize the illness to realize the patient is being threatened by the eating disorder. 

“It's a disease, not something that's wrong with the child and certainly not the child's fault,” Norris said. 

Norris said it is important to reach out for help because the longer an eating disorder is in place, the harder it is to treat.

“Awareness is the number one message,” Little said, "not only for health professionals, but for families, for parents, for kids, for the school systems and for the community at large.”

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The National Eating Disorder Association (NEDA) has a confidential, toll free helpline at 800-931-2237 as well as an online click-to-chat service. For 24/7 crisis support, text “NEDA” to 741-741. The NEDA has also provided a list of recommended websites and free or low-cost resources.