The COVID-19 pandemic has reportedly fueled a rise in eating disorders among young people. As devices replaced in-person contact amid physical distancing, many adolescents succumbed to the influence of social media awash with promotion of diets and exercise programs.
“The message was: Don’t gain weight because you’re home and you have access to all this food and you’re not doing much.,” said clinical psychologist Meghan L. Feehan, PsyD. She is the program manager of Atlantic Health System’s Pediatric Eating Disorders Center in New Jersey and witnessed this stark rise in cases firsthand.
As restrictions on gatherings lifted in mid-2020, “we saw this rapid increase that only just settled down in February of this year,” she said. “That was pretty much the case across the board nationwide.” At one point, her clinic had 120 people on the waiting list.
“We had to refer patients to other facilities in the state due to backlog, to ensure they got timely care,” many of whom didn’t have capacity either. Feehan explained why COVID-19 has fueled so many new cases, and Atlantic Health research is revealing about the profile of adolescents presenting to the center for help.
Atlantic Health System serves the New Jersey, Pennsylvania, and New York metropolitan areas and is a member of the AMA Health System Program, which provides enterprise solutions to equip leadership, physicians and care teams with resources to advance programs while being recognized as a leader and driving the future of medicine.
Eating disorders are biologically based illnesses. Some people have a genetic predisposition to developing an eating disorder. Those with anorexia tend to be hardworking, achievement-oriented, and somewhat rigid and perfectionistic.
“These kids really yearn to have some sort of routine and structure. Quarantine introduced them to a very unstructured way of life,” said Feehan.
Coupled with social media pressure to diet and exercise, this created a perfect storm for eating disorders to rise.
Patients who receive treatment at Atlantic Health are encouraged to limit their use of social media or delete the apps. “It just breeds unhealthy competition,” said Feehan.
Learn what doctors wish patients knew about social media’s toxic impact.
Atlantic Health’s focus on children and adolescents sets it apart from other programs. According to Feehan, it’s the only partial hospitalization program in New Jersey that offers evidence-based, family-based treatment. In this modality, parents take full control of their child’s eating, supervising the child’s meal portions with a goal of weight restoration and resolution of eating-disorder behaviors.
Many patients with eating disorders need to go to an inpatient setting or program because they require medical monitoring. The Pediatric Eating Disorders Center has adolescent medicine physicians on staff who monitor patients daily, making it possible to take on more medically fragile kids. Patients also have access to a therapist, a dietitian and mental health professionals who assess the need for medication.
Learn how the AMA urges equal health care access for eating disorders.
A recent Atlantic Health study that compared pre- and post-pandemic populations yielded two telling findings about the state of youth and their health during the pandemic.
Post-COVID, there was a statistically significant increase in the number of patients who presented to the eating disorders center from the hospital, rather than from the community. They needed medical stabilization first on Atlantic Health’s pediatric floor before starting the program.
Psychiatric medication use following completion of treatment also rose during the pandemic. Before the pandemic, anxiety and depression associated with eating disorders usually resolved with weight restoration. Patients knew they’d be returning to a normal life that involved school and activities.
With the pandemic, there was less of a normal routine to return to. “The resolution of psychiatric symptoms was not seen as frequently during COVID. That resulted in kids needing more medication management as part of their discharge plan,” said Feehan.
The study results were presented at the International Conference on Eating Disorders earlier this month. Parents, physicians and other health professionals should remain vigilant about eating disorders in children during this challenging time, Feehan said.
“Even though the crisis of the pandemic has passed, a lot of these kids are still suffering the effects of it. They’re terrified of going back to quarantine and having that disruption again,” she said.
Read more from JN Learning™ about screening for eating disorders in adolescents and adults.
Essential Tools & Resources
AMA Recovery Plan for America's Physicians
Featured updates: COVID-19 resource center
Listen to the AMA Moving Medicine podcast
Subscribe to the AMA’s Advocacy Update newsletter
Explore CME options on the AMA Ed Hub™
AMA Morning Rounds®: Your daily dose of health care news