A qualitative exploration of the impact of COVID-19 on individuals with eating disorders in the UK
Open accessAbstract
COVID-19 may have substantial impact on the mental health at a population level, but also has the potential to significantly affect those with pre-existing mental health difficulties such as eating disorders. This qualitative study explores the impact of COVID-19 and associated public health measures on adults with eating disorders within the UK. We conducted 10 in depth interviews with adults (24-38 years) with a self-reported eating disorder during lockdown. Data were analysed using an inductive thematic analysis approach. We identified core themes related to social restrictions (social isolation, changes in accountability to others, and increased responsibility for self and others), functional restrictions (lack of routine and structure, a need to intentionally plan activity, a desire for secrecy particularly around food shopping) and restrictions in access to mental health services. Overall, the impact of the lockdown was experienced as a catalyst for either increased disordered eating behaviours or for a drive for recovery, depending on individual circumstances going into these restrictions. This study is the first in depth interview approach with adults with mixed eating disorder presentations in the UK during COVID-19. Findings have important implications for post lockdown intervention care and practice.
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Some patients revealed that fear of contamination concerned primarily the health of elderly and more vulnerable loved ones rather than themselves.
“Some patients revealed that the fear of contamination concerned primarily the health of the elderly and more vulnerable the loved ones rather than themselves (Brown et al., 2020).”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Brown et al., 2020
Lockdown measures might have a positive effect and lead to recovery in some individuals with eating disorders, depending on their working and living situation and eating disorder progression.
“Brown et al. (2020) pointed out that lockdown measures might also have a positive effect and lead to recovery, depending on the working and living situation of participants (alone vs. with a family or a partner or friends), and ED progression.”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Brown et al., 2020
The introduction of lockdown measures and social isolation was associated with negative mental health outcomes, sense of loneliness, tendency to become more focused on food, rumination over food intake, disordered eating behaviors such as restrictions or binge eating, and compulsive physical exercise.
“The introduction of lockdown measures and social isolation was associated with negative mental health outcomes, sense of loneliness, the tendency to become more focused on food, rumination over food intake, disordered eating behaviors, such as restrictions or binge eating, and compulsive physical exercise (Branley-Bell and Talbot, 2020; Brown et al., 2020; Clark Bryan et al., 2020).”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Brown et al., 2020
Accessibility to professional support is a crucial determinant of mental well-being for patients with eating disorders during the pandemic.
“These studies highlighted the role of the accessibility to professional support as a crucial determinant of mental well-being: patients complained about discrepancies in service provision, premature discharge, and suspension of treatments that increased anxiety, and feelings of being abandoned (Branley-Bell and Talbot, 2020; Brown et al., 2020; Clark Bryan et al., 2020).”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Brown et al., 2020
Patients with eating disorders complained about discrepancies in service provision, premature discharge, and suspension of treatments that increased anxiety and feelings of being abandoned.
“These studies highlighted the role of the accessibility to professional support as a crucial determinant of mental well-being: patients complained about discrepancies in service provision, premature discharge, and suspension of treatments that increased anxiety, and feelings of being abandoned (Branley-Bell and Talbot, 2020; Brown et al., 2020; Clark Bryan et al., 2020).”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Brown et al., 2020
Patients reported increased anxiety for the need to deconstruct rigid regimens and to adjust them to the current situation.
“Again, patients reported increased anxiety for the need to deconstruct rigid regimens and to adjust them to the current situation (Brown et al., 2020)”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Brown et al., 2020
Some participants with eating disorders reported increased self-responsibility, intentionality in planning actions, and increased attempts at self-management that improved their eating disorder behaviors.
“Some participants reported increased self-responsibility, intentionality in planning their actions, and increased attempts for a self-management that improved their EDs behaviors.”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Brown et al., 2020
Restrictions or difficulties in healthcare access was relevant in the three studies reviewed.
“This factor was relevant in the three studies (Brown et al., 2020; Clark Bryan et al., 2020; Termorshuizen et al., 2020).”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Brown et al., 2020
Brown et al. (2020) studied only 15 subjects who consented to take part in a Skype interview.
“Brown et al. (2020) studied only on 15 subjects who consented to take part in a Skype interview.”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Brown et al., 2020
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- Authors
- Brown, S., Opitz, M.-C., Peebles, A. I., Sharpe, H., Duffy, F., & Newman, E.
- Affiliations
- University of Edinburgh (GB)
- Corresponding author
- Sharpe, Helen
- Venue
- Appetite
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 156
- Pages
- 104977
- ISSN
- 0195-6663 (ISSN-L)
- PMC
- PMC7521890
- OpenAlex
- W3089040184
- Cited by
- 107
- References
- 27
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 13 · 2023: 18 · 2022: 30 · 2021: 35 · 2020: 2
- FWCI
- 8.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Appetite (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by-nc-nd)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- COVID-19 pandemic, eating disorders, lockdown, social isolation, social restrictions, functional limitations, access to mental health care, disordered eating, recovery, adults
- MeSH terms
- Social Factors, COVID-19, Adult, Feeding and Eating Disorders, Female, United Kingdom, Humans, Male, Mental Health, Public Health, Social Isolation, Qualitative Research, Pandemics
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