PreprintCited by 304Eating Disorders and BehaviorsCOVID-19 and Mental HealthNutrition, Health and Food Behavior

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Early Impact of COVID-19 on Individuals with Eating Disorders: A survey of ~1000 Individuals in the United States and the Netherlands

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Termorshuizen, Jet D., Watson, Hunna J., Thornton, Laura M., Borg, Stina, Flatt, Rachael E., MacDermod, Casey M., Harper, Lauren E., van Furth, Eric F., Peat, Christine M., Bulik, Cynthia M.·2020·International Journal of Eating Disorders

DOI 10.1101/2020.05.28.20116301PMC PMC7274236

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Abstract

We received rapid ethical permission to evaluate the early impact of COVID-19 on people with eating disorders. Participants in the United States (US, N=511) and the Netherlands (NL, N=510), recruited through ongoing studies and social media, completed an online baseline 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 revealed strong and wide-ranging effects on eating disorder concerns and illness behaviors that were consistent with diagnoses. 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.

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Authors: Termorshuizen, J. D., Watson, H. J., Thornton, L. M., Borg, S., Flatt, R. E., MacDermod, C. M., Harper, L. E., van Furth, E. F., Peat, C. M., & Bulik, C. M.
Affiliations: Karolinska Institutet (SE)
University of North Carolina at Chapel Hill (US)
Corresponding author: Bulik, Cynthia M.
ORCID: Termorshuizen, Jet D.
Watson, Hunna J.
Thornton, Laura M.
Flatt, Rachael E.
MacDermod, Casey M.
Peat, Christine M.
Bulik, Cynthia M.
Venue: International Journal of Eating Disorders
Publisher: openRxiv
Published: 2020-05-29
Volume: 53
Issue: 11
Pages: 1780-1790
ISSN: 0276-3478 (ISSN-L)
DOI: 10.1101/2020.05.28.20116301
PMC: PMC7274236
OpenAlex: W3045754778
Cited by: 304
References: 29
Citations by year: 2026: 11 · 2025: 8 · 2024: 31 · 2023: 44 · 2022: 86 · 2021: 100 · 2020: 22
FWCI: 25.22
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: International Journal of Eating Disorders (publishedVersion)
medRxiv (acceptedVersion)
PubMed (publishedVersion)
Leiden Repository (Leiden University) (submittedVersion, cc-by)
PubMed Central (submittedVersion)
UWA Profiles and Research Repository (UWA) (submittedVersion, other-oa)
Data Archiving and Networked Services (DANS) (submittedVersion, cc-by)
Funders: Sunovion
Vetenskapsrådet (R01MH119084, R01 MH120170, 538‐2013‐8864, award: 538-2013-8864, Vetenskapsrådet, award: 538-2013-8864)
Idorsia Pharmaceuticals
National Institutes of Health
National Institute of Mental Health (R01MH120170, R01MH119084, 538-2013-8864)
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, anorexia nervosa, bulimia nervosa, binge eating disorder, eating disorder symptoms, anxiety, telemedicine, relapse, dietary restriction, binge eating, well-being, family ties, self-care

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Early Impact of COVID-19 on Individuals with Eating Disorders: A survey of ~1000 Individuals in the United States and the Netherlands

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