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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
Open accessAbstract
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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“Positive effects of the pandemic were described also in this survey on both the interpersonal (greater connection with relatives) and the motivational side.”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Termorshuizen et al. (2020)
In the citing paper
“All groups described difficulties in accessing their treatments.”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Termorshuizen et al. (2020)
In the citing paper
“Patients with AN described mainly fears about the availability of foods chosen for their “special” meals. Moreover, they reported an exacerbation of food restriction.”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Termorshuizen et al. (2020)
In the citing paper
“Patients with BN and BED increased binge and purge episodes.”
From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Termorshuizen et al. (2020)
In the citing paper
“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 Termorshuizen et al., 2020
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Metadata
- 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
- Venue
- International Journal of Eating Disorders
- Publisher
- openRxiv
- Published
- 2020-05-29
- Volume
- 53
- Issue
- 11
- Pages
- 1780-1790
- ISSN
- 0276-3478 (ISSN-L)
- 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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