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Cited by 193Eating Disorders and BehaviorsNutrition, Health and Food BehaviorCOVID-19 and Mental Health

COVID-19 pandemic lockdown and problematic eating behaviors in a student population

Open access
Flaudias, Valentin, Iceta, Sylvain, Zerhouni, Oulmann, Rodgers, Rachel F, Billieux, Joël, Llorca, Pierre-Michel, Boudesseul, Jordane, de Chazeron, Ingrid +7 more·2020·Journal of Behavioral Addictions
DOI 10.1556/2006.2020.00053PMC PMC8943668
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Abstract

Background and aims: Since mid-March 2020, over 3 billion people have been confined as a result of the COVID-19 pandemic. Problematic eating behaviors are likely to be impacted by the pandemic through multiple pathways. This study examined the relationships between stress related to lockdown measures and binge eating and dietary restriction in a population of French students during the first week of confinement. Methods: A sample of undergraduate students (N = 5,738) completed an online questionnaire 7 days after lockdown measures were introduced. The survey comprised variables related to lockdown measures and the COVID-19-pandemic, mood, stress, body image, binge eating and dietary restriction during the past 7 days, as well as intent to binge eat and restrict in the following 15 days. Results: Stress related to the lockdown was associated with greater likelihood of binge eating and dietary restriction over the past week and intentions to binge eat and restrict over the next 15 days. Greater exposure to COVID-19-related media was associated with increased eating restriction over the past week. Binge eating and restriction (past and intentions) were associated with established risk factors, including female gender, low impulse regulation, high body dissatisfaction, and having a concurrent probable eating disorder. Discussion and conclusion: The higher the stress related to the first week of confinement, the higher the risk of problematic eating behaviors among students, particularly those characterized by eating-related concerns. Screening for risk factors and providing targeted interventions might help decrease problematic eating behaviors among those who are most vulnerable.

AI snapshot

Written from the paper’s full text.

TL;DR

In French undergraduate students surveyed during the first COVID-19 lockdown, lockdown-related stress was associated with higher odds of past-week binge eating and dietary restriction and with intentions to binge/restrict over the next 15 days. Pre-existing eating disorder risk, female gender, body dissatisfaction, and poor impulse regulation were also associated with these problematic eating behaviors.

Key findings

  • Lockdown-related stress was associated with greater odds of past-week binge eating (OR = 1.12, 95% CI 1.04–1.21) and dietary restriction (OR = 1.17, 95% CI 1.08–1.26), and with intentions to binge eat (OR = 1.33, 95% CI 1.19–1.48) and restrict (OR = 1.12, 95% CI 1.03–1.21) over the next 15 days.
  • Probable eating disorder symptoms (SCOFF ≥ 2) were the strongest predictor across outcomes: past-week binge eating OR = 2.82, past-week dietary restriction OR = 2.65, binge-eating intentions OR = 2.11, and dietary restriction intentions OR = 2.58; 38.3% of the sample screened at risk.
  • Female gender, low impulse regulation, and high body dissatisfaction were associated with problematic eating behaviors; for example, women had higher odds of past-week binge eating (OR = 1.40) and dietary restriction (OR = 1.79), and body dissatisfaction was associated with past-week restriction (OR = 1.80).
  • COVID-19-related stress itself was not associated with problematic eating outcomes; COVID-19 media exposure was associated with binge-eating intentions (OR = 1.20, 95% CI 1.11–1.31), while the paper’s abstract reports an association with past-week restriction but Table 2 shows that association was not significant (OR = 1.05, 95% CI 0.98–1.12, p = 0.153).

Methods

  • Online questionnaire completed by 5,738 undergraduate students from four French universities, collected March 26–27, 2020, approximately 10 days after the March 17 lockdown began; response rate was 7.9%.
  • Measures included demographics, HADS depression/anxiety, PSS-10 perceived stress, SPS-10 social provisions, EDI-2 body dissatisfaction and impulse regulation, SCOFF eating disorder screen, IBSS appearance ideals, lockdown/COVID-19 stress, media exposure, and four single-item eating outcomes (past-week binge eating and restriction; intentions to binge and restrict over next 15 days).
  • Four multilevel mixed-effects logistic regressions with a random university intercept; predictors were standardized to z-scores, significance set at 0.05, and listwise deletion removed 235 observations.

Limitations

  • The paper states: cross-sectional data limit causal inference; the four main eating outcomes were single items developed for this study; physical activity restriction due to lockdown was not assessed; the sample was self-selected and not necessarily representative, with women over-represented (74.6% vs. about 55% in the French female student population).
  • Evident from the text: the study relies on self-reported height and weight for BMI and self-reported eating behaviors, and the abstract’s statement about media exposure and past-week restriction is not supported by the reported Table 2 result.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1556/2006.2020.00053

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 5 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Students with obesity reported more binge eating episodes in the past 7 days than normal weight students.

    “students with overweight (OR = 1.26, 95% CI [1.08, 1.49], P = 0.004), and students with obesity (OR = 1.43, 95% CI [0.89–2.31], P = 0.002) reported more binge eating episodes in the past 7 days.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Self-reported height and weight accurately reflect body mass index.
    • Rests on an assumption: The single-item self-report questions validly assess binge eating and dietary restriction.
  • Findingown data

    Greater perceived stress as assessed by the PSS-10 was associated with a higher likelihood of binge eating over the past 7 days.

    “greater perceived stress as assessed by the PSS-10 (OR = 1.24, 95% CI [1.14, 1.35], P < 0.001) and higher levels of stress related to the lockdown (OR = 1.12, 95% CI [1.04, 1.21], P < 0.004) were associated with a higher likelihood of reporting binge eating over the past 7 days.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The single-item self-report questions validly assess binge eating and dietary restriction.
  • Findingown data

    Stress related to lockdown was associated with greater likelihood of dietary restriction over the past 7 days among French undergraduate students.

    “Stress related to the lockdown was associated with greater likelihood of binge eating and dietary restriction over the past week and intentions to binge eat and restrict over the next 15 days.”
    • Also stated in: § Multilevel mixed-effects logistic regression analysis to identify variables associated with binge eating and dietary restriction in the past 7 days (Table 2) · plain
      “Higher stress related to the lockdown (OR = 1.17, 95% CI [1.08, 1.26], P < 0.001) was also associated with a higher likelihood of dietary restriction over the past 7 days.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The single-item self-report questions validly assess binge eating and dietary restriction.
    • Rests on an assumption: The lockdown-related stress score, computed as the sum of 13 questions, validly measures stress related to lockdown.
  • Findingown data

    Stress related to lockdown was associated with greater likelihood of intentions to binge eat over the next 15 days among French undergraduate students.

    “Stress related to the lockdown was associated with greater likelihood of binge eating and dietary restriction over the past week and intentions to binge eat and restrict over the next 15 days.”
    • Also stated in: § Multilevel mixed-effects logistic regression analysis to identify variables associated with anticipated binge eating and dietary restrictive behavior in the next 15 days (Table 3)1 · plain
      “1.33 | 1.19–1.48 | <0.001 | Stressors: related to lockdown | 1.12 | 1.03–1.21 | 0.005”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The single-item self-report questions validly assess binge eating and dietary restriction.
    • Rests on an assumption: The lockdown-related stress score, computed as the sum of 13 questions, validly measures stress related to lockdown.
  • Findingown data

    Underweight students reported fewer binge eating episodes in the past 7 days than normal weight students.

    “those with underweight reported fewer binge eating episodes in the past 7 days than students with normal weight (OR = 0.81, 95% CI [0.66–0.99], P = 0.040)”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Self-reported height and weight accurately reflect body mass index.
    • Rests on an assumption: The single-item self-report questions validly assess binge eating and dietary restriction.
  • May combine two claims. 7
  • Classified as probably not a substantial claim. 10

  • May combine two claims.

    Findingown data

    Media exposure to COVID-19-related information is significantly associated with intent to engage in binge eating, but not with restrictive behavior.

    “Second, our results revealed that media exposure to COVID-19-related information is significantly associated with intent to engage in binge eating, but not with restrictive behavior.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Weight status was associated with problematic eating behavior; problematic eating behavior was more pronounced among the groups at either end of the weight spectrum compared to those whose BMI lay towards the middle of the distribution.

    “In the same vein, we also noted that weight status was associated with problematic eating behavior. Problematic eating behavior was more pronounced among the groups at either end of the weight spectrum compared to those whose BMI lay towards the middle of the distribution.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Participants with a score of 2 or higher on the SCOFF were considered at risk of presenting eating disorder symptoms, consistent with the validated cutoff.

    “Consistent with the validated cutoff, participants with a score of 2 or higher on the SCOFF were considered at risk of presenting eating disorder symptoms (Garcia et al., 2010).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Garcia et al., 2010

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Missing data were handled by listwise deletion, removing 235 observations.

    “All missing data were handled by using a listwise method (i.e., all the data for a specific participant were removed if data were missing on one of the variables). Two-hundred thirty-five observations were removed from the analyses.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All participants provided informed consent.

    “The study was approved by the Ethics Committee of the University of Clermont Auvergne and all participants provided informed consent.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study was approved by the Ethics Committee of the University of Clermont Auvergne.

    “The study was approved by the Ethics Committee of the University of Clermont Auvergne and all participants provided informed consent.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    No variance inflation factor (VIF) greater than 10 was observed for the four models.

    “We did not observe a VIF >10 (all the VIFs for the four models were between 1 and 2.15).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    All four models included a random university effect (random intercept) to control for unobserved university heterogeneity.

    “All four models included a random university effect (i.e., random intercept) to control for unobserved university heterogeneity.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All participants responded anonymously.

    “All participants responded anonymously.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationown data

    This response rate reflects that the particular context and the associated stress and negative affect probably promote a heightened preoccupation with eating.

    “This response rate reflects that the particular context and the associated stress and negative affect probably promote a heightened preoccupation with eating.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Body dissatisfaction and poor emotion regulation emerged as consistent predictors of higher likelihood of engaging in problematic eating behaviors.

    “Two other factors emerged as consistent predictors of the higher likelihood of engaging in problematic eating behaviors in our findings: body dissatisfaction and poor emotion regulation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Body dissatisfaction is a well-documented risk factor for problematic eating behaviors.

    “Body dissatisfaction is a well-documented risk factor for problematic eating behaviors (Stice, Marti, & Durant, 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Stice, Marti, & Durant, 2011

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The study results showed a strong relationship between problematic eating behaviors and stress related to lockdown, a relationship that was associated with exposure to COVID-19-related media coverage.

    “Our results showed a strong relationship between problematic eating behaviors and stress related to lockdown, a relationship that was associated with exposure to COVID-19-related media coverage.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The main outcomes (the four questions regarding problematic eating behaviors) were assessed by using single items developed in the context of the current study.

    “Second, our main outcomes (the four questions regarding problematic eating behaviors) were assessed by using single items developed in the context of the current study.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    The study includes a large sample, but it consists of self-selected participants and is thus not necessarily representative of the undergraduate student population in France.

    “Fourth, even though our study includes a large sample, it consists of self-selected participants and is thus not necessarily representative of the undergraduate student population in France.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    Women are over-represented in the sample (74.6% female), as average proportion of women in the female student population is around 55%.

    “In particular, women are over-represented in our sample (74.6% female), as average proportion of women in the female student population is around 55% (Kabla-Langlois, 2020).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kabla-Langlois, 2020

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Stress related to the lockdown and social isolation might increase the risk of problematic eating behaviors and this might be particularly the case for those with pre-existing eating disorder symptoms and concerns.

    “Our findings suggest that stress related to the lockdown and social isolation might increase the risk of problematic eating behaviors and that this might be particularly the case for those with pre-existing eating disorder symptoms and concerns.”
    Quote in the paperSubstantial claim
17 of 17

  • The paper relies on this without support.

    The effects of lockdown measures and the COVID-19 pandemic on problematic eating behaviors and eating disorder have not been evaluated to date.

    “To date, the effects of lockdown measures and the COVID-19 pandemic on problematic eating behaviors and eating disorder have not been evaluated.”

  • The paper relies on this without support.

    Self-reported height and weight accurately reflect body mass index.

    “body mass index (BMI) (from self-reported height and weight)”

  • The paper relies on this without support.

    The single-item self-report questions validly assess binge eating and dietary restriction.

    “Two additional self-reported indices of problematic eating behaviors were assessed: binge eating and dietary restriction during the past 7 days through two questions: “In the past week, have you experienced any episodes of binge eating (large food intake over a short period of time)?” and “In the past week, have you voluntarily restricted food intake due to weight or body shape concerns?””

  • The paper relies on this without support.

    The lockdown-related stress score, computed as the sum of 13 questions, validly measures stress related to lockdown.

    “Lockdown-related stress was assessed through the sum of the scores for 13 questions related to the new lifestyle imposed by the lockdown (work from home, impact on daily income, impact on social activities, etc.).”

  • The paper relies on this without support.

    The sample of French undergraduate students who completed the survey is representative of French undergraduate students.

    “A sample of undergraduate students (N = 5,738) completed an online questionnaire 7 days after lockdown measures were introduced.”

  • The paper relies on this without support.

    The past week assessed corresponds to the first week of the strict lockdown measures in France.

    “which corresponds to the first week of the implementation of the strict lockdown measures in France.”

  • The paper relies on this without support.

    The COVID-19 pandemic is an adverse event.

    “during an adverse event, such as the COVID-19 pandemic.”
7 of 7

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In Flaudias et al. (2020) French undergraduate students (n = 5,738), increased lockdown-related stress, subjective suffering due to forced social distancing, and daily routine disruptions were associated with greater likelihood of reporting both binge eating and dietary restrictions.

    “The increased stress related to lockdown, the subjective suffering due to forced social distancing, and the daily routine disruptions were associated with a greater likelihood of reporting both binge eating and dietary restrictions.”

    From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Flaudias et al. (2020)

  • In Flaudias et al. (2020), exposure to COVID-19 media news was associated with more severe binge eating behaviors.

    “Moreover, the exposure to COVID-19 media news was associated with more severe binge eating behaviors.”

    From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Flaudias et al. (2020)

  • In Flaudias et al. (2020), preexisting ED habits were risk factors for the development of problematic eating behaviors during the COVID-19 pandemic.

    “As expected, preexisting ED habits were the risk factors for the development of problematic eating behaviors during the COVID-19 pandemic.”

    From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Flaudias et al. (2020)

  • Uncertainty and anxiety due to the pandemic contributed to an increase in subjective discomfort and raised the risk of compulsory eating as a strategy to cope with stress.

    “We found that uncertainty and anxiety due to pandemic contributed to an increase in subjective discomfort and raised the risk of compulsory eating as a strategy to cope with stress (Flaudias et al., 2020; Puhl et al., 2020).”

    From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Flaudias et al., 2020

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Past-week restriction direction is reversed for underweight and obesity

    Major

    The narrative says both groups reported more restriction than normal-weight students. Table 2 reports odds ratios below 1 for both groups, indicating lower odds.

  • Discussion overlooks a significant past-week appearance-ideals association

    Major

    The discussion says appearance-ideal endorsement was related only to intentions, not past-week behaviors. Table 2 reports a significant association with past-week dietary restriction (OR 1.16, P < 0.001).

  • Intended restriction direction is reversed for underweight and obesity

    Major

    The narrative says students with underweight or obesity were more likely than normal-weight students to intend to restrict. Their reported odds ratios, confirmed in Table 3, are 0.29 and 0.31-both below 1.

  • Obesity is described as significantly associated with past-week binge eating

    Major

    The narrative reports P = 0.002 and says students with obesity reported more binge eating. Table 2 gives P = 0.141 for that comparison, with a confidence interval spanning 1.

  • Abstract reports a past-week media association absent from the results

    Major

    The abstract says greater COVID-19-related media exposure was associated with increased eating restriction over the past week. Table 2 reports a nonsignificant association for past-week dietary restriction (OR 1.05, P = 0.153).

  • Obesity confidence interval for intended restriction differs from Table 3

    Minor

    The narrative gives an upper confidence limit of 1.01 for the obesity comparison, whereas Table 3 gives 0.50.

  • Collection is described as both seven and approximately ten days after lockdown

    Minor

    The abstract says the questionnaire was completed seven days after lockdown measures began. The methods date collection to March 26-27, approximately ten days after the March 17 start.

  • Age P value for intended restriction differs from Table 3

    Minor

    The narrative reports P = 0.0427 for age, while Table 3 reports P = 0.027 for the same odds ratio and confidence interval.

  • Discussion calls body dissatisfaction a consistent positive predictor

    Minor

    The discussion describes body dissatisfaction as a consistent predictor of higher likelihood of problematic eating behaviors. Table 3 instead shows a significant inverse association with binge-eating intentions (OR 0.84).

9 of 9

The citation lists haven’t been fetched yet

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Authors
Flaudias, V., Iceta, S., Zerhouni, O., Rodgers, R. F., Billieux, J., Llorca, P.-M., Boudesseul, J., de Chazeron, I., Romo, L., Maurage, P., Samalin, L., Bègue, L., Naassila, M., Brousse, G., & Guillaume, S.
Affiliations
  • Université Clermont Auvergne (FR)
  • Hospices Civils de Lyon (FR)
  • Université Paris Nanterre (FR)
  • Northeastern University (US)
  • Inserm (FR)
  • University of Lausanne (CH)
  • 1Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280, Clermont-Ferrand, France
  • 8Instituto de Investigación Científica, Facultad de Psicología, Universidad de Lima, Lima, Peru
  • GHU Paris psychiatrie & neurosciences (FR)
  • UCLouvain (BE)
  • 12LIPC2S, Université Grenoble Alpes, Saint-Martin-d'Hères, France
Corresponding author
  • Flaudias, Valentin
  • Iceta, Sylvain
  • Zerhouni, Oulmann
  • Rodgers, Rachel F
  • Billieux, Joël
  • Llorca, Pierre-Michel
  • Boudesseul, Jordane
  • Maurage, Pierre
  • Samalin, Ludovic
  • Bègue, Laurent
  • Brousse, Georges
  • Guillaume, Sébastien
ORCID
Venue
Journal of Behavioral Addictions
Publisher
Akademiai Kiado Zrt.
Published
2020-10-12
Volume
9
Issue
3
Pages
826-835
ISSN
  • 2062-5871 (ISSN-L)
  • 2063-5303
DOI
10.1556/2006.2020.00053
PMC
PMC8943668
OpenAlex
W3088856653
Cited by
193
References
32
Citations by year
2026: 8 · 2025: 11 · 2024: 33 · 2023: 36 · 2022: 53 · 2021: 51 · 2020: 1
FWCI
14.08
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Behavioral Addictions (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • SERVAL (Université de Lausanne) (publishedVersion, cc-by-nc)
  • Repository of the Academy's Library (Library of the Hungarian Academy of Sciences) (acceptedVersion)
  • IRIS (submittedVersion, cc-by-nc)
  • HAL (submittedVersion, cc-by-nc)
  • Corpus Université Laval (Université Laval) (submittedVersion)
  • Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion, other-oa)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
  • Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords
COVID-19 lockdown, problematic eating behaviors, binge eating, dietary restriction, stress, university students, body image, body dissatisfaction, impulse control, eating disorder risk, media exposure, eating disorder screening
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Feeding and Eating Disorders, Female, France, Humans, Male, Pneumonia, Viral, Quarantine, Surveys and Questionnaires, Students, Coronavirus Infections, Young Adult, Pandemics

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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