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Cited by 70Eating Disorders and BehaviorsCOVID-19 and Mental HealthNutrition, Health and Food Behavior

Now it’s just old habits and misery”–understanding the impact of the covid-19 pandemic on people with current or life-time eating disorders: a qualitative study

Open access
McCombie, Catherine, Austin, Amelia, Dalton, Bethan, Lawrence, Vanessa, Schmidt, Ulrike·2020·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2020.589225PMC PMC7653176
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Abstract

Background: Many aspects of the Covid-19 pandemic may make living with or recovery from an eating disorder (ED) particularly challenging. Understanding the processes which underlie the psychological and behavioural responses of people with EDs during this time are key to ensure tailored support in these unprecedented circumstances. Methods: People with lifetime EDs were recruited through social media from May to June 2020 during a period of strict infection control measures in the United Kingdom (i.e., ‘lockdown’, ‘social distancing’). They completed open-ended questions in an online anonymous questionnaire that invited them to reflect on how various aspects of their lives have been affected by the Covid-19 pandemic, including ED symptoms and coping strategies. Responses were analysed using thematic analysis. Results: Most respondents reported that their ED worsened or resurfaced. Isolation, low mood, anxiety, lack of structure, disruption to routines, and media/social media messages around weight and exercise seemed to contribute to this. There was a clear sense that individuals struggled with which aspects of psychological distress to prioritise, i.e., mood versus ED cognitions and behaviours, particularly as attempts to cope with one often exacerbated the other. Nonetheless, some participants reported ‘silver linings’ of the pandemic. Conclusions: In this self-selected sample, deterioration or recurrence of ED symptoms were the norm. This has implications for the provision of treatment and care for people with EDs both in the immediate short-term and in potential future waves of the pandemic, with a significant surge of new and re-referrals expected.

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  • In McCombie et al. (2020) UK sample of 32 subjects, ED symptoms were described as exacerbated by the pandemic and by associated changes in lifestyle in 88% of cases.

    “Eating disorder symptoms were described as exacerbated by pandemic, and by the associated changes in lifestyle in 88% of the cases.”

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

  • In McCombie et al. (2020), 72% of participants described a positive effect of having more space and time for healing and self-care, and having less pressure to engage in social activities.

    “Unexpectedly, 72% of participants described a sort of “positive effect of having more space and time for healing and self-care,” and having less pressure to engage in social activities.”

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

  • In McCombie et al. (2020), physical and psychological isolation, worry about the future, fear around a return to normal life, and changes in daily routine were the main topics.

    “Physical and psychological isolation, worry about the future, fear around a “return to normal life,” and changes in daily routine were the main topics.”

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

  • McCombie et al. (2020) was conducted on a very small sample (n = 32) recruited with posts on Twitter.

    “A third study (McCombie et al., 2020) found non-univocal results, but was conducted on a very small sample (n = 32) recruited with posts on Twitter.”

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

  • McCombie et al. (2020) found non-univocal results.

    “A third study (McCombie et al., 2020) found non-univocal results, but was conducted on a very small sample (n = 32) recruited with posts on Twitter.”

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

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Research works printed but not linked: 1

  1. [1]Hampshire A Hellyer P Soreq E Trender W Mehta MA Ioannidis K Dimensions and moderators of behavioural and mental-health changes during the Covid-19 pandemic: an N = 343,017 study. medRxiv [Pre-print]. (2020). 10.1101/2020.06.18.20134635 · DOI

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Authors
McCombie, C., Austin, A., Dalton, B., Lawrence, V., & Schmidt, U.
Affiliations
King's College London (GB)
Corresponding author
Schmidt, Ulrike
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2020-10-27
Volume
11
Pages
589225-589225
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2020.589225
PMC
PMC7653176
OpenAlex
W3096049010
Cited by
70
References
31
Citations by year
2026: 2 · 2025: 3 · 2024: 8 · 2023: 13 · 2022: 18 · 2021: 26
FWCI
5.70
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Research Portal (King's College London) (submittedVersion, other-oa)
Funders
  • National Institute for Health and Care Research (NF-SI-0616-10075)
  • King's College London
  • Economic and Social Research Council
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
eating disorders, COVID-19 pandemic, lockdown, symptom recurrence, social isolation, social media influence, coping strategies, psychological distress, anxiety, mood, treatment demand, re-referral

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