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Effects of COVID-19 lockdown on eating disorders

Efectos Covid19

The scenario created by the Covid-19 pandemic has interfered with the lives of most of the population, and has especially affected people with previous mental pathologies. A group of researchers has focused their studies on factors related to a worse adaptation to the pandemic in patients with Eating Disorders (ED), to discover the variables that interfere in the process of their improvement in situations of isolation such as in these past months. The results obtained will contribute to improving current preventive and therapeutic programs.

iStock. Daniel Lozano Gonzalez

The health alert caused by the SARS-CoV-2 (COVID-19) coronavirus has generated enormous alterations throughout the world since it was declared a pandemic by the World Health Organization, at the end of January 2020. In addition to interfering in the routines of practically the entire general population, COVID has caused in patients with previous mental pathologies increases in the levels of anxiety, depression, impulsivity, emotional dysregulation, worsening of their functional status and even suicidal ideation. Patients with eating disorders (ED) are an especially vulnerable group to the impacts of COVID-19, due to the particular difficulties that it entails for them to adapt to the aspects arising from compulsory confinement (such as the stress derived from related concerns with the disease and access to therapeutic programs). This scenario has generated great interest in the study of the factors related to a worse adaptation to the coronavirus pandemic in patients with ED, in order to develop more effective protocols for possible future waves.

A multicenter international collaboration project led clinically by Dr. Fernando Fernández-Aranda (Coordinator of the ED Unit of the Bellvitge University Hospital, Barcelona), under the methodological direction of Dr. Roser Granero Pérez (Department of Psychobiology and Methodology of the UAB) and with the support of a large group of international experts in ED, have published different studies addressing the following objectives: a) develop a psychometric scale to measure regulatory strategies during the pandemic state and the impacts of confinement by COVID -19 (this instrument has already been translated into 18 languages); b) estimate the impact of confinement in patients with ED; c) identify factors influencing the evolution of the ED during lockdown; and d) design an guide for patients with ED, their families and therapists, with recommendations and guidelines for the confinements (also translated into 21 languages).

The global results showed that the response to treatment during confinement depended on the diagnostic subtype: patients with anorexia nervosa and binge eating disorder showed the best therapeutic response (slight improvement), while patients with bulimia nervosa barely showed changes (maintenance), and patients with subclinical or unspecified disorder increased the severity of eating symptoms. The worsening in the patients’ functional state was also associated with lower scores in self-direction, which is a personality trait related to the ability of individuals to control, regulate and adapt their behaviors to the demands of the situation (low levels in This dimension is observed in subjects with difficulty developing adaptive coping strategies). Finally, patients with anorexia showed the worst acceptance of the telemedicine intervention (compared to the previous face-to-face treatment).

Knowing the variables that influence the improvement process of patients in lockdown such as that caused by COVID-19 is essential in the health field. The results of these studies contribute to the improvement of current preventive and therapeutic programs. The development of protocols must be carried out seeking maximum customization, incorporating in each case the vulnerability factors to confinement and the added stress situations that these lockdowns entail.

Roser Granero Prez

Department of Psychobiology and Methodology of the Health Sciences.
Methodology Area of the Behavioral Sciences.
Universitat Autònoma de Barcelona.


Baenas I, Caravaca-Sanz E, Granero R, Sánchez I, Riesco N, Testa G, et al. (2020). COVID-19 and eating disorders during confinement: Analysis of factors associated with resilience and aggravation of symptoms. European Eating Disorders Review. doi: 10.1002/erv.2771.

Fernandez-Aranda F, Casas M, Claes L, Clark Bryan D, Favaro A, Granero R, et al. (2020). COVID-19 and implications for eating disorders. European Eating Disorders Review. doi: 10.1002/erv.2738.

Fernández-Aranda F, Munguía L, Mestre-Bach G, Steward T, Etxandi M, Baenas I, Granero R, et al. (2020). COVID Isolation Eating Scale (CIES): Analysis of the impact of confinement in eating disorders and obesity, A collaborative international study. European Eating Disorders Review, doi: 10.1002/erv.2784.

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