A recent study conducted in Germany has shed light on the significant impact of the Covid pandemic on the prevalence and severity of eating disorders among adolescents. The research, which analysed data from the German registry of children and adolescents with anorexia nervosa (AN) and German statutory health insurance, highlights a concerning increase in eating disorders among young people, particularly girls, during the pandemic. The findings were published in the journal European Child & Adolescent Psychiatry.
The study found a marked increase in the administrative prevalence of eating disorders in the outpatient sector among girls aged 10 to 16 years. Using routine data from the Association of Statutory Health Insurance Physicians in Saxony, the researchers discovered a 20% increase in the administrative prevalence of eating disorders among girls during the pandemic. This trend was not observed among boys. The highest increase was noted among girls aged 15 to 16 years, with a 28% rise in prevalence.
This finding aligns with other international studies that have reported a rise in eating disorders during the pandemic. A Finnish study indicated a 27% increase in the incidence of eating disorders among children and adolescents, while a US-based study showed a 15% rise in eating disorder incidences during the pandemic.
In addition to eating disorders, the study observed similar patterns for other internalising disorders. The prevalence of depressive and anxiety disorders among girls increased by 18% and 22%, respectively. Boys, however, did not show significant changes in the prevalence of these disorders during the pandemic. This suggests that girls may have been more vulnerable to the mental health impacts of the pandemic.
Interestingly, while the prevalence of eating disorders increased, the severity of anorexia nervosa (AN) did not show significant changes during the pandemic. The study analysed data from the German Registry of Children and Adolescents with AN, which included 390 children and adolescents aged 10 to 16 years treated in 14 psychiatric hospitals across Germany. The researchers found no significant differences in body mass index (BMI) at admission, body weight loss before admission, prevalence of comorbid psychiatric disorders, or use of psychopharmacological medication between the pre-pandemic and pandemic periods.
This finding contrasts with some international studies that reported an increase in symptom severity and comorbid depression among eating disorder patients during the pandemic. However, it is consistent with other studies that found no significant changes in the severity of eating disorders during this period.
The study suggests several factors that may have contributed to the increase in eating disorders and other internalising disorders among adolescents, particularly girls. The pandemic brought about significant changes in daily life, including school closures, social isolation, and increased screen time. These changes likely exacerbated feelings of loneliness, stress, and anxiety, which are known risk factors for the development of eating disorders and other mental health issues.
Additionally, the increased use of social media and exposure to weight loss content during the pandemic may have contributed to the rise in eating disorders. Adolescents reported increased preoccupation with body image and weight control behaviours, such as following influencers on social media and using weight loss apps, which could have exacerbated or prolonged eating disorder symptoms.
The findings of this study highlight the need for enhanced mental health services for adolescents, particularly in the outpatient sector. The increase in the prevalence of eating disorders and other internalising disorders suggests that more young people are in need of specialised and timely care. This is especially important under pandemic conditions, where access to healthcare services may be limited.
The study underscores the importance of monitoring the long-term mental health impacts of the pandemic on children and adolescents. While the immediate effects are becoming apparent, the long-term consequences for mental health and well-being remain to be fully understood.
