The pandemic has likely affected individuals vulnerable for developing eating disorders, as there has been an increased trend of inpatient hospitalizations. These findings were published as a research letter in JAMA Network Open.
This study analyzed deidentified data of persons in the United States insured by UnitedHealth Group. Trends of inpatient hospitalizations and outpatient care for eating disorders, alcohol use disorders, opioid use disorders, depression, anxiety, and suicidality between January 2018 to December 2020 were assessed.
A total of 3,281,366 patient records were included in this study. The patient population was 62.6% women aged mean 37.7 (standard deviation [SD], 16.2) years. Over time, the patient population was consistent, except that the age of patients hospitalized for an eating disorder decreased over time.
From the beginning of the study period, monthly rates of hospitalization for an eating disorder remained ~0.3 per 100,000 until May 2020, when the rate doubled to ~0.6 per 100,000.
Stratified by anorexia nervosa, bulimia nervosa, and other unspecified disorders, this increased trend was observed among all groups.
The length of inpatient stay during June to December also increased from a median of 9 (interquartile range [IQR], 5-17) days in 2018 and 8 (IQR, 3-14) days in 2019 to 12 (IQR, 5-27) days in 2020.
For outpatient care, the number of patients increased from 25 per 100,000 per month prior to the pandemic to 29 per 100,000 per month during the pandemic.
Compared with other behavioral health conditions, no similar increases during the pandemic were observed.
This study was limited by sourcing data from a single insurer, so data may not be generalizable to other populations.
The study authors concluded that the pandemic likely intensified eating disorders and their ascertainment. Early in the pandemic, sourcing food became more difficult due to contagion and supply concerns. In addition, the closure of schools and colleges may have allowed families to better identify unhealthy eating, leading to an increase in hospital admissions. Some individuals may have delayed outpatient care because of infection concerns, instead needing inpatient care due to deferred treatment.
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
Asch DA, Buresh J, Allison KC, et al. Trends in US patients receiving care for eating disorders and other common behavioral health conditions before and during the COVID-19 pandemic. JAMA Netw Open. Published November 16, 2021 doi:10.1001/jamanetworkopen.2021.34913