New Anorexia Cases More Than Doubled During First COVID-19 Wave in Canada

Investigators examined the incidence and severity of newly diagnosed anorexia nervosa and atypical anorexia nervosa in Canada before and during the COVID-19 pandemic.

Newly diagnosed anorexia nervosa cases in Canada rose by about 60% during the first wave of the COVID-19 pandemic, according to a study published in JAMA Psychiatry. The cases reported were more severe, with greater mean weight loss and more “profound” bradycardia, the researchers reported.

COVID-19 has taken its toll on individuals living with a range of mental health conditions, including those with eating disorders. Previous studies have reported worsening symptoms in people with pre-existing eating disorders. The current study examined the incidence and severity of newly diagnosed anorexia nervosa and atypical anorexia nervosa in Canada.

The cross-sectional study looked at new eating disorder assessments given to patients aged from 9 to 18 years between January 1, 2015 and November 30, 2020. The researchers utilized data from 6 of the 10 Canadian pediatric hospitals with eating disorder programs. The study cohort included 1883 children, most of them (91%) girls.

During the 5 years before the pandemic began, diagnoses remained relatively stable, with 24.5 cases reported across all sites. In 2020, the number of new cases across all sites rose to 40.6.

Monthly hospitalizations nearly tripled compared with prepandemic rates. The hospital regions with the highest numbers of COVID-19 cases during the time period — as well as the strictest stay-at-home measures — experienced the highest numbers of newly diagnosed anorexia nervosa.

The investigators acknowledge limitations to this study. It is possible that factors beyond the pandemic could have affected the increase in cases. Additionally, the data did not represent every province, and the study sites were located in only urban areas. Finally, many youth may have chosen to avoid hospitals due to fear of infection, potentially skewing the data further.

“These findings highlight the need for expanded eating disorder and mental health programs during and after the COVID-19 pandemic,” the researchers concluded. “Research is still needed to better understand the drivers and prognosis for these patients and how best to prepare for their mental health needs in the event of future pandemics or prolonged social isolation.”


Agostino H, Burstein B, Moubayed D, et al. Trends in the incidence of new-onset anorexia nervosa and atypical anorexia nervosa among youth during the COVID-19 pandemic in Canada. JAMA Netw Open. 2021;4(12):e2137395. doi:10.1001/jamanetworkopen.2021.37395