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Eating Disorders: An Epidemic Within a Pandemic?

September 10, 2021

There have been multiple reports of increased mental health diagnoses during the pandemic. Most pediatricians and other physicians and non-physician providers who care for children and adolescents have experienced this, and eating disorders are no exception. However, most reports of increased rates of eating disorder diagnoses have been from ambulatory settings.

This week, Pediatrics is early releasing an article that also was released in pre-publication form last month, entitled “Medical Admissions Among Adolescents with Eating Disorders during the COVID-19 Pandemic,” authored by Dr. Alana Otto and colleagues at the University of Michigan (10.1542/peds.2021-052201).

Persons with eating disorders require medical admission when there are signs of physiologic instability, such as a heart rate of <50 beats per minute. While you may not be surprised at the major finding of this paper (there has been an increase in medical admissions for eating disorders at the University of Michigan’s C.S. Mott Children’s Hospital), you will be surprised at the extent of the increase (more than double). One of my colleagues has described this as “an epidemic within a pandemic” and, especially after reading this article, I agree with that characterization.

You will want to read this article to understand some of the many reasons that could explain this increase, including increased depression and anxiety, social isolation, and boredom. I also think that many of these adolescents experienced such a profound loss of control over so many aspects of their lives, and so it should perhaps not be a surprise that some of them needed to feel that they could control some part of their lives – diet and exercise.

We all are hopeful that, as schools open for in-person learning this fall, this epidemic of eating disorders – and indeed, other mental health issues – will subside.

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