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. 2021 Dec;26(8):2787-2793.
doi: 10.1007/s40519-021-01116-5. Epub 2021 Feb 9.

Eating disorders during COVID-19 pandemic: the experience of Italian healthcare providers

Georgia Colleluori #  1   2 , Ilaria Goria #  3 , Claudia Zillanti #  3 , Simonetta Marucci  3   4 , Laura Dalla Ragione  3   4
Affiliations

Eating disorders during COVID-19 pandemic: the experience of Italian healthcare providers

Georgia Colleluori et al. Eat Weight Disord. 2021 Dec.

Abstract

Purpose: Due to COVID-19 pandemic, the Italian population lived in quarantine from March to May 2020 (lockdown phase I). Restrictions impacted individuals' psychological health, especially in those with eating disorders (ED). Healthcare providers (HCPs) treating ED provided assistance by telemedicine and/or in walk-in clinics. We hypothesize that social restrictions represented a great stressor for ED patients and HCPs, negatively impacted their therapeutic alliance, and affected the frequency of dysfunctional behaviors.

Methods: This cross-sectional study consisted of an online survey investigating the experience of HCPs involved in ED treatment, with a specific focus on difficulties concerning the therapeutic efficacy. Questionnaire (n. 18 questions) was formulated ad hoc by our research team and sent by e-mail to Italian HCPs registered on online platforms. HCPs included ED experts specialized in psychology, nutrition or medicine. Data were collected during lockdown phase I and referred to patients with Anorexia Nervosa-(AN), Bulimia Nervosa (BN)-and Binge-Eating Disorder-(BED).

Results: One-hundred questionnaires were collected; 84 and 76 were included in our qualitative and quantitative analyses, respectively. Thirty-six% of HCPs felt their therapeutic intervention was unsuccessful, 37% complained compromised therapeutic alliance. Changes in frequency of compensatory behaviors (increased in 41% AN and 49,5% BN; reduced in 14,6% AN and 21,8% BN) and binge-eating episodes (increased in 53,3% BN and 30,5% BED; reduced in 30,7% BN and 24,7% BED) were experienced and ascribed to augmented patient's anxiety. Disorders switches and variation in dysfunctional conducts frequency were both significantly related to ED category (p < 0.05 for all). Concentration techniques were recognized as useful to offset such negative outcomes.

Conclusion: According to HCPs, social restrictions affected the frequency of dysfunctional behaviors in ED patients and the efficacy of their therapeutic intervention. Further long-term studies are needed to confirm our data in a larger sample size.

Level iv: Novel results from a cross-sectional study.

Keywords: Anorexia nervosa; Binge-eating disorder; Bulimia nervosa; COVID-19; Eating disorders; Healthcare providers.

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Conflict of interest statement

Authors have nothing to disclose.

Figures

Fig. 1
Fig. 1
Eating disorders during the lockdown due to COVID-19 pandemic according to HCPs. a Percentage of therapist performing in person visits (walk-in clinic) or telemedicine. b Type of eating disorder followed during the lockdown (% value). c Percentage of patients initiating the therapy for the first time and percentage of patients who increased visits frequency according to each eating disorder category. Percentage of patients who variated the frequency of compensatory (d) and binge-eating (e) conducts according to each eating disorder category. *p < 0.05 indicating a significant relation between variation in dysfunctional behavior frequency and ED category. AN anorexia nervosa and atypical anorexia nervosa, BN bulimia nervosa and low-frequency bulimia nervosa, BED binge eating disorder and low-frequency binge eating disorder
Fig. 2
Fig. 2
Difficulties among HCPs and patients with eating disorder during the lockdown due to COVID-19 pandemic. a Difficulties experienced by patients according to HCPs (reported as HCPs %). b Difficulties experienced by HCPs during the online (telemedicine) or in person visits. HCPs Health Care Providers
See this image and copyright information in PMC

References

    1. Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395(10227):912–920. doi: 10.1016/S0140-6736(20)30460-8. - DOI - PMC - PubMed
    1. Todisco P, Donini LM. Eating disorders and obesity (ED&O) in the COVID-19 storm. Eat Weight Disord. 2020 doi: 10.1007/s40519-020-00938-z. - DOI - PMC - PubMed
    1. Haddad C, Zakhour M, Bou Kheir M, et al. Association between eating behavior and quarantine/confinement stressors during the coronavirus disease 2019 outbreak. J Eat Disord. 2020;8:40. doi: 10.1186/s40337-020-00317-0. - DOI - PMC - PubMed
    1. Termorshuizen JD, Watson HJ, Thornton LM, et al. Early impact of COVID-19 on individuals with self-reported eating disorders: a survey of ~1,000 individuals in the US and the Netherlands. Int J Eat Disord. 2020 doi: 10.1002/eat.23353. - DOI - PubMed
    1. Mukhtar S. Psychological health during the coronavirus disease 2019 pandemic outbreak. Int J Soc Psychiatry. 2020;66(5):512–516. doi: 10.1177/0020764020925835. - DOI - PMC - PubMed

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