Eating disorders rose dramatically among young Canadians during COVID’s first wave

Recent research has revealed that the first wave of the pandemic saw a veritable explosion of paediatric hospitalizations across Canada. The catch? The admissions in question were for eating disorders, not COVID-19

“The spike in eating disorder admissions to emergency departments and the long waitlists across eating disorder programs occurred not just in Canada, but internationally,” says Faculty of Social Work professor Dr. Gina Dimitropoulos, PhD. She is one of the authors of a new study that demonstrated an unsettling and concerning rise in anorexia nervosa in young Canadians during the early months of the pandemic.  

“We're seeing a rise in new onset eating disorders and the resurgence of disordered eating in people who were well,” says Dimitopoulos, who is also a research leader for the Calgary Eating Disorder Program and member of The Mathison Centre for Mental Health Research and Education, at the Cumming School of Medicine.

“The pandemic and perhaps the necessary public health measures implemented to curtail the spread of COVID may have exacerbated eating problems in young people.”

Troubling statistics emerge from research

The cross-sectional study, led by Dr. Holly Agostino of Montreal Children’s Hospital, found that the incidence of newly diagnosed anorexia nervosa or atypical anorexia nervosa in patients aged nine to 18 increased 60 per cent over pre-pandemic levels, from 24.5 to 40.6 cases per month between Mar. 1 and Nov. 30, 2020, while hospitalizations nearly tripled, from 7.5 to 20 per month during the same period.

Published in the Dec. 7, 2021 Journal of the American Medical Association, “Trends in the Incidence of New-Onset Anorexia Nervosa and Atypical Anorexia Nervosa Among Youth During the COVID-19 Pandemic in Canada” gathered data from six paediatric tertiary care facilities – British Columbia Children’s Hospital (Vancouver), Alberta Children’s Hospital (Calgary), McMaster Children’s Hospital (Hamilton), Montreal Children’s Hospital, Sainte Justine Hospital (Montreal) and Janeway Children’s Hospital (St. John’s).

The researchers found that the onset of illness was more rapid and disease severity was greater at presentation than before the pandemic.

“What this means is that young people were presenting in the emergency department with a shorter illness duration and with significant medical complications,” says Dimitropoulos.

Link between stress and symptoms

While research has shown a link between stress and the exacerbation of eating disorder symptoms, the precise drivers of this recent phenomenon have yet to be determined, Dimitropoulos has some theories, though, such as more exposure to social media and the isolation caused by COVID mitigation measures.

“The combination of increased and persistent exposure to harmful messages equating beauty with thinness, personal control with restrictive eating and an overemphasis on strategies (more exercise and watching what you eat) for preventing weight gain during the pandemic may have been a potential trigger for some young people already struggling with body image issues and eating issues,” she says.

Loneliness also meant more time on social media where young people were bombarded with harmful and unrealistic cultural ideals of feminine and masculine beauty — and how people should look on Zoom. 

"They were experiencing loss of control and lack of predictability due to the pandemic, while at the same time losing access to their peers and extracurricular activities that may have been a source of distraction from stress.”

The study also notes, however, that during the pandemic’s first wave primary care clinics were closed and there was limited access to mental health resources. As a result, many anorexia nervosa or atypical anorexia nervosa patients may have required urgent care in emergency departments instead. 

“In addition to the psychological problems associated with eating disorders, young people also experience significant medical complications that can be life threatening, which is why they need to be seen in the emergency department,” says Dimitropoulos.

Need for more supports 

Dimitropoulos is currently analyzing qualitative data — interviews with 20 young people and their families — which she hopes will shed more light on the phenomenon. In the meantime, she says now is the time to begin advocating for better resources, supports and treatments for young people with eating disorders and their families.

“To meet the demand for services and address the long waitlists, we need more supports to assist individuals who are struggling with eating disorders,” she says. “We also need to challenge weight prejudice and overvaluation of thinness or a particular body type which leads to the engagement of eating patterns that are unhealthy and potentially dangerous.”