COVID-19 Latest information
COVID-19, also referred to as coronavirus, is an infectious disease causing a current global pandemic. The pandemic has had a significant impact on people’s mental health and, for people experiencing an eating disorder, the increased stress and shifts in daily life have been especially challenging.
While the full extent of the impact of COVID-19 on eating disorders and other mental health conditions is unknown, during the pandemic, many people with an eating disorder experienced a worsening of symptoms and higher risk of relapse. Such negative impacts are likely due to the disruptions in access to treatment resulting from lockdowns and restrictions, self-isolation, food access limitations, changes in physical activity routines, increased anxiety and stress and environmental changes at home or work.(1, 2)
Similarly, there has been an increase in disordered eating among people who have not previously experienced an eating disorder. In particular there has been a significant increase in binge eating behaviours among the general population.(1) The COVID-19 pandemic has also seen increased rates of suicidal ideation and behaviour among people experiencing eating disorders when compared with pre-pandemic rates. (3) These increases in both disordered eating and eating disorders have placed significant demands on families and supports.(1, 4)
The worsening of existing eating disorders and significant increase in new eating disorders has accompanied a significant increase in the number of people presenting for treatment, in particular for anorexia nervosa and atypical anorexia nervosa. For example, there was a 63% increase in presentations to the Royal Children’s Hospital Eating Disorder Service in Melbourne during 2020 with timings corresponding to COVID-19 related events such as increased stress and stringent COVID-19 restrictions.(5)
Moreover, research into the prevention and treatment of eating disorders has suffered significant disruptions including difficulties with recruitment of participants, staffing, budget, funding, with some studies being shut down altogether.(6)
Early intervention is crucial to improving treatment outcomes for someone living with an eating disorder. The impact of the COVID-19 pandemic has meant that people are waiting many months to access care and treatment, with a resultant deterioration in physical and mental health. A 2020 report compiled by NEDC from information gathered from twenty-five eating disorder-specific services in WA, SA, NSW, VIC and QLD found:
- The COVID 19 pandemic has generated a marked increase in presentations of both new and relapsing eating disorders, with associated increases in the required medical and psychological support provided by health professionals
- Increased demand for community and inpatient services, along with an increase in complexity of presentations involving high psychiatric and medical risk, has impacted on supports available at each level of the system of care.
- An increased demand for community and inpatient services across states and territories, along with an increase in complexity of presentations including high psychiatric and medical risk.
- The Butterfly Foundation has reported a 47% increase in contacts made via its Helpline (phone, webchat, or email) over the course of the pandemic and demand for Butterfly’s school services up by 150% during the first school term of 2021, compared to Term 1 2019 (pre-COVID)
NEDC and our partners are working to support the eating disorder community in accessing accurate and timely information, particularly as it relates to the experience and treatment of eating disorders. Across Australia, initiatives to respond to the increased need for support and treatment have been introduced, including the swift adaptation to telehealth, greater flexibility in appointment times and accessibility to people living all over Australia.
Public and private health and mental health services are shifting their response and treatment options to better manage the increasing waitlists. Strategies such as increased peer workforce involvement, online resources and support services, and tertiary consultation to other mental health services and programs are being implemented to provide support for those individuals living with an eating disorder, their families and supports as they wait to access treatment.
As the national experience of and response to COVID-19 continues to unfold, NEDC continues to share useful information about COVID-19 for the eating disorder community both here and on social media. Please see a list of curated links below and check back regularly.
NOTE CHANGES TO MBS ITEM NUMBERS:
Changes to COVID-19 Temporary MBS Telehealth Services: July 2021: New, continuing and discontinued telephone items for GPs and Other Medical Practitioners.
Commencing 13 March 2020 and recently announced to be a permanent inclusion in the Medicare system, the Australian Government has made a number of temporary MBS telehealth (video and telephone) items available to help reduce the risk of community transmission of COVID-19 and provide protection for patients and health care providers.
From 1 July 2021, General Practitioner (GP) and Other Medical Practitioner telephone items will be streamlined. This change aligns with how the items are being used by providers and is also based on expert advice about the use of telephone-based services.
Click here to access a fact sheet produced by NEDC containing information about the new, continuing and discontinued telephone items from 1 July 2021, which may be relevant to GPs and Other Medical Practitioners providing services via telephone to patients experiencing an eating disorder.
Information for people with lived experience and their supports
COVID Help Hub from the Butterfly Foundation
Advice for athletes, NEDC-AIS partnership
COVID-19 and eating disorders information from Eating Disorders Victoria (EDV)
COVID-19 support from the Department of Health
Information updates from Eating Disorders Queensland (EDQ)
Tips and advice from BEAT UK
Information for health and other helping professionals
Useful advice for eating disorder clinicians from ANZAED
Key resources for primary care practictioners and mental health services and clinicians from The Victorian Centre of Excellence in Eating Disorders (CEED)
A practical guide to setting up your practice to deliver telehealth services from Mental Health Online
30-minute online training module for health care workers from the Australian Government Department of Health
1. McLean, C., Utpala, R., & Sharp, G. (2021). The impacts of COVID-19 on eating disorders and disordered eating: A mixed studies systematic review and implications for healthcare professionals, carers, and self.
2. Miniati, M., Marzetti, F., Palagini, L., Marazziti, D., Orrù, G., Conversano, C., & Gemignani, A. (2021). Eating Disorders Spectrum during COVID Pandemic: a systematic review. medRxiv.
3. Taquet, M., Geddes, J. R., Luciano, S., & Harrison, P. J. (2021). Incidence and outcomes of eating disorders during the COVID-19 pandemic. The British Journal of Psychiatry, 1-3.
4. Dobson, H., Malpas, C. B., Burrell, A. J., Gurvich, C., Chen, L., Kulkarni, J., & Winton-Brown, T. (2021). Burnout and psychological distress amongst Australian healthcare workers during the COVID-19 pandemic. Australasian Psychiatry, 29(1), 26-30.
5. Springall, G., Cheung, M., Sawyer, S. M., & Yeo, M. (2021). Impact of the coronavirus pandemic on anorexia nervosa and atypical anorexia nervosa presentations to an Australian tertiary paediatric hospital. Journal of paediatrics and child health.
6. Weissman, R. S., Klump, K. L., & Rose, J. (2020). Conducting eating disorders research in the time of COVID‐19: A survey of researchers in the field. In (Vol. 53, pp. 1171-1181): Wiley Online Library
Baenas, I., Caravaca‐Sanz, E., Granero, R., Sánchez, I., Riesco, N., Testa, G., ... & Fernández‐Aranda, F. (2020). COVID‐19 and eating disorders during confinement: Analysis of factors associated with resilience and aggravation of symptoms. European Eating Disorders Review, 28(6), 855-863. https://doi.org/10.1002/erv.2771
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet, 395(10227), 912-920. https://doi.org/10.1016/S0140-6736(20)30460-8
Brown, S., Opitz, M. C., Peebles, A. I., Sharpe, H., Duffy, F., & Newman, E. (2021). A qualitative exploration of the impact of COVID-19 on individuals with eating disorders in the UK. Appetite, 156, 104977. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7521890/
Buckley, G. L., Hall, L. E., Lassemillante, A. C. M., & Belski, R. (2021). Disordered eating & body image of current and former athletes in a pandemic; a convergent mixed methods study-What can we learn from COVID-19 to support athletes through transitions?. Journal of eating disorders, 9(1), 1-16. https://link.springer.com/article/10.1186/s40337-021-00427-3
Castellini, G., Cassioli, E., Rossi, E., Innocenti, M., Gironi, V., Sanfilippo, G., Felciai, F., Monteleone, A. M., & Ricca, V. (2020). The impact of COVID‐19 epidemic on eating disorders: A longitudinal observation of pre versus post psychopathological features in a sample of patients with eating disorders and a group of healthy controls. International Journal of Eating Disorders, 53(11), 1855-1862. https://doi.org/10.1002/eat.23368
Clark Bryan, D., Macdonald, P., Ambwani, S., Cardi, V., Rowlands, K., Willmott, D., & Treasure, J. (2020). Exploring the ways in which COVID‐19 and lockdown has affected the lives of adult patients with anorexia nervosa and their carers. European Eating Disorders Review, 28(6), 826-835. https://doi.org/10.1002/erv.2762
Cooper, M., Reilly, E. E., Siegel, J. A., Coniglio, K., Sadeh-Sharvit, S., Pisetsky, E., & Anderson, L. (2020). Eating disorders during the COVID-19 pandemic: An overview of risks and recommendations for treatment and early intervention. Eating Disorders. Advance online publication. https://doi.org/10.1080/10640266.2020.1790271
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Jones, P. D., Gentin, A., Clarke, J., & Arakkakunnel, J. (2020). Eating disorders double and acute respiratory infections tumble in hospitalised children during the 2020 COVID shutdown on the Gold Coast. Journal of Paediatrics and Child Health. https://doi.org/10.1111/jpc.15248
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McCombie, C., Austin, A., Dalton, B., Lawrence, V., & Schmidt, U. (2020). “Now It's Just Old Habits and Misery”–Understanding the impact of the Covid-19 pandemic on people with current or life-time eating disorders: a qualitative study. Frontiers in Psychiatry, 11, 589225. https://doi.org/10.3389/fpsyt.2020.589225
Matheson, B. E., Bohon, C., & Lock, J. (2020). Family‐based treatment via videoconference: Clinical recommendations for treatment providers during COVID‐19 and beyond. International Journal of Eating Disorders, 53(7), 1142-1154. https://doi.org/10.1002/eat.23326
Maunder, K., & McNicholas, F. (2021). Exploring carer burden amongst those caring for a child or adolescent with an eating disorder during COVID-19. Journal of Eating Disorders, 9(1), 1-8. https://jeatdisord.biomedcentral.com/track/pdf/10.1186/s40337-021-00485-7.
Miskovic-Wheatley, J., Koreshe, E., Kim, M., Simeone, R., & Maguire, S. (2021). The Impact of the COVID-19 Pandemic and Associated Public Health Response on People with Eating Disorder Symptomatology: A National Australian Study. https://www.researchsquare.com/article/rs-686090/v1
Monteleone, A. M., Cascino, G., Marciello, F., Abbate-Daga, G., Baiano, M., Balestrieri, M., ... & Monteleone, P. (2021). Risk and resilience factors for specific and general psychopathology worsening in people with Eating Disorders during COVID-19 pandemic: a retrospective Italian multicentre study. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 1-10. https://link.springer.com/article/10.1007/s40519-020-01097-x
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