Eating disorders surged among adolescents in pandemic

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Before the pandemic, Basma O’Neill’s 15-year-old daughter was lean but healthy, with a robust appetite.

But after the coronavirus pandemic hit and schools closed in Graham, Wash., her daughter spent most of her time alone in her room. She wore pajamas and sweats, and ate at different times than her family.

She was diagnosed with anorexia nervosa in January; by February her weight was 86 pounds, down from around 118 pounds.

“I 100% believe the social isolation from the pandemic triggered the eating disorder,” Ms. O’Neill said.

Experts across the country who treat eating disorders in adolescents and young adults say they are seeing unprecedented demand for treatment that arose during the pandemic. Inpatient units have doubled or tripled capacity, wait lists for residential programs and outpatient services are months long, and the patients coming in are sicker than ever.

Experts say they have seen the biggest increase during the past year in anorexia nervosa, an eating disorder where people deprive themselves of food. Other disorders being seen include bulimia nervosa, where people binge on food and then try to get rid of it with laxatives or vomiting, and binge-eating disorder, where people consume excessive amounts of food in a short period.

Tracy Richmond, director of the eating-disorder program at Boston Children’s Hospital, recently finished a study accepted for publication in the Journal of Adolescent Health showing hospitalization rates of eating-disorder patients at Boston Children’s more than tripled in the pandemic, with the inpatient numbers rising from three or four to more than 10 and as many as 16 at a time. Demand for outpatient treatment also has risen sharply, from an average of six case reviews a week to as many as 23.

“Patients who come in are just really sick,” Dr. Richmond said. Some have lost as much as 50% of their body weight.

“We sort of look at it like a second pandemic, the mental-health needs in adolescents,” she said, “and eating disorders is part of that.”

Dr. Richmond said preliminary data she has collected from 14 eating-disorder treatment centers nationwide indicate hospitalizations at least doubled during the pandemic.

A common scenario, she said, is a teen who comes in saying she decided to try to become healthier during the pandemic, often guided by TikTok videos and other social-media posts from fitness influencers. Social isolation, boredom and fear of gaining weight during quarantine also led to unhealthy behaviors.

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