COVID-19 pandemic has been linked with six unhealthy eating behaviors

U of M Medical School's Melissa Simone, PhD, a postdoctoral research fellow in the Department of Psychiatry and Behavioral Sciences, collaborated with School of Public Health professor and head of the Division of Epidemiology and Community Health, Dianne Neumark-Sztainer, PhD, MPH, to learn from study participants in Neumark-Sztainer's Project EAT between April and May 2020.

"The COVID-19 pandemic has resulted in the rapid implementation of public health policies to reduce transmission of the virus. While these protections are necessary, the disruptions to daily life associated with the ongoing pandemic may have significant negative consequences for the risk of eating disorders and symptoms," said Simone, who is the lead author of the study. "Eating disorders have one of the highest mortality rates across all psychiatric health concerns, and therefore, it is important to try to make links between the consequences of the pandemic and disordered eating behaviors.

The study aimed to understand potential associations between stress, psychological distress, financial difficulties and changes in eating behaviors during the COVID-19 pandemic through the analysis of both qualitative and quantitative data. Simone's findings, published in the International Journal of Eating Disorders, found six key themes of eating behavior changes:

• Mindless eating and snacking;
• Increased food consumption;
• Generalized decrease in appetite or dietary intake;
• Eating to cope;
• Pandemic-related reductions in dietary intake;
• And, a re-emergence or marked increase in eating disorder symptoms.

Approximately 8% of those studied reported extreme unhealthy weight control behaviors, 53% had less extreme unhealthy weight control behaviors and 14% reported binge eating. The study revealed that these outcomes were significantly associated with poorer stress management, greater depressive symptoms and moderate or extreme financial difficulties.

"There has been a lot of focus on obesity and its connection with COVID-19. It is also important to focus on the large number of people who have been engaging in disordered eating and are at risk for eating disorders during and following the pandemic," said Neumark-Sztainer, who is the principal investigator of Project EAT. "The majority of the young adults in our study are from diverse ethnic/racial and lower income backgrounds, who often do not receive the services they need. To ensure health inequities do not increase, we need to meet the needs of these populations."

Simone added, "The economic consequences of the COVID-19 pandemic will likely persist long beyond the dissemination of a vaccine. Because our findings suggest that moderate or severe financial difficulties may be linked with disordered eating behaviors, it is essential that eating disorder preventive interventions and treatment efforts be affordable, easily accessible and widely disseminated to those at heightened risk. As such, online or mobile-based interventions may prove to be effective and accessible modes for targeted intervention efforts."

This study was funded by the National Heart, Lung, and Blood Institute (R01HL116892, R35HL139853: Principal Investigator: D. Neumark-Sztainer), the National Center for Advancing Translational Sciences (TL1R002493, UL1TR002494), and the National Institute of Mental Health (T32MH082761).