Adolescents' acute care use for eating
disorders has risen
During the COVID-19 pandemic, a rise in eating
disorders was observed among children and
young people. However, trends among adults
are yet to be elucidated. In order to determine
the rate of emergency department (ED) visits
and hospitalizations for eating disorders and
adolescents, researchers conducted a repeated
cross-sectional study that examined
population-based data from January 2017
through August 2022. [18]
They found that ED visits and hospital
admissions for eating disorders increased
significantly among adolescents during the
COVID-19 pandemic. ED visits increased by
121% above expected levels, and hospital
admissions increased by 54% above expected
among patients aged 10 to 17 years during the
pandemic.
"We are hoping this study continues to heighten
awareness of the importance of eating disorders,
and also to bolster support for eating disorder
programs so that we can adequately care for
patients and address the increasing demand for
treatment and services," lead author Alene
Toulany, MD, an adolescent medicine specialist
and researcher at the Hospital for Sick Children
in Toronto, told Medscape Medical News.
The study was published in the Canadian
Medical Association Journal. [18]
"A Pressing Concern"
The researchers used linked health
administrative databases that included all
patients in Ontario who were eligible for the
Ontario Health Insurance Plan, which is publicly
funded. They compared observed and expected
rates of ED visits and hospitalizations for eating
disorders between a prepandemic period
(January 1, 2017, to February 29, 2020) and a
pandemic period (March 1, 2020, to August 31,
2022). The researchers examined the following 4
age categories: adolescents (ages 10 to 17 years),
young adults (ages 18 to 26 years), adults (ages 27
to 40 years), and older adults (ages 41 to 105
years).
Among adolescents, the observed rate of ED
visits during the 30 pandemic months studied
was 7.38 per 100,000 population, compared with
3.33 per 100,000 before the pandemic
(incidence rate ratio [IRR], 2.21). The rate of ED
visits among young adults increased by 13%
above the expected rate. It reached 2.79 per
100,000, compared with 2.46 per 100,000 in the
prepandemic period (IRR, 1.13). Among older
adults, ED visits increased from 0.11 per 100,000
in the prepandemic period to 0.14 per 100,000
in the pandemic period (IRR, 1.15). The rate of
ED visits among adults remained approximately
the same.
The rate of hospital admissions among
adolescents increased by 54% above the expected
rate during the pandemic. The observed rate of
hospital admissions before the pandemic was
5.74 per 100,000, vs 8.82 per 100,000 during the
pandemic (IRR, 1.54). Hospital admissions
remained stable or decreased for the other age
groups.
"Eating disorders have increased globally in
children and adolescents during COVID," said
Toulany. "There are a number of risk factors
contributing to this pandemic rise, including
isolation, more time on social media, decreased
access to care (as many in-person services were
not available due to the pandemic), as well as
fear of getting infected. All of these could
contribute to an increased risk of developing an
eating disorder or of making an existing one
worse."
Regardless of the cause, more investment in
eating disorders research and eating disorder
programs for adolescents and adults is needed,
she said. "The pandemic served as a catalyst,
because it started to shed light on the prevalence
of eating disorders, especially in young people.
But it's very important that we recognize that
this has been a long-standing issue and a
pressing concern that has been consistently
overlooked and underfunded," said Toulany.
Surging Eating Disorders
Commenting on the findings for Medscape,
Victor Fornari, MD, director of child and
adolescent psychiatry at Zucker Hillside
Hospital/Northwell Health in Glen Oaks, New
16