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Clinical Advisor: Rise in Eating Disorders Among Teens During COVID-19

By Kristin Della Volpe

Pediatric clinicians are sounding the alarm on the marked rise in eating disorders and symptom severity in children and adolescents during the COVID-19 pandemic. Eating disorders are the most deadly psychiatric condition in children, with 1 in 5 dying from suicide or medical complications related to the disorder.1,2 Experts have stressed that the need to take action is urgent.1,2

“We are seeing eating disorders rise in rates that I have never seen in my whole career,” said Jessica Peck, DNP, APRN, CPNP-PC, CNE, CNL, immediate past president of the National Association of Pediatric Nurse Practitioners (NAPNAP). As the COVID-19 pandemic surged, eating behaviors may have become an outlet for control among at-risk youth, said Dr Peck, who is also clinical professor at the Baylor University Louise Herrington School of Nursing in Dallas, Texas.

Eating disorders often have a protracted course and are difficult to treat, with only 31% of patients with anorexia nervosa recovering within 10 years.3 Early recognition and treatment of eating disorders is essential, Dr Peck said. But for children and teens, finding qualified mental health providers may be difficult.

The COVID-19 pandemic led to a profound disruption in school, sports, work, as well as social and leisure activities among people of all ages. For at-risk youth, the mental and physical effects of these disruptions triggered or worsened disordered eating behaviors. Additionally, the pandemic led to increased social media use, which has been linked to worsening symptoms in individuals with eating disorders, and increased video interactions, which may increase self-criticism and negative appearance-related comparisons.7 Altered food accessibility, food insecurity, and limited access to health care during the pandemic may also have played roles in the rising rates.7 Together, these changes have created a perfect storm of stressors in this vulnerable patient population.

The American Academy of Pediatrics (AAP) recommends screening for disordered eating and unhealthy weight-control behaviors annually at well visits and evaluating BMI, growth charts, menstrual status, and vital signs. Patient reports of dieting, body image dissatisfaction, weight-based stigma, or changes in eating or exercise may indicate the need for further exploration.12

“There are many misconceptions about eating disorders and what characteristics or behaviors are used when someone has an eating disorder,” said Amanda Dietz, MSN, FNP-C, CPN, who works at the Eating Disorder Center at Children’s Mercy Kansas City in affiliation with the Department of Pediatrics at the University of Missouri-Kansas City School of Medicine in Missouri. Weight loss noted on growth curves is an easy way to identify concerning behaviors and should prompt the provider to ask more questions, Dietz said.


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Learn more about the Eating Disorders Center at Children's Mercy

Adolescent Medicine at Children's Mercy