COVID-19 Pandemic
The Relationship Between Disordered Eating Behaviors and the Pandemic Among Undergraduate Students: A Systematic Review Bridget Murphy Hussain* Bridget Hussain Meredith Hannigan Aletha Huckins Mackenzie Gordon Danielle Conklin Audrey Beauvais
Background: Undergraduate students are vulnerable to social, emotional, physical, and financial stressors that increase risk for disordered eating behaviors. The impact of the COVID-19 pandemic on disordered eating is not fully understood, particularly as campuses reconcile the long-term impacts on students who may have missed critical developmental milestones due to the pandemic. This study sought to review observational studies evaluating disordered eating among undergraduate students during and after the pandemic.
Methods: Seven databases were searched through August 2024. Observational studies that included terms to capture disordered eating (bulimia nervosa, anorexia nervosa, and binge eating disorder) and COVID-19 (coronavirus) among undergraduates in the United States were reviewed. The search strategy was developed with an interdisciplinary team and conducted by two authors.
Results: Of 20 articles that evaluated the effects of COVID-19 on disordered eating, seven met inclusion criteria. All studies were cross-sectional, with four including data from repeated surveys among different groups. Overall, studies found a higher prevalence of anxiety and depression reported among students during COVID-19 than pre-pandemic, which was associated with more disordered eating behaviors, particularly higher caloric intake characteristic of binge eating disorder and bulimia nervosa. Studies reported the mediating effects of social media use and impact of perceived social connectivity.
Conclusions: Studies suggest a relationship between COVID-19 and disordered eating patterns, which is worsened by higher social media use, lower tolerance of uncertainty, and maladaptive stress management during the pandemic. Individuals who were undergraduate students during the pandemic and impacted by these behavioral coping mechanisms should be followed longitudinally and monitored for increased risk for long-term morbidity and mortality associated with eating disorders.