139 - Demographic and Clinical Characteristics of Adolescent Patients with Eating Disorders Before and During the Covid-19 Pandemic

Poster Number: 139
Publication Number: 139.244

Background: It is known that the frequency of eating disorders (EDs) increased during the Covid pandemic. Little is known of the differences seen in EDs during the pandemic compared to previously.

Objective: This study seeks to evaluate the demographic and clinical characteristics of patients who presented with EDs during the pandemic, and to compare them to patients that presented during 2014-2015.

Design/Methods: Our division conducted a study that examined EDs in adolescent patients presenting to our outpatient office from May 1, 2014 to April 30, 2015. That study looked at demographic and clinical variables upon presentation. This current study looked at those same variables for patients that presented from September 1, 2020 to May 31, 2021, during the pandemic. Variables were compared between the two groups.

Results: 285 patients (23.8/month) presented for an initial ED evaluation over 12 months beginning May 2014: Earlier Group (EG); 365 patients (40.6/month) presented over 9 months during the pandemic: Covid Group (CG). The following differences were found: (1) 77.5% of EG identified as White compared to 55.9% in CG (p < 0.001). (2) Atypical Anorexia Nervosa (AAN) was diagnosed in 23.2% of EG and 36.4% of CG—ARFID was diagnosed in 16.1% of EG and 21.0% of CG (p < 0.001). The frequency of AAN patients/month nearly tripled and ARFID more than doubled. (3) 34.0% of patients in EG had a history of anxiety compared with 41.9% in CG (p < 0.05). (4) In EG, 60.0% were scheduled to return in 1 week and 23.9% in 2 weeks, while in CG patients were scheduled to return later-32.1% in 1 week and 42.2% in 2 weeks (p < 0.001). There was no significant difference between the two groups in age, gender, weight, BMI, length of illness, total weight lost, time since last period, purging, binging, exercise, laxatives, GI or SSRI medications and history of OCD/depression.

Conclusion(s): The pandemic was associated with significantly more ED patients. Some differences can be interpreted as pandemic related—a stress on adolescent mental health increased ED prevalence, which necessitated that follow up visits be spaced farther apart. Other differences pertain to overall societal changes—a wider racial distribution may represent the growing diversity of the New York City area; the increased proportion of AAN may represent the increase in patients who became overweight during the pandemic; the rise in comorbid anxiety correlates with a higher prevalence of anxiety. Still, for most characteristics, there was no difference. Thus, despite the increase in patients with EDs, most of the clinical nature of the disease remained the same.