Eating disorders during lockdown: The transcultural influence on eating and mood disturbances in Ibero-Brazilian population

Abstract

Background COVID-19 pandemic has implied exceptional restrictive measures to contain its widespread, with adverse consequences on mental health, especially for those people with a background of mental illness, such as eat‑ ing disorders (EDs). In this population, the infuence of socio-cultural aspects on mental health has been still underex‑ plored. Then, the main aim of this study was to assess changes in eating and general psychopathology in people with EDs during lockdown regarding the ED subtype, age, and provenance, and considering socio-cultural aspects (e.g., socioeconomical factors such as work and fnancial losses, social support, restrictive measures, or health accessibility, among others). Methods The clinical sample was composed of 264 female participants with EDs (74 anorexia nervosa (AN), 44 bulimia nervosa (BN), 81 binge eating disorder (BED), and 65 other specifed feeding and eating disorder (OSFED)), with a mean age of 33.49 years old (SD=12.54), from specialized ED units in Brazil, Portugal, and Spain. The partici‑ pants were evaluated using the COVID-19 Isolation Eating Scale (CIES). Results A global impairment in mood symptoms and emotion regulation was reported in all the ED subtypes, groups of age, and countries. Spanish and Portuguese individuals seemed more resilient than Brazilian ones (p<.05), who reported a more adverse socio-cultural context (i.e., physical health, socio-familial, occupational, and economic status) (p<.001). A global trend to eating symptoms worsening during lockdown was observed, regardless of the ED subtype, group of age, and country, but without reaching statistical signifcance. However, the AN and BED groups described the highest worsening of the eating habits during lockdown. Moreover, individuals with BED signifcantly increased their weight and body mass index, similarly to BN, and in contrast to the AN and OSFED groups. Finally, we failed to fnd signifcant diferences between groups of age although the younger group described a signifcant wors‑ ening of the eating symptoms during lockdown.