The impact of the COVID-19 pandemic on children and adolescents eating disorders: A systematic review

• The COVID-19 pandemic had a negative impact on eating disorders. • Several factors were associated with children and adolescent’s eating disorders. • Factors included gender, age, sporting activities, and economic and social support. • Targeted measures need to be in place for future public health crisis. During the COVID-19 pandemic an increased prevalence of eating disorders was seen globally. For vulnerable groups, in particular children and adolescents, public health measures including lockdowns, limited in-person healthcare access, increased focus on handwashing and sanitization, and the increased fear related to the COVID-19 pandemic had a profound negative impact on this population. Despite the increased vulnerability of these children and adolescents to eating disorders during the pandemic and the trend observed, there has been limited research in this area. Hence, this systematic review aims to identify the impact of COVID-19 on eating disorders among children and adolescents globally. Using PRISMA guidelines, a systematic search of 8 databases was conducted. We identified 4428 results, of which 250 studies were selected for full-text review. Of these, 42 studies were synthesized for our final analysis. We found that the majority of studies (83%) reported that the COVID-19 pandemic and related public health measures had a negative impact on eating disorders among youth and adolescents. We also found several individual, household and socio-structural factors associated with the worsening of eating disorders. Specifically, 17% of studies found that pandemic-origin fears and stress increased eating disorder-related outcomes. Twelve percent of studies reported parental influence to be associated with eating disorders during the COVID-19 pandemic and 14% of studies linked the loss of health services to an increase in eating disorders. In addition, age, gender, social support, co-morbidities or pre-existing symptoms and media were significantly associated with children and adolescent’s eating disorders. Various factors stemming from the COVID-19 pandemic were found to have increased the prevalence of eating disorders in children and adolescents. Based on these findings, we suggest several policy implications and future areas of research.