Objective: This systematic review and meta‐analysis aimed to examine: the pooled prevalence of symptomatic behaviours and mental health deterioration amongst individuals with eating disorders (EDs) and obesity during the COVID‐19 confinement. Moreover, we examined changes in EDs and distress before and during the confinement, and the association between psychosocial factors and EDs symptoms.Method: A systematic search was carried out in biomedical databases from January 2020 to January 2021. Both cross‐sectional and longitudinal studies that used quantitative measures of ED symptoms and psychological distress during and after the COVID‐19 confinement were included.Results: A total of 26 studies met inclusion criteria (n = 3399, 85.7% female). The pooled prevalence of symptomatic deterioration in EDs was 65% (95% CI[48,81], k = 10). The pooled prevalence of increased weight in obesity was 52% (95% CI[25,78], k = 4). More than half of the participants experienced depression and anxiety. Moreover, at least 75% of the individuals with EDs reported shape and eating concerns, and increased thinking about exercising. However, the pooled analyses of longitudinal studies showed no significant differences from pre‐pandemic levels to the first lockdown phase in Body Mass Index and ED symptoms, whereas only few studies suggested increased distress, particularly among individuals with anorexia nervosa.Conclusions: The majority of individuals with EDs and obesity reported symptomatic worsening during the lockdown. However, further longitudinal studies are needed to identify vulnerable groups, as well as the long‐term consequences of COVID‐19.

Background: The aim of this systematic review and meta-analysis was to examine the prevalence of feeding and eating disorder (FED) symptoms or dysfunctional eating behaviours (DEB) in the general population during the COVID-19 outbreak. Method: We searched eligible articles in biomedical databases from 1 January 2020 to 31 March 2022. Prevalence rates of FED or DEB changes between pre-pandemic and pandemic time and correlation with psychological distress were pooled with a meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I²) statistics. A total of 186 studies with 406,076 participants met the inclusion criteria. Results: The more prevalent FED or DEB during the COVID-19 outbreak were: body image concerns (52%, 95% CI 0.38, 0.66), binge eating (40%, 95% CI 0.25, 0.55), and overeating (40%, 95% CI = 0.32–0.48). Pooled data of longitudinal studies (k = 8) only showed a significant difference in the prevalence of weight gain from pre-pandemic to the pandemic time. Finally, increased levels of psychological distress (k = 35) positively correlated with some ED symptoms. Conclusion: This meta-analysis evidenced a negative impact of the pandemic on eating symptoms and DEB in the general population.

Anorexia Nervosa has been associated with white matter abnormalities implicating subcortical abnormal myelination. Extending these findings to intracortical myelin has been challenging but ultra-high field neuroimaging offers new methodological opportunities. To test the integrity of intracortical myelin in AN we used 7 T neuroimaging to acquire T1-weighted images optimized for intracortical myelin from seven females with AN (age range: 18–33) and 11 healthy females (age range: 23–32). Intracortical T₁ values (inverse index of myelin concentration) were extracted from 148 cortical regions at ten depth-levels across the cortical ribbon. Across all cortical regions, these levels were averaged to generate estimates of total intracortical myelin concentration and were clustered using principal component analyses into two clusters; the outer cluster comprised T₁ values across depth-levels ranging from the CSF boundary to the middle of the cortical regions and the inner cluster comprised T₁ values across depth-levels ranging from the middle of the cortical regions to the gray/white matter boundary. Individuals with AN exhibited higher T₁ values (i.e., decreased intracortical myelin concentration) in all three metrics. It remains to be established if these abnormalities result from undernutrition or specific lipid nutritional imbalances, or are trait markers; and whether they may contribute to neurobiological deficits seen in AN.

Background: Negative effects of COVID-19 lockdowns have been reported in adult patients with feeding and eating disorders (FED) whereas evidence of its impact on young clinical populations is still limited and somewhat inconsistent. The present study aims to investigate the effect of the first COVID-19 lockdown on a range of FED symptoms in children and adolescents: (a) already receiving treatment in our specialist service for FED when the pandemic hit, and (b) prospectively evaluated in our service from October 2020 to July 2021. Methods: Out of sixty-one eligible patients with a broad spectrum of FED invited, forty-five young patients (aged 11–18) consented to participate and were included. An ad-hoc survey, consisting of open questions, multiple choice questions, yes/no questions, and a symptoms checklist, was administered online. Results: About half of the participants (46.7%) reported a positive effect of lockdown on FED symptomatology. Patients with anorexia nervosa (AN) reported the highest rate of symptomatology worsening (58.6%). Younger patients (11–13 years) showed a greater improvement of symptoms compared to older ones (14–18 years of age). COVID-19 lockdown was identified as the precipitating factor for FED onset in 60.7% of newly evaluated patients. Conclusions: Evidence from our investigation points out that although the COVID-19 pandemic was a precipitating factor for a FED for many active and newly referred patients, it had a positive impact on youth who were already in treatment and younger participants.

Children at familial high-risk (FHR) for eating disorders (EDs), i.e. born to mothers with EDs, are at increased risk of psychiatric morbidity, especially emotional and behavioural disorders. However, less is known about broader psychopathology and specific effects of maternal diagnoses. This study aimed to characterise the psychopathological profile of children at FHR for EDs, compared to healthy children at no familial risk (HC, i.e., with a mother with no ED). Sixty (60) children at FHR (median age 10; range = 7) and 63 HC (median age 12; range = 4) were assessed for psychopathology using the Development and Well-Being Assessment, the State and Trait Anxiety Inventory, the Strength and Difficulties Questionnaire and the Social Aptitude Scale respectively. Children at FHR exhibited more psychiatric disorders than HC ( p =.02 and p =.01 respectively ) . Children at FHR showed more emotional disorders ( p =.01) and overall more mental health difficulties, with elevated levels of emotional symptoms ( p <.001), hyperactivity/inattention ( p =.04), and peer relationship problems (p =.004). However, no significant differences were observed between groups in terms of state/trait anxiety. Moreover, post-pubertal development was associated with higher emotional distress and higher state anxiety levels than pre-pubertal development. Children at FHR are at increased risk of developing psychiatric disorders and psychopathology, especially in the emotional domain. Puberty may also be a critical window of risk for this group. Our findings suggest that children at FHR face an increased psychopathological burden and warrant development of interventions to support them, especially during puberty.