Covid-19 ‘perfect storm’ for teenage eating disorders, figures show

Covid-19 has been a “perfect storm” for eating disorders among teenagers, with the Health Service Executive having seen a surge in the number of people hospitalised and seeking treatment over the past year.

Figures released to The Irish Times under the Freedom of Information Act show the number of teenage girls aged 12-18 discharged from hospital with a principal diagnosis of anorexia or bulimia rose from 123 cases in 2018 and 130 in 2019 to 188 last year. The number of boys in the same age group discharged was 19 in 2018, 15 in 2019 and rose to 28 last year.

Dr Michelle Clifford, national clinical lead for eating disorders, said specialists "never could have predicted the sharp rise seen since the start of the pandemic and since then".

There was a 61 per cent increase in admissions to psychiatric units and hospitals for children and adolescents between 2019 and last year, according to information published by the Health Research Board. Overall, eating disorders represented 18 per cent of admissions for under-18s.

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Adult admissions for eating disorders are also on the rise, according to the data, which showed a 32 per cent increase among over-18s.

Covid-19 has been "a perfect storm for eating disorders", said Harriet Parsons, training and development manager at Bodywhys, a voluntary organisation supporting those affected by eating disorders.

The organisation has seen “a huge increase” in people using their support services throughout the pandemic, she said.

‘Melting pot of change’

“Everybody’s routine is suddenly changed and all the normal support structures are falling away. All of that can make a person feel really out of control. It all became this melting pot of change, and change can be difficult for some,” Ms Parsons said.

“People who didn’t have eating disorders started monitoring food and exercise, and people who might have been on the edge before are now tipped in. People who were coming out the other side relapsed and old coping strategies came back in.”

Dr Clifford said there had been a “huge rise in demand for treatment” since the onset of the pandemic, and that the high rate of referrals has continued into this year for outpatient and inpatient services.

“It’s probably a combination of people seeking help and a greater awareness of eating disorders, but there is also a genuine rise in presentations and the number of referrals,” she said.

Eating disorders have the highest mortality and morbidity of all mental health conditions and it is estimated that they will affect 1-4 per cent of the population at some point in their lives.

Dr Clifford stressed the need for “equity of access” in services “so that no matter where a person lives or who they are, they have access to appropriate treatment for their eating disorder”.

The HSE has developed a new model of care for how eating disorder services should be delivered in Ireland which envisages 16 specialist hubs across the State with eight for adults and eight for children and adolescents.

However, there have been delays in the funding and delivery of the programme, with only three treatment hubs established so far, covering patients based in south Dublin, Kildare and west Wicklow, Cork and Kerry.

“Thankfully, we do have the funding secured this year, so we’ll be recruiting two further teams, and aim to eventually fill all 16,” Dr Clifford said.