Eating Disorders in Children, Adolescents, and Young Adults During and After the COVID-19 Pandemic: A Danish Nationwide Register-Based Study

Abstract

Objective

To assess incidence rates of clinically diagnosed eating disorders among Danish youth before, during, and after the COVID-19 pandemic.

Method

This study used a population-based time series analysis with individual-level data from Danish healthcare registries. Participants included all Danish individuals aged 6–24 years from January 1, 2015, to December 31, 2023. Monthly incident cases of any eating disorder, anorexia nervosa, and bulimia nervosa were analyzed using interrupted time-series analysis. We estimated the cumulative number of excess cases of incident eating disorder diagnoses and risk ratios (RR) associated with the pandemic and post-pandemic periods compared with pre-pandemic predictions.

Results

The study population encountered a mean of 1,310,542 individuals during the study period. The study included 11,693 individuals diagnosed with an eating disorder, median age 17 (IQR 14–20 years). Incident cases increased during the pandemic (RR 1.29, 95% CI 1.15–1.45) and normalized post-pandemic (RR 1.07, 95% CI 0.91–1.25) compared with pre-pandemic predictions. Similar patterns were seen for anorexia and bulimia. Increases were significant for ages 13–16 (RR 1.19, 95% CI 1.02–1.38), 17–19 (RR 1.51, 95% CI 1.25–1.83), and 20–24 (RR 1.35, 95% CI 1.12–1.64). Post-pandemically, a continued increase was observed only for ages 20–24 (RR 1.32, 95% CI 1.02–1.71).

Conclusions

The study documents a temporary increase in diagnosed eating disorders among Danish youths during the COVID-19 pandemic, with rates later returning to pre-pandemic levels. These results provide insights into the pandemic's impact on adolescents and youths.