Eating disorder pathology and compulsive exercise during the COVID-19 public health emergency: Examining risk associated with COVID-19 anxiety and intolerance of uncertainty.

The International journal of eating disorders. 2020;53(12):2049-2054

Plain language summary

The COVID-19 pandemic has resulted in widespread repercussions and among them is increased mental health concerns. Furthering the established link between anxiety, eating disorder (ED) pathology and compulsive exercise, this study considers the impacts of intolerance to uncertainty as an additional risk factor. The aim of this study was to explore the association between anxiety and intolerance to uncertainty and the risk of ED pathology and compulsive exercise, in the context of COVID-19. The population for this study included 295 undergraduate students in the United States and various validated questionnaires were administered to evaluate ED, fear, anxiety, compulsive exercise, and intolerance of uncertainty. Evaluation of the questionnaires found intolerance to uncertainty was the strongest predictor of compulsive exercise, and anxiety was the strongest predictor of ED pathology. Based on these results, the authors conclude anxiety pertaining to COVID-19 may increase the risk for ED pathology and suggest interventions aimed at managing intolerance to uncertainty and anxiety may be effective. The authors recognize the importance of continuing to examine the longitudinal impact of COVID-19 on ED pathology and compulsive exercise behaviours.

Abstract

OBJECTIVE COVID-19 has led to disruptions in daily living and increased uncertainty about physical, financial, social, and psychological consequences, which may contribute to anxiety, eating disorder (ED) pathology, and compulsive exercise. Individual factors, such as intolerance of uncertainty, may impact risk for ED pathology and CE in response to COVID-19 anxiety. The current study examined associations between COVID-19 anxiety, trait intolerance of uncertainty, and COVID-19 intolerance of uncertainty and ED pathology and compulsive exercise. METHOD Undergraduate participants (N = 295) completed a series of online questionnaires between March and April of 2020. RESULTS COVID-19 anxiety and intolerance of uncertainty were associated with ED pathology, but not compulsive exercise. Additionally, both trait and COVID-19 intolerance of uncertainty moderated associations between COVID-19 anxiety and compulsive exercise and ED pathology. COVID-19 anxiety was more strongly related to compulsive exercise and ED pathology for individuals with lower intolerance of uncertainty. DISCUSSION COVID-19 anxiety may increase risk for ED pathology and may be specifically important in determining risk for ED pathology and compulsive exercise among individuals with lower intolerance of uncertainty. These results contribute to a growing body of research aimed at understanding the mental health consequences of the COVID-19 and suggest that individual factors (e.g., anxiety and intolerance of uncertainty) are important in determining risk for ED pathology and compulsive exercise in the context of the pandemic.

Lifestyle medicine

Fundamental Clinical Imbalances : Neurological
Patient Centred Factors : Mediators/COVID-19
Environmental Inputs : Psychosocial influences
Personal Lifestyle Factors : Nutrition ; Psychological
Functional Laboratory Testing : Not applicable

Methodological quality

Jadad score : Not applicable
Allocation concealment : Not applicable
Publication Type : Journal Article

Metadata

Nutrition Evidence keywords : ED ; Mental health