Abstract / Summary
Abstract Background This study examined the impact of the COVID-19 pandemic on eating disorder (ED)-related consultations in Japan, based on consultation data from three designated ED support base hospitals across the country. Methods We conducted a retrospective time-series analysis of 4,260 consultation records obtained at ED support base hospitals in Miyagi, Chiba, and Fukuoka Prefectures between April 2018 and March 2023. Demographic characteristics, body mass index (BMI), and consultation content were compared between the pre-pandemic period and the period following the onset of the pandemic, and between COVID-19-related and unrelated consultation records. Temporal trends were assessed using Seasonal and Trend decomposition using Loess, followed by interrupted time-series analysis with a segmented generalized linear model that included an interaction between time since pandemic onset and age group. All data were derived from consultation records rather than diagnoses established using structured diagnostic criteria. Results During the pandemic, the average age at consultation significantly decreased (from 27.5 to 24.9 years), while BMI did not differ significantly. The total number of ED-related consultations increased during periods when multiple states of emergency were intermittently declared, with a particularly marked increase in consultations involving adolescents. Interrupted time-series analysis showed a significant interaction between time since pandemic onset and the 10–19-year age group (β = 0.0061, p < 0.01), indicating a more sustained increase and a slower subsequent decline in consultations among adolescents than in the total consultation trend. Consultation records classified as COVID-19 related had a lower mean age than those classified as unrelated (22.0 vs. 25.0 years) and more frequently included complaints related to dietary restriction and thinness. Discussion Although the overall number of ED-related consultations and the mean age at consultation were gradually returning to pre-pandemic levels by the end of the study period, the increase in consultations involving adolescents was more sustained and declined more slowly than the overall trend. Stress and emotional changes associated with behavioral restrictions may have had prolonged effects on eating behaviors among adolescents. These findings highlight the importance of promoting disease awareness and establishing preventive and early-intervention measures during non-crisis periods to mitigate the impact of future emergencies.