Healthcare claims data point to a surge in treatment for eating disorders during the COVID-19 pandemic, especially among young people, a new report suggests.
From 2018 to 2022, healthcare claims for eating disorders increased 65% nationally as a percentage of all medical claims, according to an analysis of more than 43 billion private healthcare claims conducted by the nonprofit FAIR Health.
The age distribution of claims for eating disorders also changed during the study period. In 2018, people aged 19-24 years made up the largest share, followed by those aged 14-18 years. In 2022, those positions were reversed, with the largest share falling in the 14- to 18-year-old group and the second largest in those aged 19-24.
In every year from 2018 to 2022, females accounted for more than 89% of eating disorder claims.
In a statement, FAIR Health president Robin Gelburd said that the findings in this report have implications for “stakeholders across the healthcare spectrum, including eating disorder patients and the providers who treat them, as well as payors and policy makers.”
These, and other findings, are reported in a FAIR Health white paper — Spotlight on Eating Disorders: An Analysis of Private Healthcare Claims — published online November 15.
Comorbid Mental Health Conditions Common
The COVID-19 pandemic exacerbated eating disorders, the report found, with inpatient stays for eating disorders increasing compared with other behavioral health conditions. Hospital admissions among children were particularly inflated.
There is also data to suggest that the pandemic may have contributed to otherwise healthy people developing eating disorders.
According to the new report, claims for all eating disorders studied increased during the study period, but at different rates. Avoidant restrictive food intake disorder (ARFID) jumped by 305%, binge-eating disorder by 81%, anorexia nervosa by 73%, and bulimia nervosa by 3%.
ARFID was the eating disorder that most affected the youngest age groups (ages 0-9 and 10-13), while binge-eating disorder most affected older age groups (31-65 years).
The analysis also found that 72% of patients with an eating disorder had one or more co-occurring mental health conditions. Approximately 20% of patients with eating disorders also had a substance use disorder, 41% had generalized anxiety disorder, and 39% had major depressive disorder.
During the study period, patients with eating disorders were five times as likely to have a mental health condition (other than an eating disorder) and more than four times as likely to have a substance use disorder, relative to all patients who received medical services.
Perhaps not surprisingly, given the study period overlap with COVID-19, telehealth use for patients with eating disorders increased by over 10,000% from 2018 to 2022, making telehealth the most common place of service for eating disorders in 2022, the report notes.
“FAIR Health hopes that these findings will also be starting points for further research on eating disorders,” Gelburd added.
