Presentations of eating disorders among youth in Türkiye before and after COVID-19: lessons learned for the future

The COVID-19 pandemic has significantly influenced adolescent mental health, particularly contributing to increased presentations of eating disorders (EDs). This study investigates how referral patterns, diagnostic profiles, and comorbidities changed among adolescents in Türkiye before and during the pandemic.

A retrospective chart review was conducted at Ankara City Hospital, including adolescents aged 10-18 years who were referred for ED-related concerns between September 2019 and August 2021. The data were grouped into pre-pandemic (6 months) and pandemic (18 months) periods. Demographics, diagnostic categories, psychiatric comorbidities, and referral trends were examined.

Of the 176 total cases, 87.5% were referred during the pandemic. The average monthly referral rate rose by 133%, from 3.67 to 8.56 cases. Most patients were female (93.2%), and the average age was 15.1 years. The majority of diagnoses fell under OSFED (69.6%), followed by anorexia nervosa (24.4%) and bulimia nervosa (5.7%). While comorbid depression and anxiety were commonly observed before the pandemic, their rates were lower during the pandemic period, which may reflect pandemic-specific stressors and referral patterns.

During the pandemic period, the number of ED referrals was more than twice as high as before the pandemic, accompanied by differences in the complexity and comorbidity profiles of referred cases. These findings underscore the urgency of enhancing early detection, educator awareness, and service accessibility-including telehealth interventions-to meet the growing demand and support adolescent mental health, both during crises and in long-term service planning.