Changes in Hospitalization for Eating Disorders and Related Suicidal Risk, Following COVID-19 Pandemic

This study aimed (1) to assess changes in the frequency and severity of eating disorders (EDs) during the COVID-19 pandemic (March 2020-December 2024) compared to the pre-pandemic period (January 2015-February 2020) and (2) to evaluate changes in rates of self-harm and suicidal ideation among individuals with EDs.

Data were extracted from the French National Hospital Discharge Database (PMSI), including all patients hospitalized with a diagnosis of ED between 2015 and 2024 (N = 162,621). Negative binomial regression models were used, stratified by age group, to examine the impact of the pandemic on ED hospitalizations. The severity of EDs during the initial stay was studied based on admission to the intensive care unit or the presence of medical complications. The proportion of patients with self-harm and/or suicidal ideation within 2 years following an ED-related hospitalization was also estimated, and the changes among the periods were analyzed.

Compared to the pre-pandemic period, there was a significant increase in ED hospitalizations during the pandemic period, particularly among adolescents and young adults (ages 0-14, 15-19, and 20-24). The proportion of patients hospitalized for self-harm and/or suicidal ideation within 2 years of an ED stay was higher during the pandemic period (13.31% vs. 8.67%, p  < 0.01). The difference in proportion based on severity criteria is significant, with a higher percentage for the post-COVID period.

This nationwide study reveals a marked rise in both the incidence and severity of EDs during the COVID-19 pandemic, despite the limitations associated with the use of an administrative database. These findings highlight the urgent need for age-targeted prevention strategies and early intervention programs, particularly for younger populations.