Eating disorder hospital stays at this children’s hospital doubled during the pandemic

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It was last fall when Dr. Alanna Otto really noticed the change.

Typically, CS Mott Children’s Hospital at the University of Michigan, where she works, takes one or two patients a week for complications from eating disorders. But recently these prices had skyrocketed.

“One of the things that we heard over and over again during the pandemic is that our patients either started their diet or their way of exercising to try to control their diet or control their body weight,” Otto said. “Because it felt like everything else was out of control.”

But Otto and her team wanted to know if what they thought was happening – a sharp increase in hospitalizations with eating disorders during the pandemic – was actually true. And although their data only reflects the experience of one hospital, the numbers are revealing: The number of admissions with eating disorders rose from an average of 53 patients per year to 125 patients between April 1, 2020 and March 31, 2021.

And those are just the cases that got serious enough to be hospitalized.

“These are children whose bodies are failing due to poor food intake,” said Dr. Terry Bravender, director of adolescent medicine and professor in the Department of Pediatrics at the University of Michigan. “And the medical hospital is really a rescue network for them so they don’t starve to death. So this really is the tip of the iceberg for the teenagers who suffer from eating disorders. “

Specialists in eating disorders have been for months hit the alarm, Warning of exploding hotline calls, waiting lists for months Treatment, and swelling Patient stresses. But Otto and her co-authors believe their study, published in the Journal of the American Academy of Pediatrics, may add to the limited data we currently have on the medical effects of the pandemic on children and adolescents.

But is there something unique about eating disorders that makes COVID worse? Or are eating disorders just one of the more visible reasons for the mental and physical health that has suffered during the pandemic, especially among the youth population?

“I think it’s a combination of both,” said Otto. “… I think part of the unique challenge with eating disorders during the pandemic is that access to medical care has been limited. I think there was probably a component to it that if the pandemic hadn’t continued, some people wouldn’t get medical attention as soon as possible. “

Eating disorders harm the whole body, says Dr. Otto, also in a way that the patient himself may not recognize. You can tell if you are feeling weak, passed out, or have seizures.

But it’s harder to spot changes in the heart’s electrical conductivity or dangerous electrolyte leakage, low blood pressure or heart rate. And diet reintroduction can also be dangerous: so-called “refeeding syndrome” occurs when the body goes out of starvation mode too quickly, causing sudden changes in salt and fluids in the body that lead to heart problems and can even be fatal .

All of this is hard to pin down when a child or teenager didn’t show up for their annual check-up last year or only went to their doctor virtually.

And the pandemic itself, with its isolation and loss of normal life, would be viewed by eating disorder specialists as a “triggering mass event,” said Otto. This is especially true for younger people.

“You couldn’t go to school. They were unable to do their extracurricular activities or hang out with friends. I often hear that patients who are used to excelling at school, [who] suddenly had problems when things went online. Many people, as well as adults, were concerned about their own health care, the health of loved ones … And I think this gave a lot of people an impetus to try to change their behavior. And for some people who are at risk for eating disorders, it quickly got out of hand and led to really serious consequences. “

Other things also changed during the pandemic. Overall, the demographics of those hospitalized for eating disorders stayed pretty much the same at Mott Children’s: most of them are white and female. But suddenly significantly fewer patients with statutory health insurance (such as Medicaid) were admitted.

This worries both Otto and Bravender. It’s not that teenagers without private insurance simply won’t have eating disorders or even have to be hospitalized during the pandemic. He just doesn’t know where they went. Have your ambulances closed? Didn’t they have internet access to see their doctor virtually?

“It may be that those who have Medicaid have had a much more difficult problem getting access to medical care during the COVID pandemic, be it because of losing their jobs or because their parents are more likely to work by the hour who won’t let you are allowed to work from home and do not allow them to visit us for care. So I’m worried about these patients and where they are and whether they are still sick. “

Even when patients receive medical attention, treatment for eating disorders does not end with hospitalization. And many families find that their insurance doesn’t cover all of the specialized therapies our doctors recommend, Otto said. Even if they can afford it, the demand for these services is much greater than what is currently available.

“We keep hearing from families… ‘I called 20 therapists and they are all full. Nobody takes in new patients. I have nowhere to take my child for treatment, ”she said.

“So I think everyone who works with children has a real obligation to take care of these patients … We need to figure out how we can work together to care for these patients.

“And that could mean on my side [as] the type of doctor who specializes in eating disorders and how we can train general practitioners to be better prepared to care for these patients.

“It might look like connecting therapists with this type of expertise with other therapists to provide guidance and support in caring for young people with eating disorders. I think that means really exploring this transition to virtual care and figuring out what helped about it, what was less than ideal, and how we can optimize the care we can provide in the future. “

If you or someone you know needs help with eating disorders, don’t wait for help. You can call, text or chat online with someone on the National Eating Disorders Association helpline Here. They also have a free one Verification tool when you need professional help and a map from doctors in your area who can treat eating disorders. Always call 9-1-1 in a medical emergency.

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