Eating disorders during lockdown: The transcultural influence on eating and mood disturbances in Ibero-Brazilian population

Background COVID-19 pandemic has implied exceptional restrictive measures to contain its widespread, with
adverse consequences on mental health, especially for those people with a background of mental illness, such as eat‑
ing disorders (EDs). In this population, the infuence of socio-cultural aspects on mental health has been still underex‑
plored. Then, the main aim of this study was to assess changes in eating and general psychopathology in people with
EDs during lockdown regarding the ED subtype, age, and provenance, and considering socio-cultural aspects (e.g.,
socioeconomical factors such as work and fnancial losses, social support, restrictive measures, or health accessibility,
among others).
Methods The clinical sample was composed of 264 female participants with EDs (74 anorexia nervosa (AN), 44
bulimia nervosa (BN), 81 binge eating disorder (BED), and 65 other specifed feeding and eating disorder (OSFED)),
with a mean age of 33.49 years old (SD=12.54), from specialized ED units in Brazil, Portugal, and Spain. The partici‑
pants were evaluated using the COVID-19 Isolation Eating Scale (CIES).
Results A global impairment in mood symptoms and emotion regulation was reported in all the ED subtypes,
groups of age, and countries. Spanish and Portuguese individuals seemed more resilient than Brazilian ones (p<.05),
who reported a more adverse socio-cultural context (i.e., physical health, socio-familial, occupational, and economic
status) (p<.001). A global trend to eating symptoms worsening during lockdown was observed, regardless of the ED
subtype, group of age, and country, but without reaching statistical signifcance. However, the AN and BED groups
described the highest worsening of the eating habits during lockdown. Moreover, individuals with BED signifcantly
increased their weight and body mass index, similarly to BN, and in contrast to the AN and OSFED groups. Finally, we
failed to fnd signifcant diferences between groups of age although the younger group described a signifcant wors‑
ening of the eating symptoms during lockdown.
This manuscript and research were supported by grants from the Ministerio de Ciencia e Innovacion (PDI2021-124887OB-I00), Delegacion del Gobierno para el Plan Nacional sobre Drogas (2021I031), Instituto de Salud Carlos III (ISCIII) (FIS PI20/00132) and co-funded by FEDER funds/European Regional Development Fund (ERDF), a way to build Europe; European Union's Horizon 2020 research and innovation programme under Grant agreement no. 847879 (PRIME/H2020, Prevention and Remediation of Insulin Multimorbidity in Europe CIBERObn is an initiative of ISCIII, which also supports this work through the grant CM21/00172 (co-funded by European Social Fund. ESF investing in your future). RG is supported by the Catalan Institution for Research and Advanced Studies (ICREA-Academia, 2021-Programme). Additional funding was received by AGAUR-Generalitat de Catalunya (2021-SGR-00824). PM was supported, in part, by a Portuguese Foundation for Science and Technology grant (POCI-01-0145-FEDER-028145, and UIDB/01662/2020). This study was also partially conducted at the Psychology Research Centre (CIPsi), School of Psychology, University of Minho, supported by the Foundation for Science and Technology (FCT) through the Portuguese State Budget (Ref.: UIDB/PSI/01662/2020).The funders had no role in the study design, data collection, and analysis, decision to publish, or preparation of the manuscript.