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A Mixed-Studies Systematic Review on the Impact of COVID-19 on Body Image, Disordered Eating, and Eating Disorders

Objectives. This review assessed the impact of COVID-19 and restrictions related to the pandemic (e.g., social distancing and lockdown) on body image, disordered eating, and eating disorder outcomes. Method. After registration on PROSPERO, a systematic search was conducted for papers published between 1 December 2019 and 1 August 2021, using the databases PsycINFO, PsycARTICLES, CINAHL Plus, AMED, MEDLINE, ERIC, EMBASE, Wiley, and ProQuest. Results. A final sample of 74 reports, describing 75 studies, was included, and data from qualitative, quantitative, and mixed-methods studies were synthesized using a convergent integrated approach. Four themes were generated: (1) disruptions due to COVID-19; (2) variability in the improvement or exacerbation of symptoms; (3) risk and protective factors; and (4) unique challenges for marginalized and underrepresented groups. Findings across studies showed variation in individuals’ responses to, and experiences of, the current pandemic. Discussion. There is large variability in how individuals respond to COVID-19 and limited research exploring the effect of the pandemic on body image, disordered eating, and eating disorder outcomes using longitudinal and experimental study designs. Based on the findings of this review, we recommend that individuals reduce time spent on social media, maintain contact with family and friends, make time for self-care, and keep daily routines. Additionally, researchers should target more diverse participant samples and conduct longitudinal research on risk and protective factors of COVID-19 and long-term outcomes. Finally, clinicians should consider adopting flexible treatment practices, taking into account COVID-19 restrictions, patient preferences, and unique participant needs.