Abstract
BACKGROUND/OBJECTIVES: The COVID-19 pandemic has been associated with significant increases in mental-health-related concerns in adolescents, including eating disorders. Disparities in screening, diagnosis, and treatment impact adolescents with eating disorders. This study aimed to describe the patterns in the prevalence and the associations between eating disorder diagnoses and demographic factors in adolescent patients since the start of the COVID-19 pandemic. METHODS: We performed a retrospective cohort study examining adolescent patients (aged 12 to 21) with an eating disorder (ED) diagnosis documented between January 2019 and July 2023 using Epic Systems Corporation's Cosmos, a de-identified dataset aggregated from electronic health record (EHR) data. We examined the differences in demographic factors by utilizing chi-square and Kruskal-Wallis rank sum tests. RESULTS: A total of 82,435 distinct adolescent and young adult patients with eating disorder diagnoses were included in the analytical dataset. The overall prevalence of EDs has increased since 2019. The median age of patients with an ED decreased between 2019 and 2023. There was a decrease in other eating disorder diagnoses and an increase in avoidant-restrictive food intake disorder (ARFID) during the study period. There was a decrease in the proportion of individuals who identified as White and an increase in the proportion of adolescents from historically minoritized racial and ethnic groups (i.e., African American or Black and Hispanic). There was also an increase, during this study period, in the proportion of adolescents with an ED diagnosis who were from more socially vulnerable communities. CONCLUSIONS: Our study describes the changes in the prevalence of sociodemographic factors in adolescent patients with EDs since the start of the COVID-19 pandemic. Further studies should address screening, diagnostic, and treatment barriers for EDs in historically underserved communities.