*4.1. ED Subtypes and Changes during Lockdown*

In line with previous studies [26] the findings highlight a differential psychopathological impact during lockdown according to the ED diagnosis. Patients diagnosed with BN and BED reported weight gain after lockdown, the BED group experiencing the greatest weight changes when comparing by ED subtypes. It is possible that a sedentary lifestyle favored by "stay-at-home" measures and mobility restrictions during lockdown [35] may play a pivotal role in these weight changes [36,37]. Some of the increased eating behaviors related to "food insecurity" or boredom, such as snacking [35], could also lead to weight gain [16,17]. In this line, individuals with BED and BN showed a higher impairment in their eating style in comparison with the other ED subtypes. Moreover, previous studies have recognized an increased vulnerability to weight gain in individuals with overweight and obesity [38], conditions that are usually presented in individuals with BN and BED [39,40].

Eating behaviors have been described as maladaptive strategies to cope with emotional distress [13,18,22]. However, ED symptoms and emotion dysregulation were reduced in BN, which aligns with other findings [10,41]. The continued presence of other people at home and maintaining daily routines [4] are two significant socio-demographic features that characterized our sample, and may have allowed patients with BN to reduce binge episodes and purging. Moreover, the observed decrease in other maladaptive behaviors after lockdown (i.e., alcohol consumption) has been previously described in an international non-clinical study [35].

Individuals with BED reported the highest impact on ED symptoms when comparing ED subtype groups, although no significant changes in ED symptoms pre- and postlockdown were individually reported in this group. A greater illness perception among these patients together with a higher motivation for change [42], and the weight gain during lockdown, could encourage them to improve their eating style (e.g., non abuse of certain palatable foods).

Changes in eating style have also been described in patients with AN, which may suggest an increased control over food intake during lockdown. Changes in diet habits have been observed both in general and clinical populations during lockdown [16], the restricting pattern being commonly mentioned [24]. Surprisingly, and in contrast to other studies [12,43], they did not report significant modification in weight/BMI, ED symptoms nor other psychological features. Furthermore, a reduction in alcohol use was described in this ED subtype after lockdown.

Regarding OSFED group, both psychopathology and emotion regulation worsened during lockdown. This aligns with previous research which found that individuals with OSFED deteriorated in adverse situations [44,45]. Not only they did experience a greater psychological impairment than subjects from other ED groups but this impairment also persisted after lockdown [10,11,23].
