*Article* **Impact of COVID-19 Lockdown in Eating Disorders: A Multicentre Collaborative International Study**

**Isabel Baenas 1,2,3,†, Mikel Etxandi 1,†, Lucero Munguía 1,2,3, Roser Granero 2,3,4, Gemma Mestre-Bach 5, Isabel Sánchez 1,2,3, Emilio Ortega 6,7, Alba Andreu 6, Violeta L. Moize 6,7, Jose-Manuel Fernández-Real 2,8,9, Francisco J. Tinahones 2,10, Carlos Diéguez 2,11, Gema Frühbeck 2,12, Daniel Le Grange 13, Kate Tchanturia 14, Andreas Karwautz 15, Michael Zeiler 15, Hartmut Imgart 16, Annika Zanko 16, Angela Favaro 17, Laurence Claes 18,19, Ia Shekriladze 20, Eduardo Serrano-Troncoso 21, Raquel Cecilia-Costa 21, Teresa Rangil 22,23, Maria Eulalia Loran-Meler 22, José Soriano-Pacheco 24,25, Mar Carceller-Sindreu 24,25, Rosa Navarrete 26, Meritxell Lozano 27, Raquel Linares 27, Carlota Gudiol 28,29,30,31, Jordi Carratala 28,29,30,31, Maria T. Plana 25,32,33, Montserrat Graell 25,34, David González-Parra 35, José A. Gómez-del Barrio 25,36,37, Ana R. Sepúlveda 38, Jéssica Sánchez-González 1, Paulo P. P. Machado 39, Anders Håkansson 40,41, Ferenc Túry 42, Bea Pászthy 43, Daniel Stein 44, Hana Papezová 45, Jana Gricova 45, Brigita Bax 46, Mikhail F. Borisenkov 47, Sergey V. Popov 47, Denis G. Gubin 48,49, Ivan M. Petrov 50, Dilara Isakova 51, Svetlana V. Mustafina 52, Youl-Ri Kim 53, Michiko Nakazato 54, Nathalie Godart 55,56,57, Robert van Voren 58, Tetiana Ilnytska 59, Jue Chen 60, Katie Rowlands 14, Ulrich Voderholzer 61, Alessio M. Monteleone 62, Janet Treasure 14, Susana Jiménez-Murcia 1,2,3,30,\* and Fernando Fernández-Aranda 1,2,3,30,\***


**Citation:** Baenas, I.; Etxandi, M.; Munguía, L.; Granero, R.; Mestre-Bach, G.; Sánchez, I.; Ortega, E.; Andreu, A.; Moize, V.L.; Fernández-Real, J.-M.; et al. Impact of COVID-19 Lockdown in Eating Disorders: A Multicentre Collaborative International Study. *Nutrients* **2022**, *14*, 100. https:// doi.org/10.3390/nu14010100

Academic Editor: Patrick R.M. Lauwers

Received: 29 October 2021 Accepted: 20 December 2021 Published: 27 December 2021

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**Abstract:** Background. The COVID-19 lockdown has had a significant impact on mental health. Patients with eating disorders (ED) have been particularly vulnerable. Aims. (1) To explore changes in eating-related symptoms and general psychopathology during lockdown in patients with an ED from various European and Asian countries; and (2) to assess differences related to diagnostic ED subtypes, age, and geography. Methods. The sample comprised 829 participants, diagnosed with an ED according to DSM-5 criteria from specialized ED units in Europe and Asia. Participants were assessed using the COVID-19 Isolation Scale (CIES). Results. Patients with binge eating disorder (BED) experienced the highest impact on weight and ED symptoms in comparison with other ED subtypes during lockdown, whereas individuals with other specified feeding and eating disorders (OFSED) had greater deterioration in general psychological functioning than subjects with other ED subtypes. Finally, Asian and younger individuals appeared to be more resilient. Conclusions. The psychopathological changes in ED patients during the COVID-19 lockdown varied by cultural context and individual variation in age and ED diagnosis. Clinical services may need to target preventive measures and adapt therapeutic approaches for the most vulnerable patients.

**Keywords:** eating disorders; COVID-19 lockdown; COVID-19 Isolation Eating Scale (CIES); eating symptoms; psychological impact
