Youth Eating Disorder Admissions Return to Pre-Pandemic Levels

A sharp increase in the number of young people hospitalized with eating disorders immediately after the onset of the COVID-19 pandemic had returned to pre-pandemic levels, a cross-sectional study of U.S. pediatric hospitals showed.

Eating disorder-related hospital discharges among 8- to 25-year-olds increased by 30.9 (95% CI 23.9-38.0) per month through the first year of the pandemic to a peak of about 600 per month across 41 hospitals, reported Cassie Burley, MD, of Boston Children’s Hospital and Harvard Medical School in Boston, and colleagues in JAMA Pediatrics.

After April 2021, eating disorder-related hospitalizations remained stable or modestly declined before a sharp drop in October 2024 put the pattern and volume of patients back to a level statistically indistinguishable from the pre-pandemic period, averaging in the range of roughly 350 per month through June 2025.

“Five years after pandemic onset, the volume of patients with eating disorders admitted to our geographically diverse group of hospitals appeared to have returned to prepandemic levels,” Burley and colleagues wrote. “This volume was even below that estimated by the prepandemic pattern, although this difference was not statistically significant.”

The group had previously reported an increase soon after the onset of the pandemic in the number of young people who were hospitalized with eating disorders amid rising concerns about depression, anxiety, and other aspects of youth mental health.

Burley and colleagues documented a fairly stable pre-pandemic eating disorder-related hospitalization trajectory among young people, with a nonsignificant increase of 1.92 (95% CI −0.04 to 3.9) discharges per month. However, a brief decline in April 2020 of 59.8 (95% CI −113.1 to −6.5) discharges per month was followed by the sharp increase.

What was not yet known, they emphasized, was whether eating disorder-related hospitalizations among young people had returned to prepandemic levels. They sought to shed light on this question by looking at a large population across the U.S. by using administrative billing data from tertiary care pediatric hospitals in the Pediatric Health Information System (PHIS).

Overall, there were 43,101 eating disorder-related hospital discharges among young people during the study period. About 85% of individuals included in the study were female, and their age averaged 15.4 years.

To complete the study, the research team compared aggregated monthly volumes of eating disorder-related discharges before the onset of the pandemic (January 2018-March 2020) to 5 years afterward (June 2025).

Limitations included that the research team was “unable to determine the mechanism underlying the return to prepandemic volumes, including the notable decrease in the fall of 2024,” Burley and colleagues noted. “These findings may reflect changes in eating disorder prevalence, changes in eating disorder severity, new and developing points of access (eg, expanded telehealth services), or changes in admission criteria during the pandemic,” they wrote.

Additionally, some hospitals may have been unintentionally excluded from the study if they were not using ICD-10 billing codes for eating disorders at discharge, they continued. And because PHIS comprises mainly large academic institutions, findings may not be generalizable to all hospitals.

“Further research is needed to characterize post-onset patterns in eating disorder severity, phenotype and demographic characteristics,” Burley and colleagues concluded, “as well as changes in the treatment landscape to optimize care for adolescents and young adults with eating disorders.”