Recent evidence suggests psychosocial stressors stemming from coronavirus disease 2019 (COVID-19) exposure and public health recommendations and policies have exacerbated eating disorder symptoms. Consequentially, eating disorder acuity has increased during the COVID-19 pandemic. Currently, it is still unclear how the COVID-19 pandemic may be impacting individuals receiving treatment for eating disorders at higher levels of care. The purpose of this study was to examine the impact of COVID-19 on eating disorder symptoms and associated outcomes in a sample of individuals receiving eating disorder treatment compared to individuals receiving treatment in 2019.
Blinded outcomes data from 272 adults who completed treatment at an eating disorder treatment center between April and October of 2019 (pre-COVID-19 group) and 2020 (COVID-19 group) were examined. Repeated measures analyses of variance with Bonferroni correction were used to examine differences in outcome variables and treatment response.
Fewer participants reported trauma in 2020, but symptoms were more severe when present. A significant interaction effect for treatment (eg, admission, discharge) and year (eg, pre-COVID-19, COVID-19) was found for eating disorder and trauma symptoms. Moreover, trauma symptom scores were higher in 2020 than in 2019. The interaction among year, trauma, and treatment was significant ( = 2.11,  = .027, η = 0.034), indicating that individuals with severe trauma in 2020 reported less eating disorder symptom score reduction.
Results extend understanding of effects during the COVID-19 pandemic on treatment-seeking individuals with eating disorders. Clinical implications suggest that greater attention to trauma when screening eating disorder patients and selecting treatment approaches are needed, particularly during the COVID-19 pandemic.

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