Disordered eating among university students at pre- and post - COVID-19: a repeated cross-sectional study

Background: Although the COVID-19 pandemic has passed, its impact on university students’ mental health remains evident, with lasting increases in anxiety, depression, and eating disorder symptoms. A repeated cross-sectional comparison was conducted to understand the role of weight concerns, emotion regulation, stress, anxiety and depression in the expression of eating disorders (ED) symptoms among two independent cross-sectional university samples collected in 2019, before COVID-19, and in 2022, after the pandemic. Method: A total of 845 students completed the Depression, anxiety, stress questionnaire-21, the Difficulties in emotion regulation scale and the Weight concerns scale as part of a campus-wide campaign that aimed to raise awareness on psychological well-being among students, conducted before and after the pandemic. Multiple regression with interactions was run to test the effects of emotion regulation, stress, anxiety, depression and weight concerns on ED symptoms, controlling for participants’ age and sex. Results: Results showed significant increases in students’ levels of stress, anxiety, depression as well as higher emotion regulation difficulties at post-pandemic. There were also, significant effects of anxiety and emotion regulation on ED symptoms across both years whereas students who experienced higher stress and weight concerns in 2022, towards the end of the pandemic, were more likely to report ED symptoms as compared to students at pre-pandemic. Conclusion: These findings indicate that significant changes were noted in students’ emotional well-being while students with higher stress and weight concerns were more prone to disordered eating after the pandemic. Further evaluation of these factors is necessary to better understand the impact of COVID-19 on ED risk among university students and to inform universities efforts to revise and adapt prevention and screening programs to the post-COVID-19 era.