Effect of the COVID ‐19 Pandemic on Health Care Utilization for Eating Disorders in Colombia: A National and Subnational Time‐Series Analysis

OBJECTIVE: Emerging evidence indicates that the COVID-19 pandemic has had a profound impact on mental health globally, including an increase in the incidence of eating disorders. This study aims to characterize individuals diagnosed with anorexia and bulimia nervosa in Colombia and to estimate changes in the monthly age- and sex-adjusted treatment prevalence before and after the COVID-19 pandemic. METHOD: An ecological observational time series study was conducted, estimating the monthly treatment prevalence of anorexia and bulimia in Colombia from 2011 to 2023, adjusted by sex and age. Data were extracted from national administrative records and corrected for underreporting. Pre- and post-pandemic onset trends were compared using non-parametric tests and segmented regression models. RESULTS: Between 2011 and 2023, 54,471 individuals received treatment for anorexia or bulimia in Colombia. Most cases occurred among women and individuals aged 15-29 years. The adjusted monthly treatment prevalence of anorexia ranged from 0.06 to 0.5 per 100,000 population, and bulimia from 0.11 to 0.82. Following the onset of the COVID-19 pandemic, the median monthly number of visits for anorexia increased by 120% (p < 0.01) and for bulimia by 18.1% (p = 0.07). Significant inflection points were identified, with heterogeneous increases observed across departments. Antioquia exhibited the highest monthly percentage increase for both conditions. DISCUSSION: The observed increase in health care utilization for anorexia and bulimia following the pandemic suggests a substantial impact of the health crisis on eating disorders. These findings highlight the urgent need to strengthen mental health services and to develop evidence-based, targeted interventions to address the growing burden of these conditions in Colombia.