JMIR Publications

ABSTRACT

Background:

The novel 2019 coronavirus disease (COVID-19) has affected individuals with lived experience of eating disorders (ED) strongly with many reporting higher psychological distress, higher prevalence of ED symptoms and compensatory behaviors. The COVID-19 pandemic and the health and safety measures taken to contain its spread also disrupted routines and reduced access to familiar coping mechanisms, social support networks, and healthcare services. So far it is unknown how discussions in online ED communities have changed during the first months of the COVID-19 pandemic.

Objective:

The objective of our study was to identify changes in language content and style in an online ED community during the initial onset of the COVID-19 pandemic.

Methods:

We extracted posts and their respective comments from the r/EDAnonymous community on the social media website Reddit and concatenated them to comment threads. To analyze these threads, we applied top-down and bottom-up language analysis methods in the form of topic modeling with Latent Dirichlet allocation and 13 indicators from the Linguistic Inquiry and Word Count (LIWC) program, respectively. Threads were split into a pre-pandemic (before 11.03.2020) and mid-pandemic (after 11.03.2020) group. Standardized mean differences (SMDs) were calculated to estimate change between pre- and mid-pandemic threads.

Results:

N = 17,715 threads (n = 8,772 (49.5%) pre-pandemic threads, n = 8,943 (50.5%) mid-pandemic threads) were extracted from the ED community and analyzed. The final topic model contained 21 topics. Confidence intervals excluding zero were found for SMDs of 15 topics and nine LIWC categories covering themes such as ED symptoms, mental health, treatment for ED, cognitive processing, social life, and emotions.

Conclusions:

We observed a reduction in discussions about ED symptoms at the same time as an increase of mental health and treatment-related topics. This points to a change in the focus of the ED community from promoting potentially harmful weight loss methods to bringing attention to mental health and treatments for ED. These results together with heightened cognitive processing, increased social references, and reduced inhibition of negative emotions detected in discussions indicate a shift in the r/EDAnonymous community towards a pro-recovery orientation.