COVID Isolation Eating Scale (CIES): Analysis of the impact of confinement in eating disorders and obesity—A collaborative international study

Fernando Fernández-Aranda*, Lucero Munguía, Gemma Mestre-Bach, Trevor Steward, Mikel Etxandi, Isabel Baenas, Roser Granero, Isabel Sánchez, Emilio Ortega, Alba Andreu, Violeta L. Moize, Jose M. Fernández-Real, Francisco J. Tinahones, Carlos Diegüez, Gema Frühbeck, Daniel Le Grange, Kate Tchanturia, Andreas Karwautz, Michael Zeiler, Angela FavaroLaurence Claes, Koen Luyckx, Ia Shekriladze, Eduardo Serrano-Troncoso, Teresa Rangil, Maria Eulalia Loran Meler, Jose Soriano-Pacheco, Mar Carceller-Sindreu, Sara Bujalance-Arguijo, Meritxell Lozano, Raquel Linares, Carlota Gudiol, Jordi Carratala, Jessica Sanchez-Gonzalez, Paulo P.P. Machado, Anders Håkansson, Ferenc Túry, Bea Pászthy, Daniel Stein, Hana Papezová, Brigita Bax, Mikhail F. Borisenkov, Sergey V. Popov, Youl Ri Kim, Michiko Nakazato, Nathalie Godart, Robert van Voren, Tetiana Ilnytska, Jue Chen, Katie Rowlands, Janet Treasure, Susana Jiménez-Murcia

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

55 Citations (Scopus)


Confinement during the COVID-19 pandemic is expected to have a serious and complex impact on the mental health of patients with an eating disorder (ED) and of patients with obesity. The present manuscript has the following aims: (1) to analyse the psychometric properties of the COVID Isolation Eating Scale (CIES), (2) to explore changes that occurred due to confinement in eating symptomatology; and (3) to explore the general acceptation of the use of telemedicine during confinement. The sample comprised 121 participants (87 ED patients and 34 patients with obesity) recruited from six different centres. Confirmatory Factor Analyses (CFA) tested the rational-theoretical structure of the CIES. Adequate goodness-of-fit was obtained for the confirmatory factor analysis, and Cronbach alpha values ranged from good to excellent. Regarding the effects of confinement, positive and negative impacts of the confinement depends of the eating disorder subtype. Patients with anorexia nervosa (AN) and with obesity endorsed a positive response to treatment during confinement, no significant changes were found in bulimia nervosa (BN) patients, whereas Other Specified Feeding or Eating Disorder (OSFED) patients endorsed an increase in eating symptomatology and in psychopathology. Furthermore, AN patients expressed the greatest dissatisfaction and accommodation difficulty with remote therapy when compared with the previously provided face-to-face therapy. The present study provides empirical evidence on the psychometric robustness of the CIES tool and shows that a negative confinement impact was associated with ED subtype, whereas OSFED patients showed the highest impairment in eating symptomatology and in psychopathology.

Original languageEnglish
Pages (from-to)871-883
Number of pages13
JournalEuropean Eating Disorders Review
Issue number6
Publication statusPublished - 1 Nov 2020


  • COVID Isolation Eating Scale
  • COVID-19
  • eating disorders
  • obesity


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