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

Research output: Contribution to journalArticle


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.


  • 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 Favaro
  • And 32 others
  • Laurence 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
External organisations
  • Bellvitge University Hospital-IDIBELL
  • University of Barcelona
  • Autonomous University of Barcelona
  • Institutd' Investigacions Biomèdiques August Pi iSunyer (IDIBAPS)
  • CIBER Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM)
  • Hospitales Regional Universitario y Virgen de la Victoria de Málaga
  • University of California, San Francisco
  • King's College London
  • Ilia State University
  • Medical University of Vienna
  • University of Padova
  • Catholic University of Leuven
  • University of Antwerp
  • University of the Free State
  • Hospital Universitari Germans Trias i Pujol
  • University of Minho
  • Semmelweis University
  • Sheba Medical Center
  • Vilnius University
  • Inje University Paik Hospital
  • Vytautas Magnus University
  • Taras Shevchenko National University of Kyiv
  • Shanghai Jiao Tong University
  • CIBER de Fisiopatología Obesidad y Nutricion (CIBEROBN)
  • International University of La Rioja
  • University of Melbourne
  • Girona Biomedical Research Institute (IDIBGI)
  • Hospital Universitari de Girona Dr. Josep Trueta
  • University of Santiago de Compostela
  • University Clinic of Navarra
  • Sant Joan de Déu Research Institute
  • CIBER Salud Mental (CIBERSAM)
  • FITA Foundation
  • Associació Contra l'Anorèxia i la Bulímia
  • Carlos III Health Institute
  • Malmö Addiction Centre, Region Skåne
  • Charles University in Prague
  • Komi Science Center, Ural Branch, Russian Academy of Sciences
  • International University of Health and Welfare
  • University of Paris-Saclay
  • Paris Descartes University
  • Versailles Saint-Quentin-en-Yvelines University
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Psychiatry


  • COVID Isolation Eating Scale, COVID-19, eating disorders, obesity
Original languageEnglish
Pages (from-to)871-883
Number of pages13
JournalEuropean Eating Disorders Review
Issue number6
Early online date2020
Publication statusPublished - 2020 Nov
Publication categoryResearch