While COVID-19 has been a difficult time for everyone, numerous reports and studies show the eating disorder community has been hit extra hard by the crisis. Experts in the ED treatment field reveal a significant increase in problems with their patients while eating disorder helplines and call centers report an enormous upsurge in calls and inquiries for help. In this article, we look at eating disorders and COVID-19, examining the five main reasons why COVID-19 has affected the eating disorder community so hard, plus share practical ways you can combat these problems and stay on the path to recovery even in the midst of this difficult time.
How is COVID-19 Affecting People With Eating Disorders?
A study analyzing the effects of COVID-19 on people with eating disorders found that the pandemic has had a significant and negative impact on individuals with an ED. Conducted by Cynthia Bulik Ph.D., and colleagues, the study analyzed 510 participants from the Netherlands and 511 from the United States. Participants with anorexia reported higher levels of restriction, while those with binge-eating disorder reported more episodes of binge eating and stronger urges to binge. Even those who didn’t report increased levels of ED behaviors said they were concerned that the pandemic situation made them more susceptible to relapse.
“Eating disorders thrive on secrecy and isolation. They get stronger when no one knows what you’re up to.”
Furthermore, the National Eating Disorders Association (NEDA) shared that between April 2019 and April 2020, their Helpline chat queries increased by 83 percent. A quick scan through NEDA’s community forum (a resource for people with eating disorders to connect with each other, share their struggles, and get support) also reveals the negative effects of COVID-19 on those suffering from an eating disorder. Numerous individuals on the forums share that they’ve fallen deeper into ED behaviors or have even relapsed after being recovered for years. One person on the forum states, “I’d been considering myself ‘officially recovered’ from my eating disorder for a couple of years now, but like many others in this situation I feel like I’m starting to relapse thanks to COVID-19.”
There are five main reasons why the COVID-19 pandemic is affecting people with eating disorders. We’ll briefly look at each one of these reasons, then share some helpful tools you can use to support your recovery and protect yourself from relapse during this time.
Losing Control
Control has long been recognized as a contributing factor in eating disorders. In the 1900s, Hilde Bruch studied the causal relationships and underlying factors in ED, finding that often, an individual’s eating disorder is an attempt to control some small aspect of their life when everything else feels chaotic.
With all the chaos, stress, and uncertainty of COVID-19 (lockdowns, job loss, fear of sickness), many individuals with eating disorders feel an even greater loss of control than normal and are using ED behaviors as a way to cope.
Food Scarcity
Another reason why COVID-19 is affecting individuals with ED is due to food shortages, fears about food scarcity, and food stockpiling. As fears over the virus escalated and quarantine measures were put into place, people flooded grocery stores, buying up everything in sight. This led to a supply problem, leaving many shelves empty for weeks, and some people without the basic necessities they need. Many people with an eating disorder already approach food with a scarcity mindset, shares Lindsay Ronga, an ED recovery and life coach. She goes on to say that for people with an ED, fears about food running out, feelings of guilt over whether they even deserve to buy food, and stress over if their ‘safe foods’ will be available, have all been amplified thanks to COVID-19.
“Oftentimes people in recovery do well because they can eat the same food over and over again,” shares Christina Wierenga, Ph.D. But with the food shortage problems and regular grocery shopping routines disturbed, these safe foods may be much harder to find, bringing up a host of problems for individuals with an ED. Stocking up on food poses another big problem for individuals with an ED, especially for those struggling with binge eating. Having excess food in the fridge and pantry, coupled with added stress and anxiety of the pandemic, can be a trigger, leading to more binge episodes for some.
Isolation Challenges
Isolation and eating disorders often go hand in hand. Why? Isolation is frequently the default for those with eating disorders, as they get so focused on food and weight that they lose interest in other activities, are often depressed, struggle with social anxiety, and experience fear over going to restaurants and eating in public. But isolation is extremely dangerous for those with an ED, as Lindsay Ronga states in a Healthline article: “Eating disorders thrive on secrecy and isolation. They get stronger when no one knows what you’re up to.”
And with so many people spending the majority of their days alone at home, with little to no social interaction, and (in some cases) loss of accountability with therapists and dietitians, it’s no wonder individuals with eating disorders are struggling even more during this time. Environmental components caused by shelter-at-home orders can also pose a problem for individuals with eating disorders. Having constant access to the kitchen (and most likely a stocked pantry) can be a constant source of struggle for individuals with binge eating disorder. Also, with a lack of stimulation in one’s environment, like a change of scenery, boredom and stress can tend to build up, and with food readily available, bingeing can be an easy release and a way to numb what’s going on and escape the present environment.
Disrupted Routines
The shelter in place mandates of COVID-19 have disrupted most people’s daily routines, and while this may not pose a huge problem for some, it can be devastating to those with an eating disorder. Why? For individuals in eating disorder recovery, schedules and routines are often the things that keep them moving forward in their recovery.
Whether it’s a set eating schedule, the routine of work and school, a regular therapist appointment schedule, or exercise routines, all of these things help fill the empty spaces once occupied by ED behaviors, serving to “suffocat[e] out the eating disorder,” says Nancy Zucker, Ph.D., director of the Duke Center for Eating Disorders in Durham, North Carolina. With many of these routines ripped away, individuals with an ED are left with much less structure and much more empty time to fill, making it easy to fall back into harmful behaviors.
Ways to Support Your Recovery During COVID-19
While COVID-19 has been a difficult time for many people in the ED community, it is possible to continue recovering and find healing and hope during the crisis. Here are five helpful tips, shared by Marlena Tanner from Central Coast Treatment Center, on how to navigate these new challenges and stay on the path to recovery during COVID-19.
1. EXPRESS EMOTIONS
One of the defaults can be to internalize emotions and shift those hard-to-deal-with-feelings into food or body thoughts and behaviors. Resist this urge, and instead, let the emotions out. Consider starting a journal and write down anything you’re feeling, thinking, needing, and struggling with.
2. STICK TO STRUCTURE
If you’ve been struggling with ED behaviors and thoughts during COVD-19, consider making yourself a daily schedule to follow. Remember to keep it flexible (it’s not about being strict with yourself, but rather, finding a level of balance and structure throughout your day).
3. GET OUTSIDE
If this is an option where you live, take advantage of it, and try to get outside every day. The sunshine and fresh air can do wonders! And if you’re not in a place where you need to restore weight or refrain from exercise, try adding some gentle movement into your time outdoors.
4. STAY CONNECTED
Even though going out with friends or visiting your parent’s house may not be an option right now, do whatever you can to stay connected with the people you love. Whether it’s a daily FaceTime call, a weekly Zoom hang out with your friends, or a card in the mail to a neighbor, make sure to check in regularly with the people in your life.
5. MAKE A DAILY GRATITUDE LIST
We all have something to be grateful for each day, so take the time to write down 3-5 things you’re grateful for every morning. You’ll be surprised at how this can shift your perspective and help you see things in a more positive light.
If you or a loved one are struggling with eating disorder thoughts or behaviors, seek professional help today. At Ai Pono, we offer both inpatient and outpatient programs, as well as online and call support. Take the next step today and talk to someone about recovery or simply learn more about the recovery programs we offer.
