This article was written by Daria Melikova of Richard Montgomery High School
Trigger Warning: This article discusses eating disorders and mental health issues related to them.
While everyone has been impacted by the COVID-19 pandemic in some way, those suffering from eating disorders are a group that many may not think of as having been hit especially hard. However, research has shown that eating disorders are currently burgeoning, especially due to stay-at-home orders. A survey of about 1,000 people from the Netherlands and the United States, in the International Journal of Eating Disorders, indicates that 62 percent of Americans with anorexia nervosa and around a third of Americans with binge-eating disorder had symptoms worsen in July. Later in the pandemic, around September, hotline calls to the National Eating Disorders Association were up 70 to 80 percent.
The pandemic has presented countless negative mental health impacts for many. As Claire Mysko, the CEO of the National Eating Disorders Association, states, many who struggle with eating disorders also suffer from a co-occuring mental condition such as anxiety or depression. Therefore, it comes as no surprise that eating disorders have worsened so drastically in this period of upheaval, even for those that were further along in their recovery. The current environment has proved to be particularly triggering for this group with the most prevalent concerns, as found by the International Journal of Eating Disorders, including a lack of structure, an inability to access proper food for recovery meal plans and a lack of much needed social support.
For many eating disorder victims, eating is a coping mechanism for stress, a way to control at least something when everything else in life seems uncertain and unstable. Thus, one of the first steps of recovery is to establish a stable structure, such as a consistent pattern of eating. According to Dr. Kristine Luce, a co-director of Stanford University School of Medicines' Department of Psychiatry Adult Eating Disorders Program, if there is even the smallest of disturbances to this system, whether it be an interruption to lifestyle routines or fluctuations in levels of self-care, symptoms could get even worse. With the pandemic, especially in the first few months, any sort of structure has all but disappeared.
Food shortages or an inability to go out and purchase food could further trigger the urge to starve, anxiety about food availability becoming an excuse for continuing such eating habits. On the other hand, for those with bulimia or binge eating disorder, stockpiling on food paired with isolation at home could exacerbate stress about eating and overeating, triggering extra periods of bingeing and purging. “The specific stress and anxiety associated with decisions about food and availability of food can dramatically increase anxiety in folks with eating disorders,” Sarah Alder, a psychologist at Stanford University’s Eating Disorder and Weight Control Clinic, states.
Furthermore, with increased stress over food consumption comes anxiety about exercising, especially due to the early closure of gyms and the transition to a more sedentary lifestyle. This is especially an issue for those whose eating disorders involve compulsive exercise. Individuals are either constantly worrying about not exercising enough since they can’t go to the gym, or are exercising even more excessively now that they have no barriers from doing so as they are stuck at home. In fact, Lauren Mulenheim, director of the group practice center Eating Disorder Therapy LA, has seen many patients who began excessively exercising with the start of the pandemic, which resulted in either a development of an eating disorder or a worsening of a preexisting one.
Aside from triggering food conditions, social isolation is a major provocation for eating disorders. These types of mental disorders are already very isolating as they are often something that individuals keep private. Recovery is a long and arduous process, so building a support system is one of the most important aspects of it. In fact, psychologists often recommend patients to try to connect with others and build support communities, something that has proved to be difficult for many because of coronavirus-related social distancing.
While there has been a substantial increase in teletherapy, data shows that 45 percent of respondents in the International Journal of Eating Disorders’ survey were left without such care, with people of color getting treatment at around half of the rate of their white counterparts. Even for those able to receive teletherapy, the treatment isn’t as good, especially considering how difficult it is for therapists to conduct the same procedures as done in person. For example, weigh-ins to confirm that patients aren’t losing too much weight and that they are gaining according to their recovery plan are practically impossible to conduct. If a patient doesn’t have anyone at home confirming their weight, they could feel less compelled and less motivated to continue with their recovery.
With a lack of proper social support, many turn to social media—especially adolescents who have been spending more time on such platforms while being constantly stuck at home. However, social media is yet another trigger, as people tend to compare themselves to others more and see negative messages that could be detrimental to recovery. After seeing content pushing for people to remain productive in quarantine, avoid quarantine weight gain or achieve the perfect body while at home, these individuals could have a worsened self image. For those that already have anxiety about weight gain, this could worsen eating or exercising behaviors as their fears increase.
Aside from social media, the transition to video platforms for work, school or even just calls with friends forces individuals to constantly be on video and look at themselves much more than usual. This leads to a greater focus on one’s appearance, having to constantly look at oneself. For a disorder in which bad body image plays a major role, sufferers of eating disorders feel even more strain and anxiety.
Eating disorders aren’t to be taken lightly. They have the second highest mortality rate among any psychiatric diagnosis. As the pandemic presents further challenges to eating disorder sufferers, it is of utmost importance that people show empathy to those that are struggling and attempt to provide some condolence and support for those that need it. Not everyone is the same; some have actually seen improvements in their eating disorder symptoms from an increase in family connection and self-care time, while others may still lack motivation to recover even with such things. Whether you have an eating disorder or not, it’s important to reach out to others and seek out help when you feel you need it.
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