Editor's note: This article contains explicit references to disordered eating, restrictive eating, and weight and may be triggering to some readers.
“The beginning of the pandemic was the closest I’d gotten to relapse, as all I could fixate on was my figure and weight,” Christina, a UW alum and employee who asked to only be referred to by her first name, said.
During times of high uncertainty and stress, it is natural for fears of all kinds to get aggravated. That, combined with social isolation and the shutdown of coping mechanisms such as exercise and entertainment, can weaken our defenses against mental illnesses.
Admirably, many people have been actively speaking out about depression and anxiety. However, many have forgotten to include eating disorders (EDs) in the conversation.
According to a study published in the International Journal of Eating Disorders in July, 62% of Americans with anorexia nervosa experienced worsening symptoms, and 30% of Americans with binge-eating disorder reported an increase in binge-eating episodes, following the COVID-19 outbreak.
This is not the first time a pandemic has spiked the occurrence of EDs. The SARS outbreak in 2003 triggered a similar development of ED symptoms.
This relation can be attributed to various factors including high economic uncertainty, elevated stress levels, lack of control, fear over health, food insecurity, proximity to food, and social isolation.
Although it is natural to turn to food for comfort during times of high distress, it becomes concerning when food becomes the only source of escape.
“There’s a continuum between non-disordered eating, disordered eating, and eating disorders,” Lisa Erlanger, a primary care specialist at UW Hall Health, said. “As you move along the continuum, thoughts and behaviors around food and the body start to interfere more and more with your physical, emotional, and social life.”
EDs often have a strong link to trauma, which is one of the reasons they’re thriving under the trauma from the global pandemic.
“Eating disorders can lead to a certain degree of emotional numbing, which one might describe as a way to cope with trauma,” Megan Riddle, a psychiatrist at the Eating Recovery Center in Bellevue, said.
To cope with trauma and feel a sense of control in their lives, some people try to take charge by restricting their intake of food or binge-eating. Disordered eating creates a false sense of control and stability by making a person feel that they’re in charge of what they eat — that they’re not controlled by the fear of the pandemic nor the loneliness of isolation. This coping mechanism, which is often dismissed as vanity or a lack of self-control, is really a sophisticated way to manage complicated emotions.
Apart from creating a surge in emotions, the pandemic has also voided our lives of structure. Food obsession, it turns out, can be dangerously adept at structuring your day and keeping you busy.
“If you’re focused on food all day — eating it, not eating it, counting calories, exercising, bingeing or planning the next binge — there is less time to feel isolated,” Riddle said.
People in recovery from eating disorders are particularly affected by isolation. Socializing with others doesn’t just offer distraction from obsessive thoughts about food; it also provides the emotional support crucial for recovery.
“If someone values relationships and finds strength and support in their relationships, they may especially struggle right now when it's very difficult to be in community with one another,” Natalie Goodwin, a psychologist practicing in Seattle, said.
However, many college students who’ve gone home after the lockdown aren’t finding it any easier
“I was scared to be alone with my thoughts and to be back in a toxic household that encouraged bad behaviors,” Maddie B., a sophomore at UW, said. “College was supposed to be an escape for that.”
Students have lost the sense of independence that they established at school, where they could create their own routines for healthy eating.
“I was terrified [of going home],” Christina said. “I knew being around friends made me have some more ‘normal’ eating habits, and without them it was really easy for me to just not eat.”
Psychologists have observed that having the watchful eye of a parent or sibling could trigger disordered eating.
According to a study published in June, the pandemic could also make otherwise healthy individuals more susceptible to developing EDs. Disruptions to daily routines, social restrictions, proximity to food, and fear of contracting the virus are all to be blamed. Exposure to ED-specific or anxiety-provoking media can also cause harm.
During quarantine, I’ve come across memes about gaining the “quarantine 15” or people making fun of weight gain in general. People defend these “jokes” in the name of health or tell people who are offended to toughen up.
You can’t ask someone who has or is at risk of having an ED to “toughen up,” in the same way you can’t ask someone having depression to “lighten up.” Both are mental disorders. The health promotion defense is bull----. I haven’t seen a single meme about losing mileage or toe muscles. These memes are fatphobic, period. They are incredibly triggering and perpetuate the belief that thinness is an indicator of success, beauty, and self-control.
The National Eating Disorders Association reported a 70% to 80% rise in hotline calls, from June to July 2020, as compared to the same period last year. The National Association of Anorexia Nervosa and Associated Disorders (ANAD), estimates that one person dies from an eating disorder every 52 minutes. It is important not to dismiss them.
If you’re struggling with disordered eating, please know that you’re not alone. There are a lot of people in the same place. Goodwin recommends seeking professional care if you’re able to, and to check with your insurance to see if it’s covered. If you don’t have insurance, there are low-cost resources available. Eating disorders really do get better, and treatment can be incredibly helpful for recovery.
“If we turn to self-criticism and judgement right now, it will only add to our distress,” Goodwin said. “So when those thoughts come that remind us of the COVID weight we’ve gained, or when we become more aware of our struggles with our body with the extra time we have on our hands ... remember to be gracious.”
Here are a few resources that can help someone recover from eating disorders (ED):
National Eating Disorder Association (NEDA) provides excellent information about EDs.
Eating Recovery Center does free screenings with a Master’s level clinician who can help connect individuals with their next step in care.
Seattle Children’s Hospital provides a terrific ED recovery program and has a great inventory of resources.
Another treatment option is the Eating Disorders Center in Seattle.
The Emily Program provides personalized treatment for EDs.
Those interested in joining online support groups can look into offerings by Eating Disorder Hope.
Reach writer Akanksha Mishra at firstname.lastname@example.org. Twitter: @Akanksha_2200
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