Physical distancing, quarantines, and lockdowns have become necessary evils in the global fight against COVID-19 but for those battling eating disorders, this new normal – further fueled by an onslaught of mixed messaging – may make managing recovery and accessing treatment particularly challenging.
Given the importance of proper nutrition and flexible eating for sustained eating disorder recovery, one of the most disruptive pattern changes for individuals with eating disorders is limited access to restaurants and grocery stores. As health officials have encouraged the public to limit their trips outside the home, those with restrictive eating disorders may use these measures to avoid purchasing food and eating. Alternatively, the encouraged stockpiling, hoarding, and the rebirth of the home food pantry may be triggering for those struggling with binge eating.
“These conditions have created the perfect storm for eating disorder onset and relapse,” said Jaclyn Siegel, a PhD candidate in social psychology at Western University and a co-author of recent paper published in the journal Eating Disorders: Journal of Treatment and Prevention.
As an international team of researchers and clinicians, Siegel and her colleagues sought to outline a variety of ways the pandemic may adversely affect those struggling with eating disorders to help prepare clinicians and individuals with eating disorders for potential challenges, and those that may lie ahead. The study also identified general risks (e.g., anxiety, trauma, increased domestic violence) and eating-disorder specific risks (e.g., food access, fatphobic messaging) for those managing these conditions.
For instance, the forced closures and truncated hours of gyms, fitness centers and yoga studios have greatly restricted access to gentle physical activities that can help those with eating disorders manage their conditions. Combined with the drastically reduced availability for appointments with doctors, therapists and other healthcare providers and treatment centres, there is reason to believe there may be a hidden health crisis within the broader pandemic for those with eating disorders.
“Eating disorders are often trivialized as a benign affliction of wealthy, thin, teenage, white girls, but in reality, eating disorders are severe psychiatric conditions that can affect people of all backgrounds, genders, and body sizes. They have biological, psychological and social roots, and an extremely high mortality rate,” said Siegel.
Social media posts and cultural discourse have also amplified potentially-harmful messaging during the pandemic, which add another layer of concern for those with eating disorders.
“There has been quite a lot of weight-stigmatizing cultural messaging surrounding the pandemic. People have been warned to avoid the ‘quarantine fifteen’ and told that obesity worsens COVID-19 outcomes. Hearing messages that gaining weight during the pandemic is both inevitable and disastrous for your health can be really challenging, particularly for those trying to gain or maintain weight,” said Siegel. “There is new research linking obesity to increased mortality with COVID-19, but these studies often fail to control for comorbidities or other social determinants of health that may help to explain this link.”
Studies suggest an estimated 3.5 to 6.5 per cent of women and 3 to 3.5 per cent of men have experienced eating disorders throughout their life. And even in the best of times, recovering from an eating disorder can be a lifelong journey, says Siegel, who was diagnosed with anorexia nervosa herself in 2016.
“While full recovery is possible for some, many people with eating disorders experience periods of relapse and remission. It is not uncommon for some people to manage the symptoms of their conditions throughout their lives,” said Siegel. “Different levels of treatment are available to people with eating disorders, and in acute cases, those with eating disorders may need to access residential treatment centers, many of which have been affected by the pandemic. Even access to outpatient centers and in-person individual therapists are limited due to physical distancing guidelines.”
The study also provides recommendations for clinicians and individuals who are navigating eating disorder recovery, such as seeking virtual medical advice from telehealth, guided self-help, and connecting with online eating disorder support groups.
“There is a need for people with eating disorders, but really anybody living through this pandemic, to increase social connections,” said Siegel. “We also need to increase social support and limit our exposure to stressful news and messages about the pandemic because these can have an adverse effect on all of us. We encourage increasing involvement activities that are safe, enjoyable, and promote a self-compassionate self-perspective.”
The study was written during the early days of the COVID-19 outbreak, and since then, a number of studies have been published showing that eating disorder symptomology is indeed worsening for many.
“This is a really challenging time for people with eating disorders. But there are ways to get through it,” said Siegel.
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