Like many key employees, Jessica, a grocery worker and Atlanta graduate, was “extremely overworked” during the coronavirus pandemic. Overwhelmed by stress, she fell back into bad habits to cope.
Jessica, who is identified by her first name only to remain anonymous, has been battling bulimia for more than a decade.
“It’s just crowding me so I don’t break like a stressed rubber band. I know I can’t purge because it’s unhealthy,” Jessica said. “So I’m in the middle of this cycle, I’ve spent years trying to break.”
The pandemic has increased stress among many Americans, which has been exacerbated only by isolation and lack of frequent social contacts. It was the perfect storm of negative factors for people with eating disorders or for those in recovery.
“I think it was disastrous in many ways,” said Cynthia Bulik, who is the founding director of the UNC Center for Excellence in Eating Disorders, about the pandemic. Bulik co-authored a study published in July that looked at the early effects of the pandemic on people with eating disorders in the United States and the Netherlands. The study found the side effects of life in blockage, including “lack of structure, increased time spent in a trigger environment, lack of social support,” led to worsening of symptoms for people with eating disorders and a higher risk of recidivism for those in recovery.
“This is just one of the tragedies following the COVID crisis,” Bulik said of the rise in cases of eating disorders that can affect anyone, regardless of race, gender, age or weight.
Chelsea Kronengold, communications manager for the National Eating Disorders Association, said the NEDA helpline has seen a 40% increase in contacts since March 2020.
“Throughout the pandemic, NEDA has seen an increase in calls focused on suicide, self-harm and even the need for child protection services,” Kronengold told CBS News in an email. Kronengold explained that “eating disorders thrive in isolation” and that the isolation imposed by working from home, social distancing measures and interrupting the routine “can put extreme pressure on people suffering from eating disorders”.
Many individuals working from home have lost their structure to their day that has helped them establish better food patterns, Bulik said.
“Time has lost its meaning in the pandemic and everything is so amorphous, so it is much harder to overlap the recovery structure on an amorphous life,” said Bulik.
Increased isolation also leaves more time to check social media, which can be extremely triggering for people with eating disorders. Meredith, who lives in Washington, DC and works in marketing, told CBS News that she was overwhelmed by ads for job applications.
“January and February are particularly difficult months to be caught at home because every social media user is inundated with fitness and diet ads,” she said. Meredith, who is in her twenties, explained that the “boredom” of the pandemic era “leaves more time for pointless running on Instagram and TikTok”, which crawls with influencers with certain body types.
Marita Cooper, a postdoctoral fellow at Johns Hopkins University School of Medicine, said social media can be a serious trigger for people with eating disorders, especially given the prevalence of weight gain memes in the pandemic era. Cooper was the lead author of a July study that found that “the potential impact of the pandemic on people with ED is staggering and requires concerted intervention efforts.”
“The discussion about COVID’s weight gain has been really problematic,” Cooper said, referring to the so-called “COVID 15” or “quarantine 15,” a play on the often mocking phrase “freshman 15,” which refers to to 15 kilograms of college freshmen dressed.
Food insecurity levels also rose in the US during the pandemic, as millions of people lost their sources of income, which can be triggering for individuals prone to exhaustion and purification. Bulik noted that most of the cheapest foods available are also unhealthy, which can lead to a higher risk of bingeing or feeling guilty about what you eat.
“This ends up being a horrible cycle of perpetuation,” said Bulik, in which people continually eat unhealthy foods and then react in unadaptive ways.
At the beginning of the pandemic, in particular, many Americans began to accumulate food, believing that they would be in quarantine for a few weeks or months. This has been problematic for people who relied on the consumption of certain foods as a way to manage their eating disorders and now had more difficulty accessing these foods.
“Many people with eating disorders feel safe with a certain range of foods and have these foods in their meal plan,” Cooper said. “When there is little access to these types of foods, this can be really triggering.”
Food storage can also create an unsafe environment for people with bulimia or eating disorders, who are now trapped in a place where the temptation to overeat is pervasive. People who are food-insecure may frequently go overweight because they don’t know when they will be able to eat their next meal, said Erin Parks, clinical psychologist, researcher and co-founder and chief clinical officer for Equip, a virtual eating disorder program.
“They become a kind of survival behavior if you’re food insecure,” Parks said.
However, the news is not entirely bleak for people struggling with eating disorders. The study in collaboration with Bulik found that a positive consequence of the pandemic was “the perceived increase in social support that contributed to the challenge of their eating disorders and increased motivation to recover.”
Thy Vo, a 29-year-old journalist living in Colorado, said his messy eating habits are “much better” in light of the pandemic. She struggled with excessive behavior and especially purging for seven years.
At the beginning of the pandemic, she struggled to eat in front of her boyfriend because she couldn’t hide her behaviors when they were both stuck at home all the time. Although she initially strained her relationship, the forced conditions of the pandemic eventually helped her, including participating in an online group for people with eating disorders.
“Finally, being home all the time helped me normalize my eating habits, which helped significantly decrease all of my ED thoughts,” Thy Vo said. “Being forced to sit down and eat three times a day with my friend was excruciating, but in the end it helped.”
The increased time at home has also helped some adolescents with eating disorders, who have been able to receive support from their families and be held accountable. It is more difficult for young people to slip into messy eating habits when they are constantly surrounded by family members.
Parks said children and adolescents are “more likely to recover” if they have adults in their lives who support them. She added that the increased dependence on telehealth facilitated the access of family members to several counseling sessions per week, instead of physically traveling to various meetings.
“The benefit of telehealth is that everyone can come,” Parks said, encouraging people to “truly bring their entire village” to address an eating disorder. Equip offers virtual family-based treatment, which uses what Parks described as “the radical idea that families are best equipped to help their loved one recover from an eating disorder.”
However, even with the increased use of telehealth and the potential for family support, there is likely to be long-term damage due to the pandemic for people with eating disorders. Bulik said he is looking forward to a one-year follow-up study on how respondents face the pandemic months and see if people still report a stronger recovery decision or closer ties with families. their.
“I think the pandemic fatigue could erode these positives,” Bulik said.
People can recover from eating disorders with support and treatment. But the road to recovery for many has been derailed by the pandemic and it may be difficult to get back on track.
“There is this assumption that ED could disappear after life returns to normal,” Cooper said. “But this is not something that will magically disappear.”
Resources:
National Eating Disorders Association
If you or someone you know is experiencing body image or eating problems, the free and confidential NEDA hotline is available by phone or text at 1-800-931-2237 or via a click-to-chat message at nationaleatingdisorders .org / helpline. For 24/7 crisis assistance, send the text “NEDA” to 741-741.
NEDA has also developed a list of free or low-cost COVID-19 resources: https://www.nationaleatingdisorders.org/help-support/covid-19-resources-page.
National Institute of Mental Health
FEAST
FEAST is a non-profit organization that provides free assistance to caregivers with loved ones suffering from eating disorders.