The disruption of face-to-face treatment delivery services that comes as a result of COVID-19 will exacerbate the already alarming figure that fewer than 25 percent of people with an eating disorder receive care. Further, the pandemic will likely worsen the mental health of people with an eating disorder, adding further urgency to ensure that appropriate care is received during this time.
If you’re struggling with an eating disorder, then the ability to access accurate tips on how to cope during this pandemic is crucial.
Why Eating Disorders May Worsen
As someone specializing in the treatment of eating disorders, I want to provide some simple and effective self-help strategies to help you through this time. But, first, I want to outline the reasons why eating disorders may worsen during this pandemic.
1. Eating Away Stress
Most of us are currently experiencing more stress than usual. Whether it’s listening to the daily news reports of new infections or frantically trying to your homeschool your children, we’re all facing the pressure. Stress can increase eating disorder behaviors due to biological and psychological factors.
Biologically, stress contributes to increased secretion of the hormone cortisol, and elevated levels of cortisol are linked to an increased appetite and craving for sugary, salty, and fatty foods. This elevated cortisol secretion is, at times, enough to cause bouts of binge eating.
Psychologically, stress isn’t pleasant to experience, and many of us end up turning to food for comfort or as a way to escape this unpleasantness. Though some stress-induced eating may be helpful, the problem arises when people who gorge on comfort foods end up feeling worse than they did to begin with.
2. The Fight to Afford Food
For many, COVID-19 is just as much an economic crisis as it is a health crisis. The COVID-19 pandemic may worsen eating disorder behaviors due to increased economic strain and resulting food insecurity, which refers to limited access to food due to economic hardship.
Evidence shows that , even after statistically controlling for demographic differences, people who reported low food security are more likely to have an eating disorder than people who don’t report low food security. There are a couple of explanations for this.
First, people who lack adequate resources to regularly purchase enough food to meet their nutritional needs undergo periods of food restriction. Such periods of food restriction may increase the risk of binge eating via food cravings or the biological effects of starvation.
Second, those whose families suffer from a limited food supply may experience a sense of shame about their appetite, feel guilty for taking food from their family, and consequently restrict their eating.
3. Social Isolation Equals More Social Media
Social media usage will have increased as a result of this pandemic. On top of stress-induced eating and food insecurity, greater social media usage creates the perfect storm for eating disorders, as the amount of time spent on social media sites is linearly associated with eating disorder severity .
Why does social media increase eating disorder risk?
First, images on social media play a role in how one seeks validation, often finding our worth by the number of “likes” we receive. When the desired number of “likes” isn’t received, there’s an impaired sense of self-worth that is often directed towards physical appearance.
Second, the assumption floating around social media is that if you want to be accepted, then you ought to look a certain way. Women should look thin; men should look muscular. People with eating disorders naturally “buy into” this belief, leaving them feeling ashamed with their body when they realize they don’t meet these unrealistic expectations.
Tips for Dealing with COVID-19
These five simple, yet effective self-strategies can protect you during this time.
1. Maintain Consistency in Your Eating
Establishing a pattern of consistent eating throughout this pandemic is the most important thing you could be doing to address or prevent the onset of eating disorder behaviors.
What I mean by “consistent eating” is eating at least three meals and at least three snacks each day, ensuring that you leave no more than four hours between each eating episode. No skipping meals, no intermittent fasting, and no restricting after dinner.
The reason for eating regularly is to prevent the onset of extreme hunger as well as feelings of physiological and psychological deprivation. And if we’re feeling satiated throughout the day, then we are much less likely to turn to comfort foods when we’re feeling overwhelmed with stress or ashamed with our body.
To execute this, you need to come up with a schedule—a schedule that provides guidance on what times you’re going to eat your planned meals and snacks. Create this schedule and stick it on your fridge so that you know exactly what times to prepare and eat your meals and snacks.
2. Stay Present and Focused
Mindfulness is a way of paying attention that is taught through the practice of meditation or body scans, in which people learn to regulate their attention by focusing nonjudgmentally on stimuli such as thoughts, emotions, and physical sensations.
During mindfulness, we learn to observe these stimuli without evaluating their truth or importance, and without trying to escape, avoid, or change them. And because mindfulness is thought to result in increased self-awareness and an enhanced ability to respond appropriately to negative situations, these exercises are optimally suited to stop any emotional-induced eating disorder behaviors.
So, whenever you experience a sudden shift in mood, an overwhelming sense of stress, or shame about your body, opt for some mindfulness practice—it will bring forth clarity, acceptance, and minimize the likelihood of you acting impulsively on these experiences.
3. Take Up a New Hobby
Now is the perfect time to take up that hobby you’ve always wanted to. Whether it’s learning an instrument, perfecting your cooking skills, or researching your family history, immersing yourself in a new hobby is an excellent strategy for improving your mental wellbeing and eating behaviors.
The reason why taking up a new hobby is so important is because it takes away most of the factors that trigger eating disorder behaviors. More specifically, a new hobby relaxes you, gives you purpose, builds your self-esteem, and ultimately reduces the importance you place on eating, shape, and weight.
Therefore, whenever we encounter an adverse situation, encounter, or event, instead of resorting to food or eating as your coping mechanism, you’ll quickly learn to fall back on your hobby to help you through the difficult experience.
4. Modify Your Social Media Usage
I’m not going to tell you to never go on social media. In times like these, social media is excellent for helping us stay connected to friends, family, and work colleagues. However, we do know that social media usage is associated with an increase in eating disorder symptoms.
There are a couple of easy modifications you can make to your social media usage to help through this time:
- Limit the total amount of time spent on social media per day.
- Unfollow accounts that reinforce unattainable appearance ideals or that don’t make you feel good about yourself.
- Follow accounts that promote feel-good content, like body positivity or cute animals.
5. Limit Excessive Alcohol Consumption
Alcohol and eating disorders don’t mix well. There’s good quality evidence to suggest that excess alcohol consumption increases the risk of eating disorder behaviors. The reason for this is twofold.
Second, alcohol impairs our judgment and inhibits our ability to carefully consider the consequences of our actions. Therefore, when under the influence, you’ll find it extremely difficult to resist the urge to binge on your favorite foods.
So, it’s a good idea to limit your consumption of alcohol—particularly during periods of social distancing—if you’re struggling with an eating disorder.
If you're finding it difficult to control your eating, these 5 proven steps to stop binge eating from my website may help you to get into a better space.
Hart, L. M., Granillo, M. T., Jorm, A. F., & Paxton, S. J. (2011). Unmet need for treatment in the eating disorders: a systematic review of eating disorder specific treatment seeking among community cases. Clinical Psychology Review, 31(5), 727-735.
Hunt, T. K., & Forbush, K. T. (2016). Is “drunkorexia” an eating disorder, substance use disorder, or both?. Eating Behaviors, 22, 40-45
Linardon, J., Fairburn, C. G., Fitzsimmons-Craft, E. E., Wilfley, D. E., & Brennan, L. (2017). The empirical status of the third-wave behaviour therapies for the treatment of eating disorders: A systematic review. Clinical Psychology Review, 58, 125-140.
Lydecker, J. A., & Grilo, C. M. (2019). Food insecurity and bulimia nervosa in the United States. International Journal of Eating Disorders, 52(6), 735-739.
Turner, P. G., & Lefevre, C. E. (2017). Instagram use is linked to increased symptoms of orthorexia nervosa. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 22(2), 277-284.