Please contact the National Eating Disorders Association (NEDA) helpline at 800-931-2237 if you believe you or someone you love are struggling with an eating disorder and need help.
For crisis situations, text "NEDA" to 741741 to be connected with a trained volunteer at Crisis Text Line.
To state the obvious: We're all going through it right now, thanks to the global pandemic that is COVID-19. While even the most well-adapted humans are just one bittersweet TV ad away from a full-on breakdown, the effects of the pandemic and quarantine is even more challenging for those recovering from or dealing with eating disorders.
That's because—for many—an eating disorder is a response to cope with anxiety, says Shilagh Mirgain, PhD, a Wisconsin-based psychologist at UW Health, who specializes in anxiety disorders.
"It’s an anxious time for everyone, but when I get anxious, I have the tendency to be like, 'What can I control? Oh, I can control what I’m eating,'" says *Elizabeth, 28, who was first diagnosed with bulimia and exercise addiction at age 20, then again at 27.
Now, six months into recovery and several weeks into quarantine, Elizabeth is facing new challenges: "Just trying to take care of myself has been the biggest struggle because I don’t have outside influences keeping me on track."
Being isolated with limited resources messes with the when, how, and what you eat, says Deborah Glasofer, PhD, an associate professor of Clinical Medical Psychology in Psychiatry at Columbia Center for Eating Disorders.
First there's the issue of meal planning and grocery shopping: For people in recovery, like Elizabeth, that might mean feeling anxious about buying or eating foods they'd normally avoid, like pasta, bread, chips, ice cream, and other shelf-stable foods that enable us to avoid grocery stores for longer. Plus, research suggests that empty store shelves or food insecurity in general are associated with Bulimia Nervosa and Binge Eating Disorder, according to the International Journal of Eating Disorders.
Then there's that whole no-routine, no rules situation. A break from the day-to-day means more pressure to avoid relapsing and less support to do so. "Without outside influences keeping me in check, it’s up to me to make sure I don’t relapse," says Elizabeth.
Combine that with the fat-shaming "COVID 15" memes and productivity inspo on the socials and you've got a recipe for guilt, body-shaming, negative self-talk, and other destructive behaviors.
Quarantine-15 posts, which make weight gain seem inevitable and reinforce stereotypes that those who gain weight are lazy and have no self-control, "may weaken weight-related self-efficacy, or confidence in one’s ability to achieve healthy eating and activity goals," writes the author of a recent paper published in the journal Obesity. And that can trigger a binge and restrict spiral for anyone—and especially those with eating disorders.
If you're struggling to stay on track with your recovery, read the expert advice below on how you can manage and consider reaching out to the National Eating Disorders Association for free and low-cost support.
First, create a support system.
It might seem like the world has completely shut down, but many treatment programs and providers are offering services through teletherapy. Organizations like the National Eating Disorders Association and National Association of Anorexia Nervosa and Associated Disorders (ANAD) provide a variety of online support groups, hotlines, virtual therapy sessions, and more (some are even FREE!).
If you're also looking for a little extra help dealing with uneasiness while you eat, ask friends or family to keep you company during or after meals, says Dr. Glasofer.
And, for those who want the help of a profesh, Heal @ Home, which provides at-home therapy and rehab for eating disorders substance abuse issues, is offering new members a month of free virtual meal support sessions.
Then, develop an eating routine—and follow it.
To minimize the risk of disordered habits, Dr. Glasofer recommends establishing a new eating plan with set meal and snacks times. Once you've decided on the best times to eat, think about the best place to do it, which helps enforce your new normal. Taking those two steps can prevent some of the anxiety and control issues from bubbling up, she adds.
Don't forget to devise a self-care plan.
As Dr. Mirgain said earlier, stress and anxiety can trigger disordered eating and exercise habits. But you can work toward squashing that cycle by jotting down the things that trigger you and coming up with a plan to minimize how often they occur and how you react to them, she says.
Some coping ideas from Dr. Mirgain:
Mindfulness exercises, like a simple breathing practice or a body scan meditation can help you focus on the present.
Avoid the news for a day or two.
Spend some time social distancing outdoors on a hike, walk, or just lying in the grass.
Come up with a positive mantra to repeat to yourself when you're stressed.
Write down three things you did really well that day.
Express your emotions by making something, such as an art project (like Doja Cat’s masterpiece of a naked man, for real), a vision board, a collage, baking something, Tik Tok dancing, gardening, or writing.
Vent to a friend you trust.
Please—seriously—assess your social feeds.
Staying connected right now might seem crucial, but who and what you follow can seriously impact your eating disorder symptoms, warns Dr. Glasofer. For example, if your feeds are filled with content about how to eat, how to stay fit, and how to exercise while in quarantine, that can be especially unhelpful, in terms of an eating disorder, she adds.
Obviously, cutting back on the socials (and screens) in general can make you feel a lot better, says Dr. Glasofer. But if Instagram soothes you, maybe it's worth creating a finsta focused on people and topics that are totally unrelated to eating, exercise, and appearance (or any of the accounts NEDA follows). Or you could just curate your current account by unfollowing hashtags and people who bring up uneasy feels.
And, finally, respond to relapses with self-compassion.
If you fall back into disordered habits, don't beat yourself up, says Dr, Mirgain. "Recognize that this is a real challenge you’re going through and that you’re not alone." Then, do one kind thing for yourself, like taking a bubble bath, going for a walk, or any of the activities listed above, to stabilize your emotions, she adds.
"During COVID-19, we all need a lot of help," says Dr. Mirgain. "But being proactive can help your eating disorder and maybe even your entire well-being."
*Names have been changed to protect the identity of the individual.
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