The COVID-19 pandemic could worsen eating disorders, study finds. A local expert provides these tools to cope

Rebekah Freese, director of St. Louis Behavioral Medicine Institute's eating disorders program, says she has seen an increase in calls from worried patients.

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Navigating the COVID-19 pandemic has been difficult for everyone, but this year might have further affected people who were already battling issues like eating disorders. A recent study surveyed about 1,000 people in the United States and the Netherlands with self-reported eating disorders to better understand COVID-19's impact. With disrupted routines, isolation, more time spent on social media, and the added stress, those struggling with an eating disorder might resort back to bad habits to cope. 

“We’ve seen an increase in calls, which might [reflect] people having to stay at home more,” says Rebekah Freese, director of the Eating Disorders Program at St. Louis Behavioral Medicine Institute. Here, she explains what additional challenges those battling an eating disorder face during this—and what tools they can use to cope. 

Psychological Comorbidity. People who have eating disorders often experience other issues, such as anxiety. Understandably, the uncertainty of the pandemic can trigger this anxiety.  “This fear can, in turn, trigger their eating disorder, in order to feel in control over their health and environment,” explains Freese. This is why it's imperative to reach out to or keep in touch with a mental health provider or to find one if you believe you need help. Also, she urges people to discuss their triggers to their treatment team which may include therapists, registered dietitians, physicians, and/or psychiatrists. 

Food Intake. Sheltering in place means it’s harder to access food. Consequently, some people may avoid eating or eat very little which may lead to becoming underweight. “This may cause these individuals to be at higher risk for medical complications (which can vary depending on the type of eating disorder) and malnutrition,” Freese says.  

Though, some people could do the opposite: The scarcity of inventory at grocery stores at the start of the stay-at-home order may have led someone with an eating disorder to panic and stockpile food. With so much food at home, they might binge or purge.  

Freese suggests setting up regular routines for meals. Organize what time you will eat, what foods you will have, and “make plans to connect with someone perhaps before and after to check in about urges and/or emotions that may be triggered.”

Limited Exercise. Staying at home may trigger fears of gaining weight for those who battle anorexia, leading them compulsively work out. “Although exercise can be beneficial (alleviating depression and anxiety), there is a fine balance. Anyone who has an eating disorder should work closely with their treatment team to discuss when and how to safely incorporate exercise back into their lives,” Freese cautions. She adds, “Remind yourself you deserve the nutrition regardless of physical activity.”

Isolation. Staying home and having limited interactions with others can take a toll on anyone. People handling an eating disorder should stay as connected with their social support systems as they can during this time. “This is especially important during meals and snacks.  Providers have provided more support virtually for meals and snacks,” Freese says.  

For those struggling to cope during this difficult time, Freese offers this advice:

  • Reduce social media. This is to give you a break from the pandemic information.  
  • Sleep. Freese says that this is helpful for anyone, but especially those with psychological issues.
  • Create a “Coping Ahead” plan. Freese describes this as “a plan that identifies levels of intensity of the urge/emotion and specifically identifies what to do at each rating.” For example, a 0-3 level of intensity might warrant calling a friend, watching a movie, taking a bath, or listening to music. A 3-6 level of intensity might be setting up a plan to meet someone out where you can maintain a safe physical distance or attend a virtual support group.
  • Journaling. Keep a gratitude journal or write about why recovery is important to you. Review your written thoughts regularly, or at least when you are not feeling at your best.

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