Eating Disorders May Be Rising Amid Pandemic

Living through a pandemic has provided a unique challenge for our society. While some fast-paced lives undoubtedly became quieter during the COVID-19 pandemic's peak, the newly added fear, uncertainty, isolation and boredom were just cherries on top of our already overstimulated nervous systems.

Those feelings alone were a recipe for developing an eating disorder, a condition that has become more prevalent in recent years.

Food is closely connected to a wide variety of psychological functions, such as using it for comfort, reward or sociability, according to Fevronia Christodoulidi, Ph.D., a senior lecturer in counseling and psychotherapy at the University of East London.

"Beyond the obvious, which is linked to less mobility and exercise as people were isolated at home, there is a wide range of psychological reasons, such as using food to self-soothe from anxiety and fear," she said.

Other connections include body image struggles that influence restrictive or nonrestrictive eating habits and consuming processed food, often creating an addictive behavior or the deprivation of the required average food intake.

Eating disorders thrive in isolation, and the secrecy and shame attached to suffering can keep people trapped within a cycle pertaining to their respective illness, explained Kerrie Jones, a psychotherapist and the founder of Orri, a specialist day-treatment service for eating disorders in London.

"So many aspects of the lockdown mimicked the isolative, restrictive and chaotic nature of an eating disorder," she said. "You can appear incredibly high-functioning on the outside whilst deeply struggling on the inside."

Causes and symptoms of eating disorders

Obsessing over diet, exercising excessively, restricting food intake or overeating may lead to anorexia, bulimia, binge eating, disordered eating, pica, avoidant/restrictive food intake disorder (ARFID) or other specified feeding or eating disorder (OSFED), Christodoulidi noted.

"With these conditions, there's usually a combination of biological, psychological and cultural-based causes," she said. "Some common patterns we observe across the continuum are perfectionism, unrealistic expectations, distortions around body image, trauma, disrupted attachments in early childhood and associating negative meanings to specific foods."

While symptoms vary for different types of eating disorders, Christodoulidi listed some symptoms to watch for:

• Adopting strict routines and rigid thinking patterns
• Avoiding socializing if food is involved
• Excessive exercise
• Lying about your food consumption or weight
• Mood swings
• Preoccupation with food choices and body shape
• Starving yourself or skipping meals
• Taking laxatives or products that affect bowel function

Potential treatments

According to a Harvard School of Public Health report, 9 percent of the United States population—about 28.8 million people—will experience an eating disorder at some point in their lives. As a direct result of eating disorders, 10,200 Americans die annually. That's one death every 52 minutes, a difficult number to ignore.

Eating disorders are one of the most challenging conditions to treat, Christodoulidi said. Anorexia has the highest mortality rate among mental illnesses, with 1 in 5 deaths resulting from suicide.

Up to 20 percent of all eating disorder cases result in death if people don't receive treatment, according to the Center for Discovery, a national eating disorder treatment center.

"The best way to treat eating disorders is to approach them holistically, including consultations from doctors, dietitians and specialist psychotherapists," Christodoulidi explained. "It is vitally important to understand what a particular person's relationship with food is like, how it has developed and what needs to take place for them to build a more balanced relationship with food."

She added that group therapy can be beneficial as it allows sufferers to be around people going through a similar experience so they know they're not alone.

Can an eating disorder affect relationships?

"For people living with eating disorders, the condition can actively drive people away to limit the opportunity for the eating disorder or food behaviors to be challenged," Jones said.

"This act of distancing oneself from loved ones serves a purpose and can often be linked to the underlying causes which triggered the eating disorder in the first place," she said. "For instance, an eating disorder typically develops after something or someone has taught us that the world is not as safe as we once thought it was."

She added that the word "safety" can represent both physical safety and feeling safe in who we are and within the world around us.

According to Jones, relationships in our early years influence how we engage in intimate relationships as adults.

"If we have experienced consistency and responsiveness from our caregivers, we are likely to grow up feeling secure in relationships, as our very first relationship has taught us that our needs can and will be met by others and that we can be vulnerable without negatively impacting others around us," she explained.

"If we've experienced the opposite, we're likely to feel insecure in relationships and develop creative adaptations such as an eating disorder to cope with insecurity," she noted. "It's a way to numb the overwhelming feelings of challenge and shift hypervigilance into controlling food and body weight, creating a sense of security.

"Authentic relationships require you to relinquish some degree of power; share a degree of vulnerability," Jones added. "And it might be that vulnerability feels intolerable. [Eating disorders are] the antithesis of relationships."

Eating disorder sufferers often carry intense feelings of shame, low self-esteem and fear of any form of intimacy, Christodoulidi said.

"Besides the physiological factors that are present when a person is suffering from an eating disorder, the overall negative self-talk, body dissatisfaction, and difficulty with holding healthy boundaries or emotions appear to have an impact on sexual expression, libido, erectile dysfunction for men and being physically close to anyone at all levels," she explained.