Eating Disorder Recovery in the Era of COVID-19

February 25, 2021

Eating disorders, regardless of the specific diagnosis, have always come in different packages, shapes, sizes, experiences, and with their own unique challenges. But they’ve always had the same underlying constructs: disturbances in, and preoccupation with, eating and weight control behaviors, poor body image, and the resulting negative emotions stemming from these. Current statistics estimate that around 9% of the United States population- around 30 million people- will suffer from an eating disorder at some point in their lives. Of those, nearly 70% won’t seek treatment. But why?

Research points to a number of factors underlying disordered eating which includes genetic makeup, trauma, co-morbid mental health disorders, and personality characteristics- just to scratch the surface. Further, we live in a world saturated with social media, diet culture, and expectations of a certain ideal of perfection that doesn’t always fit into the realities of everyday life. 

The idea of dieting, particularly fad diets and quick fixes, has become so ingrained in our society that we don’t always recognize it as unhealthy or maladaptive. A study from 2015 found that 80% of 10-year-old girls have been on a diet. If we don’t recognize something as a problem because it is so normalized by our surroundings, it is hard to ask for help! Further, there is a significant stigma around eating and weight behaviors that has always impacted help-seeking.

Cue 2020 and the COVID-19 pandemic

2020 actually saw a dramatic uptick in people seeking treatment for disordered eating, likely in part due to the increased awareness on mental health stemming from collective trauma around the pandemic. There has also been a significant exacerbation of symptoms for those already suffering from an eating disorder. 

Remember the expectation at the start of the pandemic, where the social media message was that if you don’t learn a new skill by the end of quarantine, you’ve done something wrong? The reality for most people was that isolation, lack of structure, and limited access to support (of all kinds), on top of very real financial stressors, dramatically impacted overall well-being and mental health suffered as a result. Disordered eating was no different, and, in fact, the number of lapses, relapses, and overall struggles with these disorders increased. That being said, the increase in help-seeking reflects a silver-lining within the pandemic. After all, what better time than now to start or continue on your recovery journey? 

Tips for Recovery

The following tips are some lessons and take-aways for eating disorder recovery in general, but specifically focused on recovery during a pandemic.

1.Create Structure: Some eating disorders thrive on rigid structure, while others thrive in chaos. Working towards balance is so important to recovery: have some general time frames for meals, try to set specific work or school hours where possible, and outlining a general routine can be helpful.

2. A Lapse is Not a Relapse: It is alright to be struggling during this period, or generally in recovery. But it’s important to hold space for the fact that a bad moment does not make a bad day, or a bad month. A lapse can be just a lapse, and doesn’t mean you are failing at recovery.

3. Get off the Hamster Wheel: By this, I mean the rigid dieting. The reason that eating disorders become engrained, and also the reason why healthy dieting often fails, is because they can be a vicious cycle. Think of it this way: 

restriction->small lapse or overeating-> binge -> shame -> restriction 

The goal here is to make a change to any of these pieces, and thus break the cycle itself. The human body is not meant to live in a state of restriction, and will always seek homeostasis and nutritional balance, which is setting you up to fail any time you restrict or under eat. Getting off the wheel means approaching eating, meals, and exercise, with balance.

4. Find a Why: Having a goal, a motivator, or something you are working towards is integral to recovery. You don’t have to want it every second of every day, but you do have to choose recovery and make steps towards it even in moments where it is hard.

5. Lean In Hard With Coping Skills: For many people, the eating disorder represents either the ultimate form of control, or a way to cope with stress. The reality is that disordered eating represents a lack of control, and is also a maladaptive coping strategy that typically ends up worsening mood and functioning rather than helping. The alternative to leaning on the eating disorder is finding something else to use as a coping strategy and working to replace these behaviors with something healthier.

6. Use Your Support System: This means people around you, but also your treatment team. You are worthy of support and help!

7. Be Mindful with Social Media: There are so many unhealthy messages, fad diets, quick solutions, and false advertising on social media. If you are going to spend your time there, be a careful consumer. Monitor and be mindful of who you are following and allowing into your headspace. Remember that a lot of social media is altered, edited, and isn’t always someone’s reality.

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