Eating Disorder Awareness Week 1-7 March 2021
Approximately 1.25 million people in the UK suffer from an eating disorder, and recently BEAT, the eating disorder charity reported that it has seen a 73% increase in the number of people accessing its services since the Covid-19 pandemic began.
A study done in America in July has shown that 62% of people with anorexia nervosa experienced a worsening of their symptoms during the pandemic, and a third with binge eating disorders experienced an increase in the number of episodes. Another study undertaken in June 2020 by mental health professionals in Australia showed that people with a history of eating disorders saw changes in their behaviour in restricting eating, binge eating, purging, and exercise behaviours since the start of the global pandemic.
Eating disorders are often made worse by changes in routine and by extreme life changes – those brought on by a global pandemic. Routines are an important part of recovery from an eating disorder – and the pandemic has disrupted routines completely. Not being able to go to work or school or to meet with friends and family, restrictions on social life and on exercise regimes can all be triggers for a relapse of an existing condition or even for a new eating disorder to develop.
There are a number of factors at play.
Eating disorders thrive in isolation. Often people with an eating disorder can be secretive about their condition and will go out of their way to make sure others do not notice their behaviour of not eating or binge eating and purging. Spending more time at home and in isolation during the pandemic can make it easier for someone to carry on their eating habits without anyone else being aware. It also means that support networks – friends, family and clinical – are no longer readily available in the same way to support recovery from an eating disorder.
An increase in feelings of stress, anxiety and depression can lead people to find comfort in eating and to use it as a coping mechanism. Boredom can also trigger a change in eating habits, especially when working from home with easy access to a fridge full of food and nobody watching or judging. These behaviours alone do not necessarily constitute an eating disorder, but when they become a frequent habit and develop further into disordered eating, then they may be termed as an eating disorder, defined as when dieting or overeating and excessive concern about weight and calories significantly disrupt everyday life.
An increase in a sedentary lifestyle for many can lead to panic over gaining weight. We have all been encouraged to get out and take our daily exercise during lockdown restrictions and have been told how important this is to both physical and mental health. Some may take this to extremes and regard this as a green light to over-exercise and become obsessed with losing weight.
Limited access to food supplies due to restrictions on getting out to go shopping and scarcity of some foods and empty shelves (at least in the earlier phases of the pandemic) can lead to individuals having a shortage of food in the house or give them a reason to justify a lack of supplies and therefore to eat less. This could lead to not eating at all. For others, there may be a fear that certain foods may be contaminated with Covid-19 and this is used as a reason to eat little or not at all. The pandemic may therefore have reinforced existing eating disorder behaviours by providing a way of rationalising food restriction.
The pandemic has led many of us to use and become more reliant on social media and technology. Whilst these can be useful means of maintaining important contact with others, they come with risks for those who have an eating disorder. Being presented with images of unrealistic body shapes and images, as well as there being a heightened emphasis online on exercising and keeping fit during lockdown, can make feelings of physical inadequacy more pronounced. Even video calls such as Zoom can place extra stresses on those with an eating disorder, causing them to look at themselves more than usual during the workday and during their leisure time, to focus on their appearance and to compare it with that of others.
For some, the pandemic may have had some positive effects on their eating disorder.
The fact that for many families being in lockdown has meant that they are able to eat together more often means that it is easier for family members to keep an eye on someone’s eating habits and challenge them if necessary.
Lockdown has also meant that others in the home may be doing the cooking and the choice of what food is available to eat is regulated.
Fewer social interactions with others – at least face-to-face interactions – has meant that there are fewer opportunities for comparisons reducing anxiety which may trigger unhealthy eating habits.
And finally, being able to wear what one wants at home and to be comfortable has meant that some may feel less critical of and aware of their body shape without having to conform to a particular shape or size and instead being able to relax and to focus less on appearance.
To learn more about Eating Disorder Awareness Week, visit the BEAT website.
The consultant psychiatrists at Private Psychiatry have many years’ experience in diagnosing and treating anorexia nervosa, bulimia and orthorexia nervosa. If you or someone close to you is struggling with an eating disorder, contact us .