Yes and no. The National Eating Disorders Association reported that in 2020 they had a 70 percent increase in those reaching out to their helplines compared to 2019. Likewise, I have had a 24% increase in the number of actual new patients with eating disorders seeking treatment over the past 3 months, beginning in April of 2020. I have also been hearing from colleagues that they are seeing a similar rise in inquiries regarding treatment for eating disorders. Almost to a person, these new patients attribute the resurrection of an old eating disorder, or the onset of a new one, to the isolation and anxiety triggered by COVID-19. So there is definitely a connection.
It makes sense. Eating disorders, in my humble opinion, are anxiety disorders with a focus; controlling/losing weight. I cannot remember a time in my life when there has been more reason to be anxious as an American. Unemployment has never been higher, businesses are closing for good, the vaccine role-out has not been a smooth one thus far and there is a new version of the virus on the horizon. Then there are the realities of social distancing and the resulting feelings of isolation and lost opportunities academically and occupationally. It is no wonder we are reacting to the anxiety with compensatory measures that seem extreme.
But no, technically, COVID-19 isn’t “causing” eating disorders. It is causing anxiety and anxiety and eating disorders go hand in hand.
The fact that eating disorders are on the rise is not the only sign that we are in crisis as a nation. Currently according to the Centers for Disease Control, there has been a significant increase in mental health conditions for adults in the United States in 2020 when compared to the same period of time in 2019. Specifically, anxiety disorder was approximately three times higher (25.5% versus 8.1%), in 2020 than in 2019 and depressive disorder was approximately four times that reported in the 2019 (24.3% versus 6.5%.) 
You do not have to be a statistician to know that those are big differences.
The relationship between eating and the extreme stressors at issue today might best be described as the worst of both worlds when it comes to the laws of scarcity and abundance. In terms of scarcity, we have empty shelves in grocery stores triggering food insecurity and hoarding impulses. Even individuals who have enough food are not doing well, especially if they have issues about overeating. In other words the law of abundance isn’t helping either. Indeed, it seems to be working against many of us as we are faced with cupboards full of foods that lend themselves to bingeing. Talk about a double whammy, empty shelves but loaded cupboards. It may feel to some as if there is no safe place or space.
There are other dynamics at play here as well. For one thing, the relationships that people have with food are largely determined by those with whom they live. Most, if not all, of those relationships have changed. For college students with issues about food who were forced to return home and for adults forced to work from home, what their parents, husbands, children or roommates regard as “good” foods for sheltering in place, may also be “fear” foods for them. This is especially true, both for those who may have recovered from a previous eating disorder, or for those who are now more at risk for having an eating disorder.
For example, the ideal “sheltering in place foods” may include frozen foods, like ice cream or frozen dinners or shelf-stable foods like pasta, rice, crackers, cookies, chips, nut butters, and nuts. While not “bad” foods on their face, they can definitely turn into “binge bait.” Generally, they tend to be more calorie dense and because they are more processed, they are more likely to have ingredients designed to make you want to keep eating.
Parents find themselves eating the foods that they have to prepare for their children who are now at home every day, all day, as they have lost their childcare. Many of the foods their children eat are not foods that they would normally eat at all. Same with roommates stuck in a dorm room all day with other roommates who are snacking constantly, or college students living at home where there is suddenly an abundance of food and drink. It is much easier to resist eating something if it isn’t there and much harder when it’s in your face. In general, there seems to be overwhelming agreement that there is way too much eating going on as a way of warding off anxiety.
It’s easy to see how that could lead to binge eating or bulimia, which involves bingeing as well as purging,  but how does too much food lead to Anorexia? The Anorexic has one job; avoid eating food. The more of it there is around, the more anxious she may become and the more work she has to do. Indeed, restricting makes perfect sense to the individual who is overwhelmed with anxiety. One writer suffering from Anorexia described her need to restrict as a “stress management technique”  in the sense that restricting gives her a false sense of purpose and of being in control.
Likewise, many individuals suffering from Anorexia feel pride of accomplishment when they restrict, especially if it results in weight loss. With everybody overeating out of boredom or in an attempt to manage anxiety, the individual who doesn’t stands out in a way that may elicit praise. Living in the most obese country in the world (that would be the U.S.) and losing weight, especially if those around you are all gaining weight, often gets rewarded with compliments and attention. Bottom line, if restricting and weight loss get reinforced… in part because the general population is doing more eating as a coping mechanism for COVID, we have yet another factor increasing the likelihood that an eating disorder develops.
What to Do?
First and foremost, seek help. If you have any of the symptoms listed below reach out to a health care provider who specializes in the treatment of eating disorders immediately. Try to avoid residential treatment, as you spend a lot of money, a lot of time outside of your real life and you get very little hands on treatment from a trained professional. Instead, look for practitioners with lots of experience who offer intensive outpatient therapy and very flexible schedules.
The quick fix offered by so many residential treatment centers doesn’t seem to have much staying power and graduates often end up back in treatment, sometimes multiple times. An interesting but alarming fact is that the more often you return for residential treatment, the more likely you are to die from Anorexia, which has a higher death rate than any other emotional disorder.
Next, be patient. The average length of treatment can be years for serious eating disorders, so give yourself or your loved one space to recover without pressure.
Finally, do whatever you can do to stay connected to those you love and/or get connected to individuals who can offer support.
- CDC – Centers For Disease Control, Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic, August 14, 2020
- Purging can be by vomiting, abuse of laxatives, abuse of insulin or over-exercising
- NBC News, This is what it’s like coping with an eating disorder during COVID-19, Natalie Johnson, October 9, 2020
Dr. Renae Norton specializes in the treatment of eating disorders. Located in Cincinnati, Ohio. Call 513-205-6543 to schedule an appointment or fill out our online contact form for someone to call you to discuss your concerns. Tele-therapy sessions available. Individual and family sessions also available.
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Materials contained on this site are made available solely for educational purposes and as part of an effort to raise general awareness of the psychological treatments available to individuals with health issues. These materials are not intended to be, and are not a substitute for, direct professional medical or psychological care based on your individual condition and circumstances. Dr. J. Renae Norton does not diagnose or treat medical conditions. While this site may contain descriptions of pharmacological, psychiatric and psychological treatments, such descriptions and any related materials should not be used to diagnose or treat a mental health problem without consulting a qualified mental health care provider. You are advised to consult your medical health provider about your personal questions or concerns.