Advice On Combatting Disordered Eating During Quarantine

During a pandemic, when resources are limited and the healthcare system is taxed, cognitive biases about weight will cost lives.

I could no longer enjoy the food I tried to eat — but that seemed like the least of my worries. I was being treated for COVID-19.

A sputtering cough became gasping hacks that produced thick, yellow mucus. I often ran out of breath while trying to chew small forkfuls, periodically spitting out little bits of food or scooting boluses into my cheek so that I could pause to take in enough air to continue. I started skipping dinner with my kids to avoid mealtime anxiety.

I didn’t expect COVID-19 to impact my ability to eat. It triggered obsessive thoughts about my body and compulsive behaviors — like meal avoidance which shifted to purging and restricting certain types of food as I recovered.

She explains that illnesses are common triggers for eating disorders. Shifts in appetite, weight fluctuations, and other symptoms (like my difficulties eating, loss of taste, and extreme fatigue) can trigger those who are already concerned about food, movement, or weight. These experiences can even be the cause of disordered thoughts and behavior someone didn’t have before.

A potent, low-dose corticosteroid was prescribed to decrease the inflammation in my lungs — but when I ran out of meds, my respiratory symptoms got worse. The quiet rumble in my chest progressed again to a noisy crackle, and my breaths became shallow and weak. Telemedicine connected me to a new doctor who denied my request to continue using the steroids I needed for just one reason: they could make me gain weight.

Unfortunately, it is not something all providers understand — and they’ll continue to harbor cultural ideals about thinness while they analyze the severity and urgency of symptoms and discern treatment options.

Experiences of trauma and adversity are also linked with disordered eating or exercising. So are pre-existing mental health concerns. Those already living with anxiety, depression, OCD, or other struggles are especially challenged right now as the world reels in an increasingly chaotic state. The lack of normalcy in and of itself could lead some to spiral — and many are additionally grieving jobs, hobbies, and loved ones or living in fear during this crisis.

Dr. Reichmann explains that even slight changes in schedules cause difficult adjustment periods which shift meal times — making it easier to skip eating or cause us to feel unmotivated to consume food altogether. It also leaves more time for compulsive exercise. Food scarcity and economic insecurity create additional barriers for accessing foods that people feel safe and comfortable eating. For some, it means difficulty finding any food at all. She reminds us,

A s a writer, social media helps me find and share stories, but it’s also a place where other writers talk about the projects they’re working on and friends oblivious to diet culture promote problematic views. I consistently see requests for interviews from those who wanted to share tips to avoid gaining weight during their time at home, and I’ve even been invited to a weight loss group boasting free portion-control containers for new members.

Reichmann warns against using weight as a goal.

Memes that promote diet culture and increased access to online workouts have caused some people to set fitness goals by participating in social media challenges.

In contrast, some people feel worried that they’re sitting, eating, or sleeping too much. Reichmann is especially concerned for those who feel isolated right now.

They’re just not healthy ones.

Better coping mechanisms include art, music, breathing exercises, reading, seeking out a positive community, and even watching a few shows on Netflix.

Chatter on social media can be problematic — but it’s also a source of connection and strength. I’ve been careful lately about what groups or organizations I’m interacting with and intentionally checking in with specific individuals rather than mindlessly scrolling through my feeds.

Dr. Reichmann is currently working on a book about steps to take when recovering from an eating disorder using a more radical approach. Her perspective includes embracing fat positivity while in recovery — but she suggests that all people need to be reminded of its toxicity.

These principles include eating in ways that promote pleasure, finding joy in our bodies, and celebrating diversity. Eating disorder recovery groups can include many thousands of participants on Facebook, Reddit, and other platforms — and they have been crucial to me in times of crisis. These peer-led spaces aren’t for “thin-spiration” or content that promotes unhealthy habits.

They serve to create gathering points for people who want to share about their experiences and come together in mutual understanding and support. When I was first starting to recognize that my disordered tendencies were back, members reminded me that I am a person of value, that the food allotted to me isn’t a waste even if I can’t finish it all.

I’m now more consistently present with my family during meals, and I never regret showing up to the table.

This could be helpful for those who need a community with structure.

Eating and exercise disorders are rarely only concerned with food or weight and one common theory is that people who struggle with these behaviors seek a sense of control. I suspect that the cause of my relapse is at least in part a loss of control throughout my illness and my inability to do much about the condition of the world during this crisis.

We’re living in a time of waiting, pause, and confusion. Those realities often lead me to focus on what I can manage as a coping skill. Redirecting my anxious energy to a more minute aspect of my life helps me combat the stress of chaos and uncertainty. I’ve realized that I need to guide my energy away from more compulsive thoughts and behavior to healthier outlets — like organizing my home or focusing on a creative project.

It often takes a lot of awareness to recognize when we’re struggling with these issues. Reichmann explains:

1. “Rally your troops. Make sure you are reaching out to those you trust. Isolation is different from social distancing; it can be poisonous to the mind. Be wary of going days without talking to people.” This doesn’t need to go further than texting or calling those you want to connect with. If you don’t have anyone, utilize social media to find your people.

2. Get support when you need it. Ask a partner, friend, or roommate to sit with you during or after meals, prepare foods for you, or help you establish a schedule to ensure you’re eating and exercising more appropriately. If you aren’t sure what kind of support you need, just letting someone you trust know that you’re struggling might be enough to relieve some of the pressure you feel and reassure you that you aren’t in this alone.

3. Write it down! Schedules and other ideas you have to maintain a routine can be written down so that you have reminders, but Reichmann recommends journaling too. You could write about what motivates you to stay in recovery if you fear relapse, opt for prompts that are specific to your issues with disordered eating or exercise, choose affirmations to pick you up out of a dark place, or just vent.

More formal resources — like the structured care of online support groups or books, podcasts, and other materials on the subject are just a few clicks away. If you want to speak to a professional, you could seek online counseling as a new client with a variety of clinicians who have moved their practices to virtual care for now.

Reichmann reminds us, “Keep your appointments with therapists (even if you feel that virtual therapy is not optimal).” For those in crisis, inpatient treatment is still an option.

She urges, “Be kind to yourself. Now is not the time for guilt about what or how much you are eating or engaging in movement. Remember that you are allowed to rest right now. You are allowed to have all the feelings. And keep reminding yourself of the fact that this is temporary.”

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