The COVID-19 pandemic has taken a toll on our collective mental health. We’ve had to navigate unprecedented grief and stress, often while separated from friends and family and worrying about staying physically healthy.
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“If you had a predisposition for depression, anxiety or an eating disorder, what we saw over the past year is that the pandemic really increased the number of people who are struggling with mental health issues,” says psychologist Susan Albers, PsyD. “It may also explain why we may have seen an increase in the number of people who were calling help centers about eating disorders.”
Calls to the National Eating Disorders Association (NEDA) Helpline increased 40% in the pandemic’s first year. In an August 2020 International Journal of Eating Disorders survey of people with anorexia who had been discharged from inpatient treatment in 2019, about 70% credited the pandemic for increasing “eating, shape and weight concerns, drive for physical activity, loneliness, sadness, and inner restlessness.”
Recommendations such as social distancing helped protect us from COVID-19. However, it was emotionally taxing being separated from friends and family. “During the pandemic, there were higher levels of depression, anxiety and stress, and a real appreciation that periods of isolation and disconnection are tough on mental health,” says Dr. Albers.
Isolation provides the right environment for eating disorders to thrive, she adds: “When you are alone you can eat — or not eat — in any way that you choose. We’ve experienced some extreme levels of isolation with the pandemic.”
In non-pandemic times, isolation can also be an eating disorder warning sign. “If you find that a friend or family member is canceling dinner reservations or not eating meals with family, these are significant signs they are struggling with their eating,” Dr. Albers says.
Disordered eating habits are easier to spot during in-person interactions. “When you are going out to dinner with people, eating with others, eating with family members, they notice what you’re eating or not eating,” says Dr. Albers. It’s also easier to compare what (and how much) you’re eating with others at communal meals.
Being separated from loved ones — and, by extension, a strong support system — can also hide eating disorder relapses.
“If you had an eating disorder in the past, you might have had support from family members,” says Dr. Albers. “However, you may not have seen them for long periods of time because of the pandemic. They may not have recognized changes in your weight or eating habits.”
Dr. Albers adds that changes to habits and routines may have also been a factor.
“People lost their jobs, or had such changes that they financially may have had changes to the foods they could buy and/or access to healthcare,” she says. “During the pandemic, it was hard for people to get in touch with a therapist or reconnect with their therapist. This may be another reason for the rise in numbers as the pandemic progressed.”
Eating disorders arise from “how people think, feel and relate to food in their lives,” says Dr. Albers. “Eating disorders are a psychological condition in which people have an unhealthy preoccupation with eating habits, their body image and food.”
In the United States alone, 9% of the population will have an eating disorder in their lifetime. You can’t tell if someone has an eating disorder by their appearance or weight, and anyone can develop an eating disorder at any age.
Common eating disorders include:
Eating disorders aren’t caused by just one factor or trigger.
“When we look at someone’s genetics, we can see different family members who have struggled with eating disorders,” Dr. Albers says. “However, there’s also a social/psychological component.” If you have self-esteem issues or are a perfectionist, this can make you more predisposed.
Your friend group — or teammates — might also have an impact. “If you have friends who struggle with eating or are talking a lot about dieting, if you are immersed in a diet culture, or a community that, like athletes, feels pressure around the body and body image, this may also be a trigger.”
Dr. Albers adds that body trauma and “any kind of significant stress” can also be factors that set off eating disorders. That’s one reason why the pandemic may have triggered an increase.
“For most of the population, the pandemic has been a very stressful event,” she says. “It has caused a lot of collective trauma. We know that something is going on when people experience stress — and intense amounts of stress.”
It’s understandable anyone with eating struggles might feel anxious easing back into the world after spending months inside. However, Dr. Albers suggests using this time as an opportunity to reevaluate your life.
“Take a moment to pause and think about who you’re around, what impact the pandemic had on you and your eating habits — and what you want going forward,” she says.
This might mean taking a look at your social circle and making some hard choices about with whom you spend time. “Is it friends or family members — and do they help or hinder your eating behaviors?” Dr. Albers says. “If you are in a group of people who talk a lot about dieting or body image issues, that can be a significant trigger. If you are with friends and family members who are accepting and supportive, this can be very helpful.”
And if you are feeling like you could use some extra support, Dr. Albers says therapy (or, if necessary, treatment) is always an option — and you wouldn’t be alone. “I’ve noticed a lot of people reaching out to get significant help and support,” she says. “If there’s one silver lining we can take from the pandemic, it’s prioritizing the importance of mental health.”