Eating Disorder support During COVID-19
By Alexandra Iula, MS, NCC, LPC, Philadelphia Eating Disorder Therapist
“What if the grocery store doesn’t have the food I need?”
“How am I supposed to buy enough food for two weeks?”
“Am I hungry or just bored?”
“I can’t order out again I’ve eaten out 4 times this week!” “
“I am going to use this time to finally do that work out plan I have been trying to do for the past year- everyone else is ”
“I haven’t done anything all day how am I hungry again?! I am definitely going to gain the quarantine 15.”
I have been hearing these self-judgments and comparisons from many of my clients (and all over social media) during these past few weeks as we are adjusting to our “new normal” in the COVID-19 quarantine in Philadelphia.
With routine being thrown out the window and heightened levels of anxiety around a pandemic that feels completely out of our control, many people are turning to their go-to coping mechanisms to manage this stressful time.
Therefore, people with a history of disordered eating may be tempted to fall back into old behaviors to find a sense of comfort and control. While our world is taking extra precaution to focus on the health of our communities, there seems to be endless talk about food and physical fitness while social distancing. There is constant discussion amongst family, friends, and media providers around restaurants being closed and who is offering take out options, grocery stores struggling to keep food in stock, the push to buy self-stable products in bulk, and what gyms are offering at-home workouts.
For those with history of disordered eating these constant conversations are putting their recovery to the test- leading to shame if they fall back into old behaviors.
Yet feeling tempted to fall into old behaviors is a normal response to the uncertainty of our world right now. And while the world is experiencing fear and anxiety around the virus and the many repercussion this may have on our social and economic health, those with eating disorders may feel increasingly alone in their anxiety about their eating disorder voices getting louder. The anxiety of having endless quantities of unstructured time can lead to an increase in open headspace for disordered thoughts, behaviors, and obsessions to seep back in.
If you or your loved one has a history of disordered eating, here is why this time may be particularly difficult.
Change in Routine and Environment
The lack of face to face social connection during this time is impactful for everyone, yet for someone with a history of an eating disorder social connection may be the one thing that is keeping them working towards recovery.
Eating disorders thrive in isolation, so in a world that is practicing social distancing those eating disorder thoughts may be popping back up due to this unique opportunity for secrecy.
If you live alone or have roommates or family members who are working on the front lines during this time, your eating disorder may be rejoicing over the fact that there are fewer people to hold you accountable for your meals. This means meals can slip by without someone “watching you” eat a meal or “catch” you bingeing or purging.
In other environments, where family or roommates are now home, some may feel more scared of being “caught” in the eating disorder behaviors you have so greatly hidden while everyone was busy going to work, school, and engaging in normal daily activities. Anxiety may be heightened because you know that telling loved ones “I already ate” won’t cut it during quarantine, when everyone in the house is much more clued in to each person’s daily activities. This new environment can be scary because it may force those with an eating disorder to approach anxiety-provoking activities they have been avoiding, such as meals with family or roommates, cooking, and ordering take-out from local restaurants.
Food Scarcity
For a person with an eating disorder going to the grocery store on a normal day can be very anxiety provoking. Yet having to go when there is constant chatter of food stockpiles and shortages brings up a whole new level of anxiety. With public health professionals encouraging people to buy in bulk the idea of having “extra” food in the house may be a trigger for someone with a history of an eating disorder to binge or restrict their intake. The need to rely on self-staple products may force someone to buy food they deem as “unhealthy” in order to survive. Some may not be able to get hold of "safe foods” due to scarcity of resources and may lead to increased guilt over buying and eating food that is outside of their comfort zone.
Fatphobic Memes and Fitness Challenges
Anyone who has an Instagram or Twitter account has probably seen some variation of “The Quarantine 15 is the New Freshman 15” meme on your timeline. While humor can be a helpful coping strategy, the constant talk of weight gain during his time may lead to increased anxieties for who suffer with eating disorders. These memes around weight gain communicate to the public that weight gain is bad and leads to an increase in fat shaming. These memes are supporting a culture of “fatphobia” and weight stigma, which sends a dangerous message that one body size is better than another. With constant media posts about at home workouts and “healthy” cookie recipes, it’s hard for those with an eating disorder to stay positive, or even neutral, about body image. Those in recovery may feel particularly anxious about the change in their fitness routine- fear of how their body will change in not being able to go to the gym for an unknown period of time. This may lead to increased obsession with physical activity- taking multiple socially distant walks a day or doing 2-3 home workouts daily- while others may completely restrict their intake for t belief that they don’t need as much food because they are not able to burn it off at the gym.
How to Help Yourself and Your Loved Ones
The most important thing to remember during this time is you are not alone. Regardless of where you are in your eating disorder treatment or recovery- if you are suffering with an eating disorder right now, your struggle and recovery still matter.
During this time it important to validate your emotional experience, whether it be fear, sadness, anxiety, or grief. All emotions during this time are valid and deserve to be felt. Here are some things you can remind yourself of and do when the emotions become overwhelming and the eating disorder voice gets louder:
Be compassionate with yourself.
It is normal for eating disorder thoughts to come back during stressful times. Give compassion to yourself if you slip back into old behaviors and remind yourself that you are doing the best you can. We are in a global pandemic its okay if you fall into restricting, binging, or purging and remind yourself just because you fall back doesn’t mean your recovery is ruined. This is when it is important to look out for “all or nothing” thinking patterns.
Trust your body during this time.
Know that human bodies are extremely resilient. Just because your meals look different than they normally do doesn’t mean that your body won’t know how to use the nutrients you provide it with. Your body will adapt to going to the gym or your not having your walk to work each day.
Unfollow unhelpful social media influences.
Use this time to unfollow any accounts promoting weight loss, preaching intense home workouts, or promoting “fatphobic” content. This content may lead to unnecessary comparison and harsh self-criticism that trigger eating disorder behaviors and negative body image. Remind yourself that your body is not the problem- our fatphobic culture is. If you’re looking for helpful recovery account to follow, find our instagram @spilovepsychotherapy and you will find many other pro-recovery accounts in our followers/followings and listed in our posts!
Utilize your support system.
Let you family and friends know if you are struggling. Social connection is needed now more than ever so if you quarantined at home alone connect with loved ones via technology. Be vulnerable and ask your supports to FaceTime during meals or snacks to help hold you accountable. Schedule a telehealth session with your therapist. Join one of Spilove Psychotherapy’s Virtual Groups- our Body Image Group is starting Monday April 13th. Whatever you can do to stay connected in your recovery during this time- do it!
Remember the long term consequences.
Lastly remind yourself that while these eating disorder behaviors may allow you to numb out your emotions in the short term, these behaviors have negative long term consequences on your physical and emotional well-being. Engaging in these behaviors will only reinforce that you need to engage in your eating disorder to feel in control, when in fact the only things you can control during this time is washing your hands and staying away from social gatherings.
Remember, there is no “normal” way to respond right now- none of us have been here before- so be gentle with yourself, you are doing the best you can.
Alexandra Iula, NCC, LPC
Philadelphia Eating Disorder Specialist
Alexandra Iula, NCC, LPC received her Masters of Science in Clinical Mental Health Counseling from Johns Hopkins University School of Education in May 2017. She moved back home to the city of Philadelphia after graduation to start her career as a therapist. She worked for three years as a Senior Therapist an outpatient partial hospitalization and intensive outpatient treatment center specializing in treating women, from age 12 and up, suffering with eating disorders and their co-morbid diagnoses such as depression, anxiety, PTSD, borderline personality disorder, and substance abuse. She is currently a National Certified Counselor from the National Board of Certified Counselors and I received my LPC in 2019 after accumulating two years post graduate school in the clinical field. She has extensive clinical training and experience in treating the whole person when approaching an eating disorder. She specializes in treating adolescents and adults struggling with disordered eating and body image issues, low self-esteem, trauma, depression, and anxiety. It is her hope that by being a non-judgmental professional she can create a safe and nurturing space that allows each client to work towards to developing confidence and acceptance in one’s relationship with food, their bodies, and their emotions.