For many who struggle with an eating disorder, the state officials’ mandate of practicing social distancing can feel like a complete juxtaposition with having access to a kitchen full of food at home (California Department of Public Health, 2020). This can trigger feelings of helplessness, extreme fear, and even rage that can make it extraordinarily difficult to refrain from restricting, binging, and/or purging food by various means.
I have heard many clients with eating disorder treatment discuss how most of their eating disorder behaviors happen during the day when loved ones are at work or school. This may be when someone struggling with Binge Eating Disorder, Bulimia Nervosa, or Anorexia Nervosa skips breakfast, has binge episodes, or spends hours at the gym during the day when their children, spouse, or parents are busy with their own schedules (Diagnostic and Statistical Manual of Mental Disorders 5th ed.; DSM-5;American Psychiatric Association, 2013). Weekends can be exceptionally difficult with a full house of watchful, concerned eyes. Perhaps the one thing that got your loved one with an eating disorder through eating dinner with you was taking refuge in having freedom the next day. The secretive behavior of binging on the way to or from work may be eliminated, for example, now that your husband or wife are not driving to the office due to the Safer at Home order. But are people with eating disorders really feeling “safer” away from the one thing that felt like comfort?
Seeking therapy for an eating disorder often brings feelings of apprehension, anxiety, and shame for individuals. It may be difficult to determine if they need support because it often feels easier to avoid those emotions and cope with them through food.
Here are some warning signs that you or your loved one may benefit from online therapy:
1. An Increase in Secrecy
You may be noticing more distance, arguments, or anxiety between you and your partner or child with an eating disorder. Like many things that we do that evoke shame, eating disorder behaviors are typically done in secret. You may notice that your spouse or child are feeling more irritation in the kitchen, using the restroom more often, or isolating in their bedroom. There may be a strong compulsion to engage in behaviors that are normally done in secret and are currently disrupted now that the family is sheltering at home.
2. A Change in Meal Consumption
Individuals with eating disorders build patterns with food that follow patterns of their work or school schedule and the schedules of others within their households. This means that while they may have typically eaten breakfast or dinner in a normal fashion with you present, they may feel an increase of shame or anxiety for eating those meals knowing that you will also be present at lunch now that you are home. This could lead to an increase of food restriction or binging behaviors that do not follow the typical pattern that correlated with work and school schedules prior to social distancing.
3. An Increase in Anxiety
Grocery stores have proposed special shopping hours for elders, pregnant women, and other individuals with medical conditions or disabilities in efforts to increase physical distancing practices and curb hoarding observed across the globe (California Department of Public Health, 2020; Centers for Disease Control and Prevention [CDC], 2020). Shopping for groceries prior to the pandemic is a common source of fear and trigger for panic attacks for people with eating disorders. Panic attacks are commonly triggered by the anticipation of being in large crowds (DSM-5; American Psychiatric Association, 2013). Increased anxiety around shopping, purchasing food, or experiencing panic attacks may be heightened during this time due to the effects of social distancing. While anxiety disorders are commonly diagnosed as co-occurring with eating disorders, it may look differently in individuals. Although state officials have reassured citizens that there is not a reduced availability in food during this health crisis, the local news continues to report observed hoarding behaviors within various communities (California Department of Public Health, 2020). For some, a perceived scarcity in food may trigger more worry and food restriction. For others, having more food available in the home can serve to heighten anxiety about having urges to binge and/or purge.
If any of these warning sound like something that you or your loved on are currently struggling with, please review the online registry on FindEdHelp.com to find licensed professionals that specialize in treating eating disorders.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Centers for Disease Control and Prevention. (2020) Social distancing, quarantine, and isolation. Retrieved from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html
California Department of Public Health. (2020) State officials announce latest COVID-19 facts (NR20-067). Retrieved from. https://www.cdph.ca.gov/Programs/OPA/Pages/NR20-
Dr. Theresa “Tracy” Ballardo is a licensed psychologist with 8 years of treating eating disorders at all levels of care: inpatient hospitalization, outpatient hospitalization (PHP and IOP), residential treatment, community mental health settings, college settings, and private practice. She is passionate about working with adolescents and college students/young adults and uses creative art interventions in addition to talk therapy to provide a safe, comforting, and age-appropriate means to treat eating disorders, depression, and anxiety. She is currently treating clients residing in California through virtual therapy using a HIPAA-compliant video platform in order to reduce the spread of the COVID-19 virus. CLICK HERE for more information.