- Anxiety about the coronavirus pandemic, as well as social distancing and quarantine efforts, can be difficult for people with a risk or history of disordered eating, experts say.
- Symptoms of disordered eating vary widely. Those with a tendency to restrict calories might rationalize it as rationing food for an emergency, even though there's no reason to believe there's a shortage.
- Hoarding food could also be an issue for people who struggle with binge eating.
- Even during quarantines, there are online and virtual resources available to help if you or someone you know is struggling, including the National Eating Disorders Association Helpline at (800) 931-2237.
- Visit Insider's homepage for more stories.
Amidst the global spread of the coronavirus, many people are feeling increasing anxiety as cities are self-quarantining, stores are selling out of basic supplies, and it becomes increasingly unclear when things might return to normal.
People with a history of eating disorders or patterns of disordered eating may be uniquely vulnerable right now, according to experts.
"As anxiety increases, which is increasing for everyone, it can be risky for people who don't have a neutral relationship with food, " Melainie Rogers, executive director of Balance Eating Disorder Treatment Center, told Insider. "When we feel that external factors are out of control, we focus on things we think we can control such as exercise, weight, and food."
This can manifest in a variety of ways, depending on the individual, she said. Here are some possible symptoms of disordered eating related to the coronavirus pandemic, and how to handle them.
Rationing food could be a trigger for calorie restriction
A common response to the pandemic has been panic-buying, with stores selling out of many household goods like cleaners and paper products.
This can lead to the feeling that supplies might generally be running out, and could prompt an urge to ration food — but that may actually be an insidious form of calorie restriction for people prone to disordered eating.
"Some clients have had a deep fear and desire to ration. I think it's another way of restricting food with a moral high ground and rationale,"Rogers said.
For someone with a history of anorexia, their brain might associate a higher calorie intake with feelings of anxiety — as a result, limiting that intake becomes a way to try to reduce anxiety, she explained.
This is a nuanced problem, according to Sarah Herstich, a body image therapist and licensed clinical social worker.
"As people's sense of safety and security is threatened, they may do what they feel they have to in order to get through. Disordered eating is so normalized in our society, many would dismiss this as being normal," she told Insider via email. "If you are in recovery from disordered eating, it feels important to investigate the desire to ration as best you can and consider how you can best care for yourself right now."
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Stockpiling or hoarding food could lead to binge eating behaviors
On the other side of the spectrum, binge eating is also fueled by fears about restriction, Herstich said.
Anxiety could drive people to purchase more food than they typically might and, with many people confined to their homes, that can be a challenging environment for people with a tendency to binge-eat.
"If you're bringing more food into the home, you're more at risk of overeating because it's right there," Rogers said. "For some people it's their worst nightmare. Like an alcoholic being locked into a wine store."
The urges to hoard, overeat, ration, and under-eat are all related to a drive to use food to soothe underlying anxiety, Rogers explained, which manifests in different ways depending on a person's history with disordered eating.
Eating to 'boost your immune system' could fuel orthorexia, or an obsession with 'clean' eating
Another side effect of the pandemic is a rise in marketing of products for "boosting" your immune system, including diet plans and vitamin supplements (none of which are actually proven to help).
These can fuel a specific eating disorder called orthorexia, characterized by a fixation on eating only things perceived as healthy, safe, natural, or "clean." This can be exacerbated by marketing strategies that play into those fears, Rogers said.
"Eating disorders are steeped in food rules," Herstich said. "It's important to challenge the media's messages, reminding the public that there is no one food that will cure or kill you — and certainly no food that will make you immune to the coronavirus."
Being unable to go to the gym could prompt panic around exercise, body image, and weight gain
Many gyms and fitness centers have closed their doors to prevent spread of the coronavirus, which has left exercise enthusiasts without their usual source of stress relief.
But missing the gym — a mild inconvenience for most people — could be a major source of panic and body image issues for someone with an eating disorder, since EDs are often accompanied by a compulsion to work out known as exercise addiction.
The disruption of normal routines can add even more stress, since people might also have feelings of guilt or shame about being unable to go to the gym.
"The idea of 'laziness' can be very triggering for people struggling with food and body," Herstich said. "This additional stress, on top of all that is happening in the world, adds to vulnerability and turning to old ways of coping."
Symptoms of disordered eating also include obsessive thoughts about food, weight, or exercise
Many other factors could influence patterns of disordered eating during the pandemic — restaurant closures could limit food options, for example. Social isolation can also compound the challenges of living with and recovering from an eating disorder.
Rogers said potential warnings signs of excessive anxiety include irritability, feelings of being overwhelmed, or constant feelings of being on the verge of tears.
"Try to objectively gauge what's going on in your thoughts, if you're having obsessive thoughts about weight, food, exercise," she said. "If you're weighing yourself more frequently, for example, that can be a barometer of your internal state."
She also said it's important to be aware of symptom substitution — drinking too much alcohol as a coping mechanism, for instance, instead of over-eating.
If you notice warning signs in yourself or a loved one, reach out for help
"This is uncharted territory for all of us. If people find themselves restricting, hoarding, or bingeing, my hope is that they don't judge themselves, but they ask themselves what they might need to care for themselves," Herstich said.
Virtual contact with both loved ones and medical professionals can help bridge the gap. Consider scheduling a phone or video call with trusted friends or family members to help maintain routines and stay social even while stuck at home.
The National Eating Disorder Association (NEDA) offers many resources for people to connect with virtual support, as well as a map of treatment centers across the US. Many dietitians are now offering meal support, chats, and support groups online via live streaming or other virtual platforms, Herstich said.
"This is hard enough, and people don't have to do this on their own. We are in the midst of a crisis and there's a lot of resources available, so reach out for help," Rogers said.
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