COVID-19 has changed the way we live, work and interact with one another. It has also changed the way we move, exercise, shop, prepare food, and eat.
During the pandemic, we’ve seen marked increases in across the board. But Australian and international research suggests lockdown measures have presented unique challenges for people living with eating disorders.
Eating disorders are complex mental illnesses
Eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder and . They centre around disordered eating (for example, fasting and dieting, binge eating, or purging behaviours), and often include problems with body image.
Eating disorders are with high levels of depression and anxiety.
For some people with these conditions, rigid routines (around exercise, food preparation or eating habits), are a way of coping with symptoms and distress.
It’s no secret the pandemic has significantly disrupted our usual routines. For example, working from home may have led people to be more sedentary, or allowed more time for exercise. Social distancing has meant we’ve spent less time seeing others and sharing meals.
People of different ages, genders and backgrounds can develop eating disorders. | Shutterstock
COVID-19 restrictions and social distancing measures, though imperative to reduce the spread of the virus, have resulted in a , especially for people experiencing social isolation, reduced or uncertain employment, financial strain, or health concerns.
We know people with existing mental health problems have been . However, people with eating disorders are vulnerable not only to these mental stressors; but also to the physical changes to everyday routines, and social conversations about which have popped up during lockdowns.
What does the research say?
Research predicted COVID-19 and the associated restrictions may increase eating disorder risk in a few important ways:
disruptions to daily routines and reduced access to social supports
- increased exposure to anxiety-provoking media (messages about possible links between high , or about weight gain during lockdown
- increased use of video conferencing where people are exposed to their own image on camera
- anxiety about contracting COVID-19 – the authors suggested this may lead people with eating disorders to engage in dieting for perceived immune system benefits
Australian researchers conducted what was to our knowledge the first on disordered eating behaviours during COVID-19. Participants with eating disorders reported a worsening of symptoms – they were restricting their food consumption, binge eating and engaging in purging behaviours more often. They also reported doing more exercise, and high levels of depression, anxiety and stress.
Studies from around the world have since shown similar results. They’ve also found people with eating disorders have about not being able to find foods consistent with meal plans, while have led to heightened psychological distress and worsening of eating disorder symptoms.
It comes as little surprise demand for eating disorder support has increased significantly. The Butterfly Foundation – Australia’s leading support organisation for people affected by eating disorders and body image issues – has reported in calls to its helpline over the course of the pandemic.
Similarly, inpatient and outpatient services around Australia – particularly where residents experienced a prolonged second lockdown – have seen , resulting in longer wait lists for eating disorder services.
People with eating disorders are likely to need extra support beyond the pandemic. | Shutterstock
Looking ahead
Although we still don’t know what the long-term psychological effects of COVID-19 will be, previous pandemics such as SARS have taught us these sorts of crises can result in , and may trigger the onset of mental illness, including depression and anxiety.
We don’t know yet conclusively whether the pandemic has triggered the onset of eating disorder symptoms or increased the incidence of these conditions. It doesn’t make it any easier that our understanding of the prevalence of eating disorders in Australia to begin with.
But it does seem highly likely that we will see such increases. The information we have so far suggests pandemic-related challenges can increase the risk for people with eating disorders, or those who may be vulnerable to developing them, in many and varied ways.
In addition, some research suggests food insecurity is associated with increases in , and in particular.
So even if the pandemic is brought to an end with widespread vaccination, if the associated economic recession results in ongoing disruptions to food supply chains, or in impoverished households having limited or unreliable access to food, we may see further increases in eating disorders, well beyond the life of COVID-19.
It’s critical clinical services and support organisations provide extra support to these groups, not only during the pandemic, but for a significant amount of time after the crisis has resolved. This includes increased access to treatment, as well as online eating disorder supports like , and telephone hotlines.
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