Experts Explain Why The COVID-19 Pandemic Triggered Eating Disorders - Exclusive

Trigger warning: The following article contains language regarding disordered eating. 

COVID-19 turned the world upside down, exacerbating the physical and mental health issues already plaguing vulnerable populations. For individuals struggling with eating disorders, the pandemic was particularly brutal. Research in Frontiers in Psychology notes that people living with serious psychiatric conditions like eating disorders may have lower tolerance levels for anxiety-producing situations. So when the stress and negative emotions of COVID-19 hit, folks already experiencing symptoms saw an increase in their disordered eating behaviors. According to research in the International Journal of Eating Disorders, even for people who — previous to the pandemic — never struggled with body or eating issues, the chaos of COVID-19 increased their risk of developing an eating disorder.

Clinicians treating the most severe cases of eating disorders experienced firsthand how terribly COVID-19 impacted their patients. Psychotherapist Harjeet Kaur of Safe Space Therapy told The List that, at her clinic, "Hospitalizations for eating disorder cases nearly doubled compared to prior to the pandemic." Likewise, a study from the American Academy of Pediatrics saw a more than two-fold increase in hospital admissions. Researchers also observed extended hospital stays, especially for younger patients. The percentage of patients requiring medication almost tripled, and more patients needed higher levels of care that could not be provided in outpatient treatment.

Why the pandemic wreaked such havoc on individuals with eating disorders has been the subject of much investigation. As researchers understand better how COVID-19 heightened and triggered disordered eating, they will be better prepared to help patients during future crises.

COVID-19 brought the world's day-to-day routines to a screeching halt, and while this took a toll on everyone, folks suffering from eating disorders faced additional challenges. The way we ate changed during the pandemic, notes research in the International Journal of Eating Disorders. For some, that meant further purifying or restricting their diets to help boost their immune systems out of fear of contagion. For others, the result was the "quarantine 15" — the genuine phenomenon of pandemic weight gain. For many of us, the lines between mealtimes became blurred, and so did our food intake. Research shows that a shift in eating patterns due to the pandemic can lead to mindless consumption of snack foods, leading to body dissatisfaction and an increased risk of developing an eating disorder.

We also changed the way we moved. Stuck inside our living spaces, large swaths of the world lost access to exercise. With fewer ways to access physical activity, this too, research found, could increase weight or body build concerns and heighten the risk of developing an eating disorder. The anxiety-provoking nature of COVID-19 even disrupted our nightly z's, and lousy rest can also worsen or trigger eating disorder symptoms. For these reasons, the stress of COVID-19 uniquely impacted folks struggling with these sometimes life-threatening mental disorders.

Your family and friends are more than just your loved ones — they are quite literally protection against the lemons that life throws at you. Across cultures, social support has been proven to provide communities with resilience in the face of adversity, according to research in the International Journal of Eating Disorders. But during COVID-19, social distancing made that kind of human connection impossible. 

Research published in Frontiers in Psychology found that the symptoms of disordered eating worsened as a direct result of the inability to have that social closeness during the pandemic. In addition to having their routines disrupted and experiencing more negative feelings from other social factors, people living with an eating disorder couldn't lean on their friends and family to ease their anxiety and discomfort during the pandemic. Because social support is so crucial to recovery from eating disorders, the pandemic made this already difficult process that much harder.

The relentless negative news cycle during COVID-19 wore on our collective psyches. Years from now, we'll look back and recall the anxious hours we lost to doomscrolling on our phones. Mandatory "stay at home" orders forced us away from our friends, colleagues, and peers and back onto our devices, where the self-scrutiny continued. Research in the International Journal of Eating Disorders indicates that a WFH video conference may inadvertently increase the risk of eating disorders by putting pressure on looks and focusing intensely on participants' faces. Ironically, though, these forms of communication were the only source of social comfort during this time, according to research in Frontiers in Psychology.

Harjeet Kaur confirms to The List, "Lockdown, boredom, social isolation, school via Zoom, [and] more engagement of social media (TikTok/Instagram/Facebook groups) have all contributed to the recent rise in rates of eating disorders [in] individuals." Social media can increase the risk for eating disorders in two ways — social media provides a platform where "ideal," thin body types are showcased and applauded while simultaneously targeting users with advertisements for edible goods and exercise. Social media also allows users to post their own photos, and research from 2018 found that young women who posted selfies felt less attractive, more anxious, and less confident than young women who didn't. For these reasons, it's easy to understand why people struggling with body issues were disproportionately affected during COVID-19. 

Research published in The American Academy of Pediatrics lists less access to mental health care as the first of several reasons clinicians saw a spike in eating disorder diagnoses during COVID-19. The average length of hospital admission grew by five days, primarily due to a lack of available beds in appropriate residential settings for in-patient care. Harjeet Kaur told The List, "The COVID-19 pandemic highly impacted our healthcare system and community treatment centers and increased wait times." The more time it takes for a person to get the eating disorder treatment help they need, the longer recovery can take. Without access to these services during COVID-19, many folks, especially younger women, found themselves in emergency rooms instead of getting the mental health care they needed. 

The remaining impact COVID-19 has on disordered eating will continue to reveal itself as the world recovers from more than two years of upheaval. Research in the International Journal of Eating Disorders suggests that future studies should include questions about the pandemic to understand how it contributed to eating disorders so that experts can help people during the next disaster.

If you are struggling with an eating disorder, or know someone who is, help is available. Visit the National Eating Disorders Association website or contact NEDA's Live Helpline at 1-800-931-2237. You can also receive 24/7 Crisis Support via text (send NEDA to 741-741).