COVID-19 and Quarantine: What are the Risks for People with Eating Disorders?

This past month has been a time of adjusting: to new routines, new ways of working, relaxing, and simply living while staying well. For those who experiencing symptoms of an eating disorder or working to maintain recovery, being in quarantine may feel particularly obstacle-ridden. Below, we’ve tried to identify some of those risks, as well as ways to help manage them while in quarantine.

The first major risk of our current social distancing climate is just that: social distance. Without the distraction of friends, people at work, clubs or other volunteer activities, you may notice that you’re spending more time focusing on food or exercise. If so, try to reframe social distancing as physical distancing. In fact, this is a time when we all need our social supports more than ever. Identify people in your life who you can rely on as points of contact. If you’re still working, schedule a daily check-in call or video meeting with at least one colleague. It will help you to not only stay connected to the work you’re doing, but also to the people you’re doing it with and your sense of yourself beyond any eating disorder. Set up calls with family members or friends throughout the week to stay future-focused, as well as to add structure to the week outside of mealtimes. If you already have a therapist who you see, keep up with your regularly scheduled appointments. Engaging with others and distracting yourself will help to take your mind off pre-occupying thoughts related to food, weight, and appearance.

A second risk is having more time or being in an environment conducive to lapses. This may drive an uptick in eating-disordered urges and actions like over-exercising or frequently weighing yourself. Be mindful of how much time you’re spending on these activities, and work to develop constraints for yourself. If you are going on walks for fresh air, plan a reasonable, recovery-consistent route in advance, or find a 30-minute podcast to listen to while you walk (I’ve got some podcast suggestions here!), and hold yourself to be back home once the route or podcast is finished. Depending on where you are in treatment or recovery, setting limits around obtaining your weight may vary from once a week monitoring to not at all. Accordingly, now could be the time to put your scale out of easy reach until it’s needed or discard it altogether. Whatever your plan for weighing is, stick to it!

Third, the present circumstance is ripe for difficulty with body image. For those who now find themselves working remotely, constantly seeing yourself in video calls may be upsetting and drive negative body image thoughts. This may also happen when video chatting with friends or family. Consider whether it makes more sense for you to:

  1. Treat the experience like an exposure, leaning into the discomfort and noticing when it becomes more tolerable, or
  2. Toggle with your video call settings to minimize your own picture (e.g., a gallery view) until you’re more ready to take on the exposure approach.

You might even set goals for yourself, incorporating both of these ideas, to use this time to really go after psychological flexibility related to appearance. It may also be hard, with more time at home, to step away from unhelpful scrutinizing in the mirror. Remember: this behavior tends to reinforce negative body image rather than invite a return to neutral. Body image is always changing; whatever you are feeling will come and go on its own.

Finally, being around food or close to the kitchen more frequently presents its own challenges. These uncertain times invite a “scarcity mindset,” which may lead to food rationing or increased restriction. Challenge this mindset with reminders that the supply chain of food has not actually been significantly impacted and, for you, food is medicine. It is essential for your body to be getting the calories and nutrients it needs to stay healthy, with a well-functioning immune system being especially protective during this time. Restrictive eating and heightened stress and anxiety are known to increase the risk of binge eating. The best way to mitigate this risk is to set designated times and spaces for meals and snacks – establishing a regular schedule of eating to keep your body and mind balanced and cared for.

This is a difficult time for everyone. We are all adjusting to a new way of being, and some days will be better than others. Be kind to yourself – a little self-compassion can go a long way in smoothing the ups and downs. Reach out to others for support and encouragement. Consider using this unique time to reflect on what is most meaningful to you, what you want life to look like once this has passed, and to continue to implement coping strategies and routines that will serve you well going forward.

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  1. Great article Lauren! Agree with all your points, especially about maintaining physical distance and not social distance. Staying connected through phone calls, video calls and even letter make you feel less isolated, stressed and anxious.

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