Eating Disorder Symptoms Have Spiked During Covid

Eating Disorder Symptoms Have Spiked During Covid

Sometimes it’s even free. In March of 2020, Diane Summers, a nutrition therapist in Seattle, asked her colleagues if anyone had time to offer no-cost meal support via Instagram Live. “I was kind of hoping for maybe two or three people a day to go live,” she said. “But we were just flooded with willingness to be a part of the project.” Therapists and dietitians signed up in every time zone, enabling the account (@covid19eatingsupport) to offer live meal support 24 hours a day for several months of the pandemic.

Teenagers have been particularly vulnerable to developing eating disorders during the pandemic, both because adolescence is already the most common time for such struggles to emerge and because of the added pressures they face now. “It’s a combination of the loss of structure, the loss of peer connections and the loss of their usual activities,” Dr. Muhlheim said. “They have all this time and they decide to focus on an exercise program, or maybe it feels like running is the only thing they can really still do. But we know exercise is a huge trigger.”

That’s how it started for Lily, a 16-year-old high school sophomore in Los Angeles who said that body image anxieties weren’t a big part of her life until the pandemic. “I don’t think weight loss was ever on my mind at all,” she said. “It was more of, ‘I love running, I have all this time, so why not push myself and see how far I can run?’” She began working out every day to fill the time previously occupied by school and team sports. “Lily is super book smart and school comes easily to her, so she’s had a lot of extra time,” with the switch to remote learning, her mom, Nikki, explained. (The family asked to use only their first names to protect Lily’s privacy.)

After a few weeks of intensive exercise, Nikki noticed that Lily was eating less at family meals, too. “I wasn’t necessarily skipping meals, but I was trying to eat less meat and dessert and more vegetables,” Lily said. “I thought I was being healthy.” But she also became more fixated on her weight and further curbed her eating.

In those who are vulnerable to eating disorders, even unintentionally dipping into a negative energy balance, which happens when you expend more energy than you consume in calories, can trigger the rigid, restrictive mindset that is the hallmark of most eating disorders, said Dr. Kenisha Campbell, director of adolescent medicine outpatient clinical services at the Children’s Hospital of Philadelphia.

“Eating disorders are brain disorders because the brain cannot function without appropriate nutrition. So once the ‘eating disorder brain’ is in control, they can’t make any decisions around eating,” explained Dr. Campbell, who specializes in eating disorder treatment. “We have to feed the brain, so the brain can fight the eating disorder.”

By December, Lily often felt dizzy and had developed a resting heart rate of 40 beats per minute, which was dangerously low for her. She was put on bed rest by her family doctor, and a psychologist prescribed an intensive family-based treatment in which her parents planned meals and monitored everything she ate. On tough days, it felt like the whole family was trapped in the house with her eating disorder, Nikki said.

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