A study on the impacts of eating disorders during the Covid-19 pandemic found, “The ED (eating disorder) population is at significant risk of negative impacts of the pandemic; the consequences of which may be felt long after a societal return to ‘normality’.”
Since the start of the pandemic, coping mechanisms have been eradicated for many suffering with many forms of mental health problems. This has meant that some with EDs struggle even more with the day-to-day mundanity of lockdown.
The ED charity Beat, define eating disorders as “serious mental illnesses affecting people of all ages, genders, ethnicities and backgrounds. People with eating disorders use disordered eating behaviour as a way to cope with difficult situations or feelings.”
Alice*, 23 from Hertfordshire is like any other 20-something currently, missing the luxury of gig going and travelling around the globe. With having the ‘heyday’ being halted for young adults since March 2020, Alice( like the rest of us) is wanting nothing more to socialise again with her friends and to have a drink or two in a pub garden.
However, Alice hasn’t just been struggling with her early 20s passing swiftly by,Alice has been struggling with an eating disorder in the midst of a pandemic.
Alice was diagnosed with ENOS (eating disorder not other specified) in 2019 when she was 20 years old, “I can link my eating habits back to around 2016; I was unable to eat properly for a month and the weight just dropped off me”.
“Obviously I then got loads of comments from people about how good I looked which just fuelled me to try and stay that size. I never use to see anything wrong with my eating until I started putting weight back on,” she said.
“I sat back and realised what I was about to do to lose weight again and it put things into perspective. I spoke to my therapist at the time about it and I ended up being diagnosed with EDNOS.”
Since the announcement of the roadmap to exit lockdown on February 22, social media has been filled by memes to combat the ‘lockdown weight gain’, which is being championed by the Prime Minister Boris Johnson himself.
“Lockdown was especially hard I feel, as there was such a surge of people who wanted to ‘get fit’ and ‘lose weight’ and it almost felt like it was expected,” Alice admitted. “Lockdown got me really hard at the start, I was so depressed I wasn’t even going on my daily walks and I was ordering takeaways left right and centre as I had no motivation to cook.”
“However, I’d then go on social media and see all these people losing weight, so then I’d go into a cycle of barely eating for days. The pressure of getting fit in lockdown but the mixture of feeling so low all the time definitely made suffering with an ED much harder,” Alice told us.
Fitness during lockdown has been a way to keep a healthy mind during the Covid-19 pandemic, however with a higher focus on fitness, for some this has caused their ED more harm than good.
Alice sees how the lockdown was warped into a ‘caterpillar to a butterfly’ type situation, as a ‘fresh start’ and a time to ‘focus on yourself’.
“Focusing on yourself too much is a perfect pawn in the Eating disorders warped game of chess. Lockdown is a perfect concoction to cause a mental health crisis.”
“At the start of the pandemic when my therapy was stopped, I was so upset, as even though I understood that they were unexpected times for us all, I knew that I would need support here more than ever,” she said.
“I phoned my GP in August and just got chucked anti-depressants with no real consideration for the eating side of things. It’s not until recently where I have begun therapy again that I feel support may be starting again; the therapist I’m with now seems lovely and seems to want to help. But this is about eight or nine months after my last therapy sessions, and some real damage could have been done.”
With face-to-face contact becoming somewhat extinct and Zoom calls becoming the go-to for pretty much anything of recent, therapy has become limited and somewhat less ineffective, for some bringing on a greater bout of anxiety.
Dr Dawn Branley-Bell, Chartered Psychologist and Research Innovation Fellow at the Centre for Digital Citizens at Northumbria University, who was one of the authors of the research paper said: “It is vital that healthcare provisions are available and accessible even during lockdown periods.”
The same applies in general for individuals who may find it difficult to access in-person services. At the start of the lockdown, the individuals they interviewed reported differences in service provision across the UK, with some healthcare providers being better equipped to make the switch to remote service provision more quickly than others. One respondent described this as a “postcode lottery”.
“We must ensure that going forward, everyone has equal, open access to essential eating disorder treatment, including adequate remote services,” said Dr Branley-Bell.
“Our research also highlighted that existing technology may not always be appropriate for remote services, for example, many of our respondents were uncomfortable with being faced with their ‘self-view’ during video calls.
“It is important to consider the suitability of any technology adopted for remote treatment. For example, this may involve disabling ‘self-view’ as the default option on video calls or using alternative technology,” she added.
The eating disorder charity Beat predicts that “1.25 million people in the UK suffer with an eating disorder”. Staying inside for considerable amounts of time creates an essence of fear of weight gain.
“As an example of this discourse outside of the online environment, we have also researched public opinion of the UK governments ‘Better Health’ campaign. Many individuals with eating disorders found this campaign to be potentially damaging due to the language used and its focus on weight-loss to ‘protect against COVID’ and ‘protect the NHS’,” Dr Branley-Bell said.
“The findings highlighted the importance of considering the language that is used in public health campaigns, to protect against unintended detrimental impacts for vulnerable populations.”
“I would like to make it clear that social media platforms are not inherently positive or negative, they are simply platforms through which we interact with others,” she added.
“It is the nature of that interaction that determines the impact for the individual user – in much the same way as our offline interactions. Social media have many positives, including for individuals with eating disorders who report using these platforms to seek healthcare assistance and advice.”
Beat, offers a short guide on the website addressing the issues of heightened responses to eating disorders due to Covid, the charity states “A number of people have mentioned to us that their exercise has increased due to anxiety around being ‘stuck at home’, as well as listening to the Government’s messages around being able to exercise every day. Some people have said that this has driven them to exercise more.”
“Pre lockdown my packed agenda was a great excuse to skip meals or burn energy. I can’t now.”
However, not everyone who has an ED has had a negative experience with lockdown. Journalist Francesca Baker, has had a more positive experience finding the lockdown has allowed her to revaluate her day to day routines.
“Flexible working from home has become the norm, so there’s less commuting which drains energy. I’ve not been rushing around so am able to focus on my meal plan. Usually, I’m out every night, keeping busy, and that burns energy. I’ve been much more relaxed. Pre-lockdown my packed agenda was a great excuse to skip meals or burn energy. I can’t now.”
Francesca expressed her initial worries about the first lockdown in March 2020 and how that affected her ED.
“I was so stressed about gaining weight or not being able to get my safe foods, but that hasn’t happened. The fixation on diet and weight loss has always been there, and over the last 16 years of having anorexia has been a struggle. My family and friends are really good at helping me mute those triggering voices and reminding me what matters.”
Francesca has been able to be reflective of her experience over the last year and what this means for her now: “I think coming out of lockdown I need to remember that a chilled pace of life suits me more than I ever realised.”
Mental illness isn’t black and white. Everyone is different and deals with things in their own way. With the third lockdown coming to an end and everyone’s mental health bearing the brunt of the last year, those with ED’s are having to battle government narratives around weight that may be triggering.
“Since our initial study, we have continued our research into the impact of the pandemic for individuals with lived experience of eating disorders,” Dr Branley-Bell said.
“We looked at the UK governments controversial ‘Better Health’ campaign, as mentioned before, and we have also conducted another study looking at factors impacting eating disorder recovery or relapse during lockdown.
“Lockdown is a period when we are all likely to have experienced significant disruption to our daily lives and a sense of reduced control,” Dr Branley-Bell added.
“Our results suggest that for some of the individuals who reported relapsing during lockdown, many described relying upon eating disorder behaviours as a form of auxiliary coping mechanism to regain some sense of control. We are continuing our research in this field with the aim of identifying ways to support individuals living with eating disorders during the pandemic, and into the future” Dr Branley-Bell commented.
Eating disorders are not just about weight loss, they are complex and are often rooted in regaining a sense of control. Beat offers a lot of advice and clarity on ED’s and also help.
Post-pandemic life is going to be a challenge for everyone. Let’s make it less challenging for those who already struggle by keeping weight gain and weight loss narratives at bay.
* Some names have been changed at the interviewee’s request.
Featured image by Layla Nicholson.
Edited by Giuli Graziano and Daniela Ferreira Teixeira.