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For many with eating disorders, pandemic set off ‘cascade of problems.’ Here’s how to get help.


When the novel coronavirus began spreading nationwide, prompting restrictive shutdowns and fueling pervasive feelings of loneliness, anxiety, depression and stress, it didn’t take long for Marita Cooper and other experts who specialize in eating disorders to see the pandemic’s effects on their patients.

Beyond the broad mental health impacts linked to the sudden disruption of lives and widespread isolation, coronavirus-related restrictions created specific factors that could put people with eating disorders at increased risk, said Cooper, a postdoctoral fellow at Johns Hopkins University.

In July, she and a team of researchers published a peer-reviewed article that detailed known triggers of disordered eating and theorized how they could be worsened by the pandemic: Grocery panic-buying and stockpiling had prompted concerns about food access, according to the article. Many people were also largely cut off from their support systems and healthy coping tools, such as in-person therapy, and social media had become flooded with potentially triggering content about the “Quarantine 15,” or pandemic-related weight gain.

She had spent her whole adult life struggling with an eating disorder. After recovery, a week of self-isolation felt like the ultimate test.

“Unfortunately, a lot of the things that we suggested at the time are the things that people are struggling with,” Cooper said. Though food access challenges may be less of a worry now, she noted that the pandemic has still unleashed a “cascade of problems” that could affect those with eating disorders. An estimated 28.8 million people in the United States — about 9 percent of the population — will have an eating disorder in their lifetime.

“A lot of people seem to be getting worse,” Cooper said, and some may even be developing eating disorders for the first time because of pandemic-related stressors. “I wouldn’t be surprised if future epidemiological studies find an increased prevalence during 2020.”

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The National Eating Disorders Association (NEDA) has been inundated by people looking for support during the pandemic, said Lauren Smolar, the organization’s senior director of programs. In November, Smolar said NEDA saw a 72 percent increase in online chats and a 10 percent rise in calls compared with the same period last year. And the association is anticipating yet another surge around the holidays, a historically difficult time for people with eating disorders.

People will be “continually needing support at a higher level than we’ve seen in previous years,” Smolar said, noting that NEDA is offering online chat hours on Christmas Day. “As trends go on and the world kind of closes and opens back up again, we’re continuing to see those patterns of people who are looking for additional opportunities for community and support and treatment options.”

Here’s how experts say people who are struggling during the pandemic can get help.

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Reach out early

Do not try to handle an eating disorder on your own, said Michael J. Devlin, a professor of clinical psychiatry at Columbia University’s Vagelos College of Physicians and Surgeons.

“Everybody’s temptation, I think, when things start to go off the rails is to clamp down and isolate and be by themselves, and that’s almost always the worst thing that you can do,” said Devlin, a staff member at the New York State Psychiatric Institute’s Eating Disorders Research Unit.

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Seeking help early could also keep an unhealthy behavior from becoming a disorder, said Cynthia Bulik, founding director of the Center of Excellence for Eating Disorders at the University of North Carolina at Chapel Hill. For instance, stress eating, which has increased during the pandemic, can be a “very common path” to a binge-eating disorder, Bulik said.

“It’s possible that these unhealthy eating behaviors are going to be time limited and associated with the pandemic,” she said. “But for some people, they’re going to stick, and they’re going to crystallize into a full-blown disorder.”

It can be as simple as contacting a trusted family member or friend if you don’t feel ready for professional help yet, Devlin said.

Loved ones should be supportive and encourage that person to access care, Smolar said. NEDA provides resources for how family and friends can help, and Smolar noted that they can contact the organization’s helpline if needed.

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But Devlin emphasized there is only so much laypeople can do.

Where loved ones can go wrong is when they try to take on too much responsibility and feel like it’s their job to get whomever they are concerned about “back on track,” he said. “You can’t do that. That really has to be up to the person.”

Be aware of support options

If you are looking for help with unhealthy eating behaviors, there are channels you can go through. On its covid-19 resources page, NEDA provides links to online support groups and forums, as well as information on how to access the helpline.

Through the helpline, Smolar said, trained volunteers can assist you in determining what kind of support is going to be helpful for your situation.

“It’s really important that if somebody is actively struggling with an eating disorder or beginning to struggle with eating-disorder symptoms that they’re in touch with professionals who really specialize in this,” she said, noting that eating disorders are often “incredibly individualized.”

The pandemic has given rise to telehealth and remote therapy, reducing some of the barriers to access care, especially for people who may have been nervous about in-person treatment or those in more rural areas, Cooper said.

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For people who might not be comfortable with more formal care options, Cooper suggested trying out free virtual support groups that are run by professionals with experience in eating disorders. She added that social media accounts on Instagram and TikTok have also started hosting live meal support sessions, which “can be a motivator to encourage people to eat.”

“One of the really great things about the pandemic is that people have tried to be really innovative with the ways that they’re offering treatment now,” she said.

Establish connection and a healthy routine

Eating disorders thrive in isolation, and social support is critical for recovery, Bulik said. People around you, whether it’s your family, friends or treatment team, can help hold you accountable. If you aren’t seeing them or having regular contact, it’s “easier for the eating disorder to go into secrecy mode,” she said.

Though video calls have emerged as a popular alternative to in-person interactions, people with eating disorders may struggle with constantly seeing themselves on camera, Bulik said.

“These are people who have really negative body image and often body dysmorphic symptoms as well,” she said.

Still, you should prioritize staying connected with family and friends, experts said. And oftentimes, a video call might be the only option.

Cooper suggested turning off your self-view on a call if possible or dressing up in a funny costume. Do whatever helps to keep you from staring at yourself, picking out flaws and engaging in critical self-talk, she said.

“It’s not necessarily how much time you’re spending on Zoom but the way that you’re interacting with yourself on Zoom, whether you are objectifying yourself or being overly critical,” she said.

(During these calls, family and friends should be mindful about commenting on appearances, Bulik said. “Just tell people how great it is to see them and leave it at that.” And if someone wants to leave their camera off, “respect their privacy,” she said.)

It’s important to schedule time to engage with loved ones as part of your daily routine, Cooper said, so you aren’t “sitting at home for endless amounts of time.”

Try to follow a sleep schedule, and make sure you’re eating meals at regular times throughout the day, she said. Consider planning tasks that can give you a sense of achievement — for example, finishing your holiday gift shopping or organizing your email inbox. You should also find activities that bring you enjoyment or pleasure, she said.

Meanwhile, she urged people to keep reaching out for help.

“It’s not something that you have to deal with for the rest of your life,” she said. “There are effective treatments, and people do get better.”

To reach the National Eating Disorders Association’s helpline, call or text 800-931-2237. More information about support, resources and treatment options can be found at