The coronavirus has made life more challenging for many of us. But the isolation and stress that seem to be part of the pandemic are hitting those with eating disorders particularly hard.
"Eating disorders thrive in isolation," said Jillian Lampert, chief strategy officer with the Emily Program. "Particularly if you live by yourself, or if you're in a situation without a lot of social support, the eating disorder isolation messages or thoughts and feelings that people have get so intense."
Isolation has made the symptoms of the disorder — restricting calories, binge eating, overexercising and purging food — easier to go undetected.
"You don't have to explain to anybody why you won't go out for pizza with them. Nobody's going out for pizza," said Lampert. "You don't have to explain to anybody why you can't be around for a meal, because you're not going anywhere for a meal," she said. "For that part of it, people are at a much higher risk, because the isolating behaviors are really supported, in a way."
And the attendant stress can serve to exacerbate the mental health issues often coupled with eating disorders, such as anxiety, depression and substance abuse.
In addition, the stay-at-home order has spawned concern about weight gain (the so-called COVID-15) and overeating while in quarantine.
Those messages can be triggers for people who struggle to maintain a healthy relationship with food, said Claire Mysko, CEO of the National Eating Disorder Association (NEDA).
"We are hearing, and seeing, and being exposed to a lot of messages about fear of weight gain — influencers and companies capitalizing on this anxiety with messages about fitness and diet," Mysko said. "And it's very harmful."
In part to combat those messages, NEDA has launched "COVID-19 forum," an online chat, as well other resources to help during the pandemic. Mysko said NEDA's online chat resources have seen an increase in use.
"In quarantine, and when people are at home, they're dealing with a lack of privacy. And so people are looking for ways to reach out that are, you know, more private and discreet," Mysko said. "And so we've seen a spike in our chat volume as a result."
She and Lampert advised anyone who is struggling to reach out for support or offer it to a loved one.
"It's a great opportunity to say, 'You know, I'm really, really struggling with this, can you sit down with me and have this meal?' Or, 'I'm going have the meal, can you play a game with me afterwards to keep me distracted?' " Lampert said.
Shira Charpentier, founder of the nonprofit Living Proof MN, which provides free support groups and one-on-one mentoring, has had to discontinue the in-person meals she regularly hosts for people in her home.
"When that stopped, a lot of people went downhill pretty quickly," she said. "And then I got a lot of e-mails and texts, saying, 'My treatment center has closed or my therapist is online,' or, you know, 'The things that I used to do are unavailable. Now I really don't know how to get support and I feel just completely isolated.' "
'An odd silver lining'
However, there are bright spots in eating disorder treatment.
The increased access to telehealth makes it easier to get help, especially since there's no need to leave home to have access to therapy. And insurers are more widely covering online appointments.
In addition, some treatment programs are seeing a swelling of support and follow-through.
Lampert said the Emily Program's family-based treatment programs are seeing progress, perhaps because people have more time to spend with their children.
"There's so much more opportunity for supervision and support, that this is a great time," she said. "It's an odd silver lining."
While transitioning to online treatment has been complicated, the Melrose Center, another treatment facility, has seen an increase in calls for assessments and fewer no-shows and canceled appointments, said the center's clinical director, Heather Gallivan.
COVID-19, and the challenges it brings with it, is likely to be with us for a while. That's why experts are urging people with eating disorders to do their best to take care of themselves.
"Yes, there's a pandemic and, yes, you have an eating disorder," said Lampert. "You still deserve treatment, you still need treatment, you still need help and support.
"Your problem is not lesser, just because there are other gigantic problems happening."
Cleo Krejci (firstname.lastname@example.org) is a University of Minnesota student on assignment for the Star Tribune.