Wellness

Anyone In Eating Disorder Recovery Should Read This Coronavirus Advice

Stress and different access to food during social distancing can trigger harmful thoughts. Here's how to handle it.

The COVID-19 pandemic has brought seismic changes to all of our lives in the past weeks. We’re being urged to self-isolate in our homes, stay away from other people, and stock up on necessary supplies like food and hygiene products to limit trips to the store. These new guidelines, and the uncertainty around how long they will last, are anxiety-inducing for everyone.

If you’re currently in eating disorder recovery, you’ve likely felt triggered by what’s going on. To encourage you and help you feel less alone, we asked a few experts for some guidance on how and why to stay on track with recovery during this universally tough time.

(Note: We’ll talk more about this below, but if you have the option, it’s important to stay virtually connected with your treatment team throughout this pandemic. You can also reach the National Eating Disorders Association hotline at 1-800-931-2237.)

The realities of this global health crisis will affect people in different ways, including those in eating disorder recovery.

Needless to say, different people will be affected in different ways by self-isolating, social distancing, and other implications of the pandemic. Likewise, people in recovery will face their own individual challenges.

The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) recognizes multiple eating disorders, but generally, they fall into three categories: restrictive eating disorders like anorexia nervosa, binge eating disorders, and eating disorders that show characteristics of both.

“The pandemic is going to affect different recovery journeys in different ways,” said Colie Taico, a North Carolina-based psychotherapist who specializes in eating disorders and trauma. “Someone recovering from a restrictive eating disorder might feel their eating disorder telling them to use limited grocery store trips as a reason to not eat adequate food, whereas this same scarcity mentality might trigger the urge to binge in someone with bulimia nervosa or binge eating disorder.”

Be compassionate with yourself. It’s normal for eating disorder thoughts to creep back in during stressful times.

Feeling especially tempted to fall into old behaviors is a normal response and doesn’t mean you’re failing. The development of an eating disorder is multifaceted and complex. In addition to many other factors like genetics and temperament, some people that develop eating disorders have experienced trauma in their lifetime, whether that’s the trauma of living in diet culture, experiencing a relationship that was emotionally abusive or experiencing an assault, just to name a few examples.

Disordered food behaviors like restricting, purging and binging can develop as a response to these traumas. “Engaging in those behaviors can do a number of things inside us that help in the short term — numb a difficult emotion, for example,” she said.

If you’re being tempted by eating disorder thoughts or behaviors right now, recognize that they could be a reaction to what’s going on in the world.

Remember that eating disorder behaviors don’t actually solve any problems ― and, in fact, make things worse.

As anyone in recovery knows, the same behaviors that can numb our emotions in the short term can cause serious long-term physical and mental health problems. Those practices also don’t solve anything.

“Returning to eating disorder behavior is not, in fact, going to change the circumstances in which we live,” said Anna Sweeney, a Boston-based certified eating disorders registered dietitian. “Instead, it will reinforce false thought patterns that suggest an eating disorder is the answer, when in fact right now there just isn’t an answer, except for washing our hands and staying away from other people to the best of our ability.”

Of course, we’re all desperately searching for an answer, but now is the time to remind yourself what recovery has already taught you — that eating disorder behaviors are never the solution.

“Don’t let this pandemic stand in your way. You can do this. One step at a time.”

- Colie Taico, a North Carolina-based psychotherapist

Don’t let old eating disorder thoughts prevent you from buying what you need at the grocery store.

“I’ve had clients contact me from the grocery store saying, ‘I can’t get my safe food, I can’t get the replacement for my safe food.’ There’s a scarcity effect happening right now ― it’s happening for all of us,” Sweeney said. But she said it’s especially exacerbating for people recovering from eating disorders.

First of all, you might need to stock up on foods you don’t feel comfortable with.

“Your eating disorder may label shelf-stable foods as ‘bad’ or ‘unhealthy,’” said Lauren Haughey, a Colorado-based certified eating disorders registered dietitian. Many people in recovery may also feel anxiety around having so much food in the house at one time. “Know that human bodies are extraordinarily resilient, and your body can handle and get adequate nutrition and variety from shelf-stable food.”

Haughey recommended trying to be neutral about foods ― really push back against “good” and “bad” food thoughts ― and giving yourself permission to eat what you want when you want.

“To be clear, this time and these new guidelines will be scary and potentially really dangerous for some folks with eating disorders,” Sweeney added. “But for others, I think this is going to move them through phases and stages of recovery that perhaps they didn’t think they were ready for.”

The necessity of buying a food that you aren’t comfortable with might speed the process of becoming comfortable with it. Or the fear of having too much food in the house at once might start to dim as it becomes a more normal reality.

If you truly aren’t comfortable, there are alternatives for people who can afford them. Haughey suggested using grocery delivery services at the same frequency you’re used to shopping, or ordering take-out or delivery from restaurants you know and feel comfortable with.

Know that your body is resilient and can live without exercise.

Limiting or avoiding exercise is an important recovery step for most people with eating disorders, but self-quarantine adds a whole new layer of anxiety around lack of movement.

“It could be especially hard to remember that you still need enough food even when you are doing less,” said Katie Gilder, a Minnesota-based dietitian. “You don’t need to compensate for the fact that their gym is closed [by restricting food].”

If you’re freaking out about not getting as much movement, take a deep breath.

“The human body can be OK not going to the gym,” Sweeney said. The same goes for working out at home. With so many people posting their exercise routines on their Instagram feeds, it can feel like you’re not doing enough. Remind yourself that you don’t always need to do an intense workout.

“The majority of calories that we burn go towards just existing, because keeping our bodies at 98.5 degrees takes a lot of energy,” Sweeney said. “It’s going to take a lot of skill for [people in recovery] to be able to tolerate this new normal, but our bodies are designed to persist.”

Establish a routine to help keep eating disorder thoughts at bay.

Whatever routine you establish for yourself in the near future will look different than it did a few weeks ago. That doesn’t mean you shouldn’t have one. Taico recommends eating regular meals and snacks on a schedule similar to the one you’re used to and sticking to your meal plan if a dietitian has prescribed one. Following a regular sleep schedule can also keep you healthy and feeling more normal.

Taico also recommends journaling each day to get your anxieties and feelings out on paper without judgment. No matter where you are in your recovery journey, it can be helpful to think through why certain eating disorder thoughts might be surfacing right now.

Stay digitally connected to friends, loved ones and online support systems.

Another thing to build into your routine: regular contact with friends and family. Eating with others is a powerful recovery tool, and if that’s not possible right now, consider making virtual lunch and dinner dates, and FaceTiming with one other person or a group as you all eat at home.

Don’t hesitate to talk to people you trust about what you’re going through. “Communicate with safe, recovery-positive people around you about what your eating disorder part is likely to dream up in terms of relapse fantasies, and ask for accountability,” Taico said. You don’t need to share these thoughts with everyone, but confiding in one or a few individuals ― and asking them to check in on you regularly ― is a great idea.

Online forums are another good option. This past Sunday, Sweeney announced that she would do a free hourlong Instagram Live session every Monday to support those in recovery. Since then four other practitioners have volunteered to do the same thing on other weekdays. You can find the schedule here and tune in every weekday at the designated times.

“None of us have concrete answers right now, but all of us need connection. It really is important that we engage as much as possible in personal online connection,” Sweeney said.

In addition to Instagram Live sessions, there are Facebook groups and other online forums that support people in eating disorder recovery, many of which are listed here.

Make virtual therapy appointments.

This should go without saying, but none of the above is a substitute for individual therapy.

“It’s normal to feel increased anxiety right now, and your recovery is still very important. Even with social distancing, you can reach out for support from your treatment team, as many providers are offering telehealth now,” Haughey said.

“Anyone working to recover from an eating disorder would be wise to continue on with their therapist and dietitian exactly the same, just online,” Taico added. She noted that telehealth is very similar to in-person therapy, with the downside that you’re not in the same room and experiencing the feeling of being near someone who cares about you.

But Taico said anyone who’s already formed a connection with their provider will likely feel that connection virtually as well. “If you are meeting a therapist for the first time virtually, you may feel a bit awkward at first, but that’s about it,” she said.

Remind yourself that recovery is a very worthwhile process and that you’re so much more than an eating disorder.

There’s a lot of uncertainty about how long these self-isolation and social distancing recommendations will last, but they won’t be forever.

“Every step you take backwards in your healing journey is one more that your future self will need to walk again,” Taico said.

You’ve likely already learned in recovery that your eating disorder was holding you back from living a full and happy life, and that healing can happen. “Don’t let this pandemic stand in your way,” Taico said. “You can do this. One step at a time.”

If you’re struggling with an eating disorder, call the National Eating Disorders Association hotline at 1-800-931-2237.