The rapidly evolving COVID-19 pandemic has brought considerable changes to our lives, resulting in a lack of control for many. For Australians living with an eating disorder, the extreme nature and unpredictability of the current global health crisis may impede their ongoing efforts to effectively manage their illness.

To hear how COVID-19 is affecting people living with an eating disorder, VIVA!’s COVID Comms Cast asked Clinical Psychologist and Clinical Stream Lead at the InsideOut Institute, Dr Helen Rydge, Sydney, for her insights on the topic.

“People living with an eating disorder often feel that the illness helps them cope by numbing their emotions, distracting them from reality, or giving them a sense of accomplishment, which can help them to feel in control.

“In our present, unpredictable world, those living with an eating disorder are experiencing increased anxiety due to the huge changes to our daily routines being forced upon us by COVID-19. This, coupled with a lack of social interaction, is robbing people of their helpful coping strategies, including their ability to access support from their family and friends, to help counter any unhealthy thoughts and behaviours in this especially difficult time,” said Dr Rydge.

With the redistribution of healthcare services prioritising coronavirus cases, treatment access for people living with eating disorders may be interrupted, which is especially problematic for those with severe symptoms requiring hospitalisation. Dr Rydge is therefore urging those living with an eating disorder to stay in regular contact with a treating health care professional (HCP).

“It is extremely important that people living with an eating disorder during COVID-19 continue to keep their regular medical appointments. The InsideOut Institute is encouraging the use of telehealth services, where necessary, to stay connected with doctors and mental health professionals at this point in time.”

Of particular concern are those suspected of having an eating disorder but not yet formally diagnosed. The InsideOut Institute highlights the importance of early intervention for people living with an eating disorder, as they are serious, potentially life-threatening mental illnesses, and the speed of recovery can be contingent upon access to treatment.¹

“Although accessing professional treatment and support for the first time may be more difficult than usual at this point in time, it should still prove extremely worthwhile. InsideOut Institute’s Treatment Services Database may be useful for those seeking help for the first time from a HCP,” Dr Rydge said.

Management of eating disorders during COVID-19 has proven particularly difficult due to the scarcity and unpredictability of food availability. The community’s initial response of widespread hoarding, and the more recent sharing of memes about ‘getting fat in iso’ on social media can be triggering for a person living with an eating disorder.

“The initial media reports involving lack of access to foods were confronting for people living with eating disorders. People may not have access to the foods they would usually feel comfortable eating, some people are experiencing guilt around buying food, and having large amounts of food readily available at home can be particularly problematic for those who have a tendency towards bingeing.

“With exercise being one of the only acceptable reasons to leave the house, social media has been focusing on people ‘making the most of iso’, by engaging in home exercise and posting personal workout goals. This can be triggering, by giving the illness more ‘excuses’ to pursue driven, solo exercise in those prone to over-exercising, or to achieve and maintain unrealistic expectations in those with pre-existing body image concerns,” said Dr Rydge.

Although concerns arising from this global pandemic differ for each individual, in Dr Rydge’s recent experience, patients with eating disorders are engaging in more regular psychological sessions for both therapeutic support and social connection.

“My patients are seeking more regular assistance with managing their anxiety and depression, establishing new routines to cope with the lockdown measures, figuring out how to manage mealtimes and their access to food, or scheduling pleasant activities into their day. Some are dealing with issues involving interpersonal or long-standing family dynamics that are coming to the fore, with members of the same household bunkering down together during isolation. Others are concerned about their finances, job stability and dealing with the disappointment of missing planned events, due to the pandemic.

“One unique factor stemming from the current situation, is that members of the same household are eating together more frequently than ever. This activity is enabling family members or housemates to notice worrying behaviours in their loved ones, often for the first time. Knowing how to raise your concerns with a loved one living with an eating disorder can be challenging, so InsideOut has developed some tips to help broach the subject,” Dr Rydge said.

As the world continues to navigate the unchartered waters of COVID-19, Dr Rydge urges those living with an eating disorder to continue to visit their HCP, or to start engaging with one, for medical and psychological support.

“Discuss with your loved ones what specific support you may need and let people help you. Stay socially connected with others, even via text or video-chat. If you are isolated and need support, call the Butterfly Foundation National Helpline on 1800 ED HOPE.

“For those who have a loved one living with an eating disorder, or any mental illness, now is a particularly important time to check in with them and stay connected. Make yourself available to them and remember to be sensitive and kind to what they’re going through,” said Dr Rydge.

Reference

1.  InsideOut Institute. Getting Help Early. 2020. [May 2020]; Available from: https://insideoutinstitute.org.au/resource-library/getting-help-early.