Covid-19 and Eating Distress

Eating Distress sits at the intersection of physical and mental health making us particularly vulnerable at this time. 

This blog piece is written by a member with their own experience of eating distress and uses quotes from Twitter followers (with permission).

Empty supermarket shelves. Text: Covid-19 and Eating Distress

Turns out that successfully managing a 30+ year eating disorder for years by shopping infrequently and buying multiples of the same few items doesn’t work in a pandemic with restrictions. The gradual erosion of parts of life that feel possible, in the absence of help, is a worry.

For those of us with current or former difficulties with eating this is a mental health nightmare. Some of us took years to painfully regain some health and we can’t replace ‘safe’ foods with just anything. 

I’m struggling to get my ‘safe’ foods. Dx anorexia many years ago and still feel in control if I eat certain things and certain times. Been going on for so many years. I feel uuurgh too when many have no food at all. Also with all other things in the world out of my control, my control is needed more… if that makes sense 

Covid lockdown has had enormous impact on our mental and physical health. Many of us are having to self-isolate and are having to rely on supermarket deliveries, friends and family and volunteers to deliver our food. 

We may be unable to access possibly the only source of viable food due to restrictions on the number of items supermarkets will allow customers to buy.

We may have to purchase expensive meal replacement drinks not prescribed. 

We may feel embarrassed by volunteers seeing how restricted our food intake is.

Does anyone else feel that if they asked someone to get some food for them that it must be ‘essential’ ie no junk food lol

The inability to obtain key items can unravel a finely balanced ability to eat. The constant fear of ‘where does the next X come from?’ or ‘when will a delivery slot become available?’ leads us to focus and obsess.

I finished CBTE for this a couple of months ago, and everything I worked so far for has completely unravelled (CBTE – Cognitive Behavioural Therapy for eating disorders)

Some of us have permanent health problems as a consequence of anorexia, bulimia or binge eating . These can include dental, bowel and/or bone conditions, which require permanent prescribed medicines and affect what we can and can’t eat. 

The Government registration covers limited physical conditions but not mental health conditions. Relevant charities could have made representations to the supermarkets – but it shouldn’t be based on BMI like services!

Food bank and government food parcels rarely contain fresh vegetables, fruit or dairy. Many of us struggle to eat a lot of rice, pasta, lentils or beans because of our health conditions. 

yes the food bank and Age UK parcels are very limited. The sad thing is many of us would be ok (enough £ permitting and yes it’s more expensive now), if we could access supermarket delivery slots. Some people I talk to in private need things like fortisip and are trying to get it online (fortsip – supplementary food)

Cooking is an issue for people who struggle with eating distress. Some of us can’t cook from scratch and many of us need ready meals which have the calories on the box.

Once you’re no longer seriously underweight and your eating has some semblance of ‘normality’, most people think that it’s all behind you. However, this is often not the case. 

Eating disorders in the context of a global pandemic are not easy. After a decade and a half of solid recovery from Anorexia nervosa, within days of the lockdown becoming inevitable I was under the duvet, barely eating and planning an exercise regimen to see me through being housebound. My appetite went AWOL due to anxiety and my weight started dropping.

Eating distress can often centre on issues of control  so finding ourselves in a situation where we are suddenly finding ourselves without the control over what food we can get hold of – and even allow into your home – can trigger more dangerous methods of control, methods we had once relinquished, such as the tyranny of the scales.

I felt really silly — I consider myself fully recovered from my ED. I never imagined I would be triggered like this. I started to speak out a little, expecting to be ridiculed. Many people do not know that I ever had an ED diagnosis. I suppose at some level I am ashamed of ever having had it at all. ED is a horrible illness that wrecked havoc in my life and seriously affected my family as well. I do not want a full-blown relapse. 

These issues are difficult to raise at a time when it is assumed that if you are in need of food help, ‘you will eat what you’re given’.

I think those feelings are heightened at a time of ‘we must be grateful for anything’ and there are sooo many people around us in dire circumstance

yes, and also related to feeling guilty about spending “badly” when income so reduced…sometimes feel my life is held together with bits of sticky tape (and this situation is pulling away some needed bits)

Mutual aid groups are doing brilliant work, but it’s not easy to say something like ‘I need 7-14 of these yogurts to live’ or whatever it is you need. So many issues – safe food no longer available, scarcity of food causing lots of ED. 

Thoughts and actions can get worse, getting used to having an empty stomach again because I can’t access the food I need which is a vicious cycle. 

And then there’s the impact of covid-19 on eating disorder services. 

For people who are at a clinically dangerous BMI some services have cut support or downgraded the BMI eligibility bar from 15 to 12. Some people can die at 15.

Have heard that eating disorder units are limiting admissions even more. You now have to be BMI 12 or under. People are dying because of this and it may not be listed as Coronavirus on the death certificate but it sure created the conditions to cause it.

Advice from members and followers who are dealing with eating distress at the moment.

  • Don’t beat yourself up for how triggered you are or how much you are struggling. This is the first global pandemic in our lifetimes. Give yourself time to freak out as you need to but keep this in check so that your ED cannot get a stronger hold on you. 
  • Speaking out about what you are struggling with helps. If you are ashamed to speak out publicly, discuss privately what problems you are facing and brainstorm solutions.
  • There is an enormous amount of exercise porn on the social medias, as if lockdown is an excuse for a fitness bootcamp. Acknowledge that this kind of messaging is not aimed at you right now and try to minimise exposure to it — unfollow unhelpful social media accounts, change the subject when talking to friends, figure out your own plan, check that out with friends, family or your treatment team and stick to that instead. Remember, Permitted Exercise takes place once per day! [Government guidelines at the time of writing.] 
  • Similarly there is a lot of productivity porn around. Cut yourself some slack. As someone said “The current era is crap enough without having to feel guilt that we aren’t learning Greek and painting watercolours of daffodils. If you brushed your teeth today and got showered and ate something and spent ten minutes not looking at the news then well done it’s an achievement.”
  • Keeping eating going is a priority, for all that your ED might tell you that it isn’t. Whether you’re finding it difficult to get hold of your safe foods, struggling to stick to a routine (like me), trying to work out how you can avoid binging when you cannot shop only for one day’s worth of food, or anything else, there will be solutions. ED loves rules. It’s time to make new ones, or adapt the old ones for these changing times. 
  •  Things will settle, they won’t be changing this fast for all time. Even if we are locked down for a while, the supply of foods will level out and new routines will be established. In the mean time it is about not getting worse for now. Reach out to your support networks both professional and informal and figure out what you can do today and this week. 
  • It is possible to buy nutritional shakes from Amazon (but it’s expensive) or ask your prescriber to prescribe them. They help me to reestablish a regular eating pattern without really thinking too hard; this might be an option for you, too.
  • Your ED makes you vulnerable to interruptions in the supply chain for foods. You need to work around this. Use family, friends and formal and informal support services as you find out how to keep your own nutrition going.
  • Accountability is an option. Make virtual lunch, snack or dinner dates and check in with each other. As the disability community, we owe it to each other to look out for each other. If you know your pal is struggling ask them how eating is going; respect each others’ boundaries though and back off if your pal would prefer not to talk about it for now.
  • Being underweight or undernourished will not be good for your immune system. Healthy immune systems are important. If you cannot eat for yourself, take care of your physical health for the sake of the rest of us. I’m not trying to guilt trip anyone but ED sits at the intersection of physical and mental health making us particularly vulnerable at this time. Hold onto your recovery, it is precious and a real asset in the fight against COVID-19. 

What has your experience been? Tell us on Twitter @RITB_ 

Useful links

An article by Radical Dietician, Lucy Aphromor Stress Eating is Life-Affirming and Can Help Us Cope in Troubled Times