Eating Disorders and COVID-19: The Perfect Storm

According to Jennifer Lombardi, a certified eating disorder specialist and the manager of behavioral health for the Kaiser Permanente Sacramento Medical Center, “The Covid-19 pandemic has created what’s considered to be the perfect storm of high-risk factors for eating disorders.” The main issue lies in eating disorders on the rise because they thrive on secrecy. “During the pandemic, when people are fearful, stressed, and disconnected from others; it’s challenging for them to use healthy coping mechanisms.”

Overall, the above-mentioned link between covid and eating disorders is referencing what ultimately led to an increase in eating disorders such as bulimia, binge eating disorder, and/or anorexia. One of the eating disorder studies indicated that the hospitalizations for eating disorders had doubled alone in 2020. The full impact of the Covid-19 pandemic on various individuals’ healthy eating habits might not fully be discovered in completion for some time. 

What Is an Eating Disorder?

An eating disorder is considered a very serious and complex mental illness. It can be life-threatening if not addressed as soon as possible. They aren’t a lifestyle choice or a diet that has gone too far. It is often characterized by disturbances in thoughts, behaviors, eating, attitudes towards food, and body weight or shape. 

It’s important to understand that eating disorders have extremely harmful impacts on a person’s life and can result in consequences. Generally, the consequences of eating disorders on the rise are psychosocial, medical, and psychiatric. Eating disorders are considered super common and are increasing in prevalence. 

The lifetime prevalence is an estimation at 8.4% for women and 2.2% for men. About 9% of the U.S. population, or 28.8 million Americans will have an eating disorder in their life. Roughly 10,200 deaths per year are a direct result of an eating disorder, which adds up to 1 death every 52 minutes. 

Types of Eating Disorders

Anorexia Nervosa

This is a condition in which individuals avoid food, eat very small quantities of food, or severely restrict their food. They might also weigh themselves repeatedly. When these individuals are dangerously underweight, they might see themselves as overweight. 

There are two subtypes of this eating disorder: a binge-purge and restrictive subtype. A restrictive subtype of anorexia nervosa is individuals who severely limit the type of food and the amount of food they consume. Individuals with a binge-purge subtype of anorexia nervosa also greatly restrict the type of food and the amount of food they consume. 

In addition to the above-mentioned action, those with anorexia nervosa binge-purge subtype experience binge-eating and purging episodes. This means they will eat large amounts of food in a short period. It is then followed by vomiting or even using laxatives or diuretics to eliminate all that was just consumed. 

It’s important to understand that anorexia nervosa can be fatal. It has an extremely high mortality rate compared with other mental disorders. Individuals with anorexia nervosa are at a high risk of dying from the medical complications that are associated with starvation. Suicide is considered the second leading cause of death for individuals diagnosed with anorexia nervosa. 

Bulimia Nervosa

This condition is when individuals experience frequent and recurrent episodes of eating an oddly large amount of food and then feeling a lack of control over these episodes. The binge eating episode is then followed by behavior that makes up for overeating such as excessive use of laxatives and diuretics, forced vomiting, excessive exercise, fasting, or a combination of these behaviors. Individuals with this disorder might be normal weight, overweight, or slightly underweight. 

Binge-Eating Disorder

Binge-eating disorder is a condition where individuals lose control over their eating and experience reoccurring episodes of eating oddly large amounts of food. Unlike bulimia nervosa, the periods of binge-eating aren’t followed by excessive exercise, fasting, or purging. As a consequence, individuals with binge-eating disorders are often obese or overweight. This is considered the most common eating disorder in the U.S. 

Avoidant Restrictive Food Intake Disorder

The avoidant restrictive food intake disorder, also known as (ARFID), which was previously known as a selective eating disorder, is a condition in which individuals limit the type or the amount of food eaten. Unlike anorexia nervosa, individuals with ARFID, do not have an extreme fear of gaining weight or a distorted body image. This condition is the most common in middle childhood and generally has an earlier onset than various other eating disorders.

Many children go through phases of picky eating, but a child with ARFID doesn’t consume enough calories needed to develop and grow properly. An adult with ARFID doesn’t eat enough calories needed to maintain basic body function. 

COVID-19 and eating disorder

Signs and Symptoms of Eating Disorders

Symptoms of Anorexia Nervosa

  • A distorted body image, a self-esteem that is heavily influenced by the perceptions of shape and body weight, or being in denial of the seriousness of low body weight 
  • Having a relentless pursuit of thinness and an unwillingness to maintain a healthy or normal weight
  • Extreme thinness or emaciation 
  • Intense fear of gaining weight
  • Extremely restricted eating

Symptoms of Anorexia Nervosa That Can Develop Gradually

  • A drop in internal body temperature, causing the individual to feel cold all of the time
  • Sluggishness, lethargy, or feeling tired all of the time
  • Thinning of the bones (osteoporosis or osteopenia)
  • Damage to the structure and function of the heart
  • Growth of fine hair all over the body, (lanugo)
  • Mild anemia and muscle wasting/weakness
  • Slowed pulse and breathing
  • Yellowish and dry skin
  • Low blood pressure
  • Brittle nails and hair
  • Severe constipation
  • Multiorgan failure
  • Brain damage
  • Infertility

Symptoms of Bulimia Nervosa

  • Electrolyte imbalance (too high or too low levels of calcium, potassium, sodium, and other minerals) can lead to heart attack or stroke
  • Worn tooth enamel and increasingly decaying or sensitive teeth as a result of exposure to stomach acid
  • Acid reflux disorder and other gastrointestinal issues
  • Intestinal irritation and distress from laxative abuse
  • Swollen salivary glands in the jaw and neck area
  • Severe dehydration from purging of fluids
  • Chronically inflamed sore throat

Symptoms of Binge-Eating Disorder

  • Eating unusually large amounts of food in a certain amount of time in a 2 hr period
  • Feeling ashamed, distressed, and/or guilty about your eating habits
  • Eating alone or in secret to avoid embarrassment
  • Eating even when you are full or not hungry
  • Frequently dieting, without weight loss
  • Eating until you are uncomfortably full
  • Eating fast during your binge episodes

Symptoms of Avoidant Restrictive Food Intake Disorder

  • Limited range of preferred foods that becomes even more limited than it is (“picky eating” starts to get progressively worse)
  • Abdominal pain, upset stomach, or other gastrointestinal issues without a known cause
  • Dramatic restriction of amount or types of foods eaten
  • Lack of interest or appetite in food
  • Dramatic weight loss 

Risk Factors of Eating Disorders

There are various risk factors for eating disorders. Eating disorders can affect individuals of all racial/ethnic backgrounds, body weights, ages, and genders. Frequently, eating disorders appear during the teen years or even young adulthood.

Eating disorders can also occur during childhood or later in an individual’s life. Researchers have dived further into eating disorders studies and discovered that they are caused by a complex interaction of biological, psychological, social, behavioral, and genetic factors. Utilizing the latest science and technology to better understand eating disorders, it’ll make a world of difference in the future. 

There is one approach that involves the overall study of human genes. Eating disorders are known to run in families. Researchers are working on identifying DNA variations that are linked to the overall increased risk of developing eating disorders. 

Also, brain imaging studies are providing a more concrete understanding of eating disorders. For example, the researchers have discovered differences in the patterns of brain activity in women with eating disorders compared to healthier women. This type of research can assist in guiding the development of new means of treatment and diagnosis of eating disorders. 

Often, obesity is cited as a risk factor for individuals with severe COVID disease and poor outcomes even in younger individuals. Overall, this news could have triggered disordered eating patterns in more vulnerable people. According to the study published by JAMA Network, it was revealed that the number of hospitalizations for eating disorders including bulimia, anorexia, and binge-eating disorders, among others, dramatically increased during the pandemic. 

According to Dr. Kelly Allison, who is one of the researchers on the study and the director of the Center for Weight and Eating Disorders at the Perelman School of Medicine at the University of Pennsylvania, the overall results suggest the following: “that disordered eating became more severe in disorders of extreme restriction, as well as in those with loss of control eating.” What’s even more troubling than that statement is that the average age of patients has also decreased over time. 

Eating disorders are considered among the deadliest mental illnesses among individuals, and it’s the second only to opioid overdose. To paint an even clearer picture of the seriousness of eating disorders, about 26% of individuals with eating disorders attempt suicide. Lastly, the total economic cost of eating disorders is $64.7 billion every year.

Learn More About the Relationship Between Covid and Eating Disorders

In today’s blog, the overall relationship between covid and eating disorders should have been thoroughly explained, along with eating disorder studies. Eating disorders on the rise are an extremely serious concern to be addressed. Here at Discovery Institute, we understand the importance of seeking treatment early for mental health disorders. 

Mental disorders such as anxiety and depression stem from something: whether that is trauma, abuse, unemployment, familial relationships, eating disorders, or other personal issues. Complete recovery is possible with one of our facilities. Let’s get started today on the journey.

Reviewed for Medical & Clinical Accuracy by Dr. Jeffrey Berman, MD

Dr. Jeffrey Berman is a psychiatrist in Teaneck, New Jersey and is affiliated with Robert Wood Johnson University Hospital. He received his medical degree from State University of New York Upstate Medical University and has been in practice for more than 20 years. He also speaks multiple languages, including French and Hebrew.