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Eating disorders ‘risen considerably’ during the pandemic: An expert has spoken of a significant increase in eating disorder referrals – and explained how focusing on food and weight, by over-eating or restricting food intake, can be seen by those with eating disorders as a way to “cope” with the pandemic.
Dr Lorna Richards cited a number of factors for the rise in eating disorders including “fear and uncertainty, fuelling anxiety symptoms”, a feeling of not being in control, social isolation, and changes to people’s routine and home lives.
“There has also been widespread concern (among the general population) about lack of physical activity, and about weight gain during periods of lockdown, which has seen the nation both dieting, and exercising, en masse,” she said.
“Eating disorders have thrived in this environment, as the focus on eating and weight control becomes a way of coping.”
She says that for some people, focusing on food, either by restricting, over-eating or using other weight control measures such as purging and over-exercising, can be used as a way of “coping”, and provide “a sense of control or mastery”.
As the pandemic took hold last year, Priory Group, the mental health providers, saw a 61% increase in the number of enquiries it received about treatment for anorexia nervosa at its private clinics, and a rise of more than a quarter (26%) in the number of enquiries it received regarding treatment for binge eating disorder.
Dr Richards specialises in adult eating disorders at Priory’s Woking Hospital and Priory’s Life Works centre and has been involved in the development of NHS national guidelines and policy around eating disorders.
She said: “Since the early summer of 2020, I have seen a huge increase in referrals from people with pre-existing disorders who have deteriorated since the pandemic emerged.
“I have also seen an increase in new patients – specifically people, who, during the first lockdown, were starting to develop eating disorders for the first time. For those who are vulnerable to developing a disorder, there have just been too many challenges – and they are ongoing.”
What exactly is an eating disorder?
Dr Richards says: “We all need a degree of certainty and security, and the more things that are uncertain to us or feel unsafe, the more we feel a need to ‘control’. We do it in different ways. Some might be more obsessionally tidy, or ‘helicopter’ around their children, or try to maintain control in relationships or the workplace.
“Those with eating disorders turn to controlling their diet or using food in unhealthy ways like binge eating, purging or exercising. It can provide a structure, routine and focus for the day, as well as a distraction from anxious thoughts.”
She said shopping habits had also changed, with families doing large online shops, and this had an impact. “For someone with binge eating disorder this can feel overwhelming and increase the likelihood of binge episodes.”
Dr Richards added: “Binge eating disorder affects adults of both genders. Bingeing means eating an objectively excessive amount of food and there is an element of compulsion to it, so you feel like you can’t control yourself.
“There are two key triggers; when people are restricting their intake in an attempt to lose weight, this triggers a hunger response with an increased risk of overeating when food becomes available.
“The other trigger is psychological; people may binge eat to manage difficult emotions or indeed to numb them. When people are planning a binge, it can be a distraction from other things that are going on. It is usually done in secret and there is a huge amount of shame, with people believing that others judge them as greedy and lacking all self-control. The shame that everyone with an eating disorder feels often prevents them from accessing help.”
Dr Richards’ advice:
- Anyone who notices that they are focusing more on eating and weight, whose eating habits or weight have changed or is concerned in any way, should reach out for help
- Children, young people and adults can consult the Beat charity‘s website and local support groups, and should speak with their GP who may refer them for online therapy
- Eating disorders are serious illnesses and can lead to significant problems with physical and mental health as well as relationships, and the ability to study or work
- The longer a person leaves it, the more entrenched the eating disordered way of thinking and behaving becomes, and it is harder to make changes – and they are less likely to fully recover.