Introduction
The prevalence of eating disorders worldwide, as well as the negative physical and emotional outcomes correlating with conditions such as anorexia and bulimia, exemplifies a major challenge that affects numerous individuals. Eating disorders (EDs) can also be exacerbated as a result of the external environment. Currently, such disruptions are often correlating with parental conflicts, peer pressure, and school problems. Nonetheless, the recent experience with COVID-19 and subsequent changes have highlighted how state and country-level regulations, as well as health risks, can affect people with eating disorders. It is essential to consider the restrictions that have impacted individuals, such as isolation measures, the closing of schools and businesses, and the lack of opportunities for interactions. It has negatively impacted a variety of individuals but had a particularly negative effect on people with the aforementioned conditions. In this paper, the correlation between COVID-19 and EDs will be assessed through the exemplification of increases in cases, lack of healthcare access, lifestyle disruptions, and a lack of peer interactions.
ED Rate Increase
As mentioned previously, external factors do, indeed, correlate with risk maximization or reduction in the rate of eating disorders. A similar effect was observed during the COVID-19 pandemic. Namely, researchers mention an increase of more than 15% in ED cases (Zipfel et al., 2022). The challenge was primarily observed in adolescent girls with anorexia nervosa. Several potential triggers can be highlighted concerning the phenomenon. On the one hand, the government restrictions, which have led to a remote education process, may have maximized the focus on nutrition. Thus, without potential distractions, people who were already suffering from Eds and were in remission or have had mind symptoms without fully experiencing the conditions were more triggered by the change in their external environment. The fact that individuals with anorexia nervosa were most effective highlights the severity of the pattern in ED rate increase during COVID-19. Namely, anorexia is the condition most frequently referred to as a disorder linked to a high mortality rate, namely due to health problems, which are especially common among anorexia patients who purge (Mehler et al., 2022). As a result, it can be highlighted that COVID-19 negatively affected individuals with eating disorders and has facilitated an increase in negative health outcomes, especially when it comes to patients with anorexia.
Lack of Healthcare Access
The COVID-19 pandemic has caused major disruptions in many areas of life. Namely, schools have switched to a remote system, and multiple non-essential businesses have closed. Nonetheless, it is essential to acknowledge the burden the lockdown has had on the healthcare sector as a whole. The medical establishment was under major pressure to combat the negative consequences of the pandemic, which means that conditions other than COVID-19 have become less of a concern. However, the phenomenon has adversely impacted individuals with eating disorders who were unable to access the services and treatment they required to manage their conditions. Researchers highlight that while ED patients were more likely to access support from family members and partners, relationships with their nutritionists, therapists, and other medical personnel directly associated with their recovery were minimized (Haghshomar et al., 2022). This may correlate with the focus on telemedicine and the negative correlations that followed. As eating disorders are often perceived as shameful by those who have them, sharing experiences and symptoms and seeking advice via phone communication were perceived as less effective and ethical. As a result, people were less likely to address their disorders and more likely to suffer from the negative consequences of being isolated and not having the resources to combat their symptoms.
Family Support
While correlating with negative aspects, stay-at-home orders also had a positive influence in certain regards. Namely, as mentioned previously, individuals with ED were more likely to receive support from their family members and partners, especially because they were enclosed in the same area for a long time (Haghshomar et al., 2022). For example, parents who would otherwise be at work had the opportunity to monitor their children’s food intake and ensure they were not showing signs of binging or restricting. A similar effect has happened concerning monitoring the progress of recovery. Individuals with ED were able to receive assistance from loved ones through moral support and encouragement to continue their healthy journey and avoid potential relapses.
Lifestyle Disruptions
Lifestyle disruptions occurred for most people during the COVID-19 stay-at-home order. Namely, as businesses and schools closed, people were operating remotely both in terms of their jobs and education. This majorly affected individuals with eating disorders as their lifestyles changed drastically without time to adapt to the alterations. For example, researchers mention that limited physical activities worsened self-perception (Miniati et al., 2021). Namely, the fact that gyms were closed resulted in disturbances in how people viewed themselves, which was especially critical for people with EDs. Since body dysmorphia is often a condition that aligns with eating disorders, the lack of opportunities to exercise adversely affects it. The same argument can be associated with the closing of restaurants and limited food access. Individuals with ED were not able to have the same lifestyle in regards to their preferred places where they eat, which is why worsening of the disorders may have occurred. Lifestyle disruptions, despite the direct effects such as limited food options and a lack of physical exercise opportunities, indirectly impacted people with eating disorders (Gao et al., 2022). Psychological well-being is minimized when an individual is put under stressful circumstances outside of one’s comfort zone
Lack of Peer Interactions
Based on the aforementioned phenomena, such as the closing of schools and businesses, social interactions were minimized. This affected individuals with eating disorders in two ways. On the one hand, adolescents with EDs specifically lost the factor of peer-to-peer comparison that may have triggered their eating disorder (Feinmann, 2021). These factors may also be associated with a positive implication as the lack of need for comparison could positively affect self-perception. However, on the other hand, people were more likely to emerge in social media due to the lack of in-person communication. As a result, unrealistic portrayals could generate more adverse outcomes for individuals with a distorted self-perception. Lack of peer interaction also had contrasting outcomes regarding its impact. On the one hand, individuals were more likely to avoid potential negative comments concerning their appearance, which often triggers EDs. However, another effect is the lack of additional support in case friends, classmates, and peers were supporting with one’s recovery.
Recommendations
The current literature, as highlighted previously, recognizes that the positive aspects of the COVID-19 lockdown impact on individuals with ED include maximization of family support and a lack of peer-to-peer comparison. On the other hand, lifestyle disruptions, lack of regular access to food, social media influence, and inability to access healthcare services have been highlighted as negative. Thus, the aspects are to be considered concerning potential recommendations. As mentioned previously, people with eating disorders were unable to access the healthcare resources they used to (Haghshomar et al., 2022). Thus, addressing the issue through the establishment of more accessible online platforms for patients to communicate with physicians concerning their eating disorders can address the barrier. Another aspect was the increased time people spent on social media, which can be addressed through monitoring. This intervention can be applied to parents and their approach to how minors are influenced by unrealistic body standards that trigger body dysmorphia and eating disorders. Such recommendations can be applied in case other health crises occur and lead to government restrictions.
Conclusion
COVID-19 and the stay-at-home order had a major impact on most people, but it is especially important to recognize its effects on individuals with eating disorders. Current literature highlights the major barriers correlating with disruptions in lifestyles, limited access to food, lack of peer support, limited health service provision, and increased use of social media. On the other hand, a lack of negative peer-to-peer comparisons as well as family support was mentioned as a positive aspect. For the care for ED patients to be maximized, it is vital to address the aforementioned challenges through monitoring of social media use as well as the establishment of more effective telemedicine measures. As a result, people who have eating disorders would be more likely to reach and maintain recovery from their conditions.
References
Feinmann, J. (2021). Eating disorders during the COVID-19 pandemic. BMJ. Web.
Gao, Y., Bagheri, N., & Furuya-Kanamori, L. (2022). Has the COVID-19 pandemic lockdown worsened eating disorder symptoms among patients with eating disorders? A systematic review. Journal of Public Health, 30(11), 2743–2752. Web.
Haghshomar, M., Shobeiri, P., Brand, S., Rossell, S. L., Akhavan Malayeri, A., & Rezaei, N. (2022). Changes of symptoms of eating disorders (ed) and their related psychological health issues during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Eating Disorders, 10(1). Web.
Mehler, P. S., Watters, A., Joiner, T., & Krantz, M. J. (2022). What accounts for the high mortality of anorexia nervosa?International Journal of Eating Disorders, 55(5), 633–636. Web.
Miniati, M., Marzetti, F., Palagini, L., Marazziti, D., Orrù, G., Conversano, C., & Gemignani, A. (2021). Eating disorders spectrum during the COVID pandemic: A systematic review. Frontiers in Psychology, 12. Web.
Zipfel, S., Schmidt, U., & Giel, K. E. (2022). The hidden burden of eating disorders during the COVID-19 pandemic. The Lancet Psychiatry, 9(1), 9–11. Web.