The global COVID-19 pandemic has impacted all of us but some vulnerable populations are facing unique struggles as a result of social distancing and shelter-in-place orders. For individuals with an eating disorder during COVID-19, the current situation has created the perfect storm with disruptions to conventional treatment programming, a lack of structure and routine, mounting triggers as a result of messaging around food and fitness, frenzied grocery shopping behavior and ‘hoarding’ tendencies. Worst of all, young adults with an eating disorder are struggling with a loss of familiar connection and support. Isolation is rampant and eating disorders thrive best when there is social isolation.
Below, Dr. Amanda Fialk, Partner and Chief of Clinical Services at The Dorm, shares 9 concrete tips for young adults coping with an eating disorder during COVID-19 while at home.
1. Create Routines Whenever Possible
- People do better with structure but this is particularly important for anyone with an eating disorder during COVID-19. Create a routine that involves getting up, getting dressed, and doing something every day that feels productive. Routines should include mealtimes!
- Find activities that bring joy or develop a skill like learning a new language. Engaging in these activities is a way to prevent depression
- Try to incorporate as many activities from your “former” shelter in place life into your new routines (safely!). If there was something you were doing before, try and see if there is an online equivalent such as a virtual Broadway show, meetup groups, movies, museum tours, classes, etc.
2. Plan Your Meals with Your Dietitian
- An eating disorder recovery plan includes 3 meals a day and 2 to 3 snacks evenly spaced throughout the day; always have a general idea of what and when your next meal or snack will be
- Having a structure and a plan to prevent grazing will help you to regulate your hunger and satiety cues, reduce binge eating, avoid undereating, and manage your food supply
- Plan meals that are satisfying physically and emotionally
- Depriving yourself of adequate nutrition and enjoyable foods is not going to keep you safe from a virus
- Staying emotionally satisfied and nourished will help stabilize blood sugar levels, mood, and emotional coping
3. Try To Observe a Mindful/Intuitive Eating Approach (with the Guidance of a Professional!)
- Intuitive eating is a mindful nutritional philosophy and a journey of discovery around health and food that has nothing to do with diets or meal plans.
- Intuitive eating is about teaching a person to get in touch with their body through cues like hunger and fullness
- Make choices around and about food that feel good and do not encompass judgment or influence from diet culture
- Listen to your body’s own cues versus eternal “rules” or influences
- Intuitive eating promotes balance, health, and wellness.
4. For Those Struggling With Eating Disorder During COVID-19, Staying Connected Is More Important Than Ever
- Eating disorders thrive in isolation, so stay connected to a support system
- A supportive community is necessary to combat eating disordered behaviors which tend to persist and perpetuate when one is isolated
- Social distancing does NOT need to mean social isolation
- Don’t just text, Facetime and video chat
- Have a video meal with a friend
- Watch a virtual movie
- Play a virtual board game with a friend
- Most of all, remember that YOU ARE NOT ALONE!
5. Practice Self-Compassion and Self-care
- If you eat something you didn’t plan to, accept that it happened and
- Remember that you are not a failure!
- Don’t perpetuate the cycle by restricting; instead, get back on track with your next scheduled meal
- Having a toolkit of healthy coping skills can help you better manage the stress you feel
- Do some meditation or relaxation
- Take time to rest
- Be patient with yourself
- Try to get regular sleep
- Spend some time outdoors
6. Practice Mindfulness Skills
- When urges come up, use the five senses to help you stay connected to the moment
- What do I see/hear/smell/feel/taste right now?
- Tune in to what your body really needs
- Some find the skill “HALT the BS” helpful
- It helps you identify when you feel an urge to go to food and to ask yourself the questions: Am I “Hungry, Angry, Lonely, Tired, Bored or Stressed/Sad”?
- Once you identify the underlying feeling, you can move towards a coping skill that addresses the feeling versus the urge itself
7. Empower, Reframe, Radically Accept
- Rather than say “I cannot handle this, I am being exposed to my biggest trigger” say “I have support, I can handle this, this is an opportunity to confront a hurdle head-on”
- Radically accept feelings! It is ok to feel overwhelmed and anxious and afraid. This is unchartered territory for all of us
- Write down positive/grounding thoughts on a post-it and place it somewhere central in your living space or in a place that is likely to trigger more difficult moments, (kitchen, mirror, closet)
8. Take 1 Day at a Time, 1 Meal at a Time
- When life and recovery feel overwhelming it can help to take life one hour at a time, 1 day at a time, 1 meal at a time
- If you slip that is OK – don’t compensate
- There is no such thing as a perfect recovery or a perfect meal day
- We have to be ok with the grey
9. Get Help and Recognize that Online Resources and Online Therapy Can Work!
- If you’ve been putting off getting help or getting the right level of care for your eating disorder or are experiencing increased anxiety, now is a good time to reach out
- There are numerous therapists, dietitians and treatment centers providing services through telehealth
- EDA meetings are wonderful self-help and free resources
- If viewing your therapist, doctor, or dietitian over the computer is new to you, recognize that telehealth is appropriate for many populations and can be as effective as sessions delivered in person. It may just take a little adjustment