Eating Disorders and the Pandemic

These stressful times are also causing more concerns about eating and body image. I answer listeners' questions, and discuss when it's necessary to get help.

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Episode Transcript

Speaker 1 (00:05):
These are challenging times, but you don't have to navigate
them alone. Welcome to How Can I Help? I'm Dr
Gale Saltz. I'm a clinical Associate Professor of psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,

(00:27):
hopefully with understanding, insight and advice. The current COVID nineteen
pandemic has created various situations that are likely to increase
eating disorder risks and symptoms, and also decrease factors that
protect against eating disorders, as well as creating barriers to

(00:48):
getting actual care. It's an urgent topic, and that's why
I'm devoting today's episode to a listener question related to
eating disorders. But first, here's some background. There are three
pathways which exist by which the pandemic may exacerbate an

(01:08):
eating disorder risk. One, the disruptions to daily routines and
constraints to outdoor activities can increase weight and shape concerns,
and they can negatively impact eating, exercise, and sleeping patterns,
which may in turn increase in eating disorder risk and

(01:30):
the symptoms. Also, the pandemic and all the social restrictions
that may deprive individuals of social support and healthy ways
of coping, which elevates the eating disorder risk and symptoms
by removing these protective factors. Two, Increased exposure to eating

(01:51):
disorders like specific or anxiety provoking media, as well as
much more video conferencing with other people where you're often
looking at yourself may increase your eating disorder risk and symptoms. Three.
Fears of contagion in general may increase eating disorder symptoms

(02:12):
specifically related to health concerns, for example, by pursuing a
restrictive diet focused on increasing immunity that can make you
more likely to experience an eating disorder. In addition, elevated
rates of stress and bad mood due to the pandemic
and social isolation can also contribute to increasing risk. The

(02:37):
National Association of Anorexia, Nervosa and Associated Disorders reports that
nearly twenty nine million Americans, nine of the population, will
have an eating disorder at some point during their lifetime,
and these complex psychological conditions are among the deadliest of
mental illnesses. Actually in the endemic, these numbers have only

(03:02):
gone up across all age groups because eating disorders are
made worse by trauma, and this pandemic is traumatic to
so many of us. This is likely why I've been
getting so many questions about weight gain, body appearance, food
and exercise. Today's question relates to this topic, So let's

(03:26):
get to it and see how can I help? How
can I help with Dr GAYL. Salts will be back
after this short break. Dear Doctor Saltz. I'm very conscious
about my health, but sometimes by myself getting stressed about

(03:49):
the number of calories I'm consuming and burning off. I
also have been weighing myself a lot more than I
used to. Am I being too obsessive? Well, the answer
is maybe anxieties about health can raise overall anxiety level.
When anxiety is up overall, for many people, this causes

(04:11):
them to obsess much more, to have one concern that
goes around and around in their head over and over.
Especially for a person who already in their lives at
some point felt concerned about weight, food intake, and body image.
This issue can easily return when anxiety is increased about

(04:32):
another topic and when times are generally very stressful. Well,
it's okay to be aware. Generally, speaking of eating in
a healthy way, and including how much and what type
of food you eat, And it's also okay to be
aware generally speaking of your weight and wishing to keep
it from going up. A lot where you raise a

(04:52):
red flag is in your saying you've suddenly increased the
frequency with which you weigh yourself, and you also know
a change and how concerned you feel you use the
word stressed about how many calories you take in and
how many you burn. Calories that you're counting can be

(05:12):
used as a device to maintain weight at a healthy place,
but stressing about calorie counting and calorie burning such that
you start thinking about how to restrict your calories and
how to burn more calories signals more anxiety about your
body and eating and controlling your calories and weight. This

(05:34):
distress is a frequent friend of eating disorders. Once you
start down the slope of so much checking, as in
checking your weight and checking what you eat and checking
how many calories you've burned, you're on the road to
the obsessive thoughts and compulsive behaviors that are a hallmark
of eating disorders. The earlier that you can step back

(05:57):
from this gravitational poll of an eating disorder, the better
your chances of not going farther and of recovering. I
would suggest limiting your way ins looking at the scale
more than once a week is actually unnecessary for weight
management and likely to be a symptom that gets positively
reinforced each time you do. In other words, you step

(06:19):
on the scale, you feel something relieved or not happy,
and make a plan of what you have to do
and in the moment that makes you feel better and
that keeps the worries front of mind. It positively reinforces
that obsessional thought. So scale back to once a week,

(06:41):
try to go back to avoiding calories in and out
and counting instead, go back to a generally healthy diet
and a generally healthy exercise plan. If you're having trouble
doing this on your own, you might unless someone you
trust who's close to you and tell what's been going
on and that you love some support to shop, for example,

(07:05):
for regular non deety food, to do some exercise that's
not overdone, to be able to talk about staying in
a zone of moderation. A friend can help you do that,
but it needs to be a friend that you feel
comfortable trusting and being vulnerable with Do address your overall
stress level, because if you can bring down your overall

(07:28):
stress and anxiety level, you'll have an easier time dialing
back this budding eating issue. If you do find yourself
unable to back off the path you're on on your
own or with the help of a friend, reach out
for an evaluation with a professional who treats eating disorders.
The earlier you have intervention, the more likely you are

(07:49):
able to dial back the symptoms. I hope that was helpful.
Eating disorders have not only been going up this year,
there been more new diagnosis of eating disorders and women
who did not have the issue earlier in their lives.
And eating disorder can take various forms. It can be restrictive.

(08:11):
You restrict what you take in even if you're very thin,
because you still see your body as overweight. Your body
image is distorted, and you make every effort to control
both your body and your food intake, no matter how
much it is or is not needed. This is called anorexia.

(08:31):
The question posed today sounds like the concern would fit
with anorexia nervosa possibly, but there are other types of
eating disorders that have also been increasing this year. Binge eating,
which is characterized by excessive eating beyond the point of
feeling full, and this is actually the most common of

(08:52):
all eating disorders in the United States. And then there
is Bolivia nervosa, which begins with binging or over eating
a lot of food very quickly, but followed by purging,
which is some method of quickly getting rid of the
food that you just ate. Through vomiting, through laxative abuse,
or even through over exercising. People suffering from bulimia and

(09:17):
be either underweight, a healthy weight, or overweight. No matter
which eating disorder a person is struggling with, early treatment
makes all three more treatable. Do you have a problem
I can help with? If so, email me at how
Can I Help at Seneca women dot com. All senders

(09:39):
remain anonymous and listen every Friday to how can I
Help with Me? Dr Gale Salts