The hard thing about determining what exactly the era of Covid-19 has done to us is that we are still very much in the era of Covid-19. Though the darkest days of quarantine are behind us and vaccines have sharply reduced our risk, we still live in a world that is in many ways being shaped by the pandemic. It is foolish to think we could go through something so life altering without a few scars.
For many of us, impact is tangible – a lost loved one or an opportunity lost to the ravages of lockdown. For others, the lasting trauma isn’t quite as visible. Mental and emotional health battles. Old demons like a dependence on drugs or alcohol given new levels of fight during the long days stuck inside. And for unprecedented millions of young people, a battle with eating disorders.
In April of 2021, the National Eating Disorders Association helpline recorded a 40 percent jump in call volume over the previous year Among callers who gave their age, 35 percent were teenagers — a five percent increase from pre-pandemic numbers. The New York Times reported that University of California, San Francisco’s eating disorders center was seeing twice as many adolescent patients as they had before the pandemic, with a six-month wait on outpatient services.
A clutch of studies in 2021 made similar findings, with the Centers for Disease Control and Prevention finding that the number of teenage women who went to the emergency room because of an eating disorder doubled from pre-pandemic times.
But in this, like in so many things, it seems the pandemic exacerbated a pre-existing issue instead of creating a new one. Eating disorders were already on the rise before the pandemic, climbing by over 119 percent among American children in less than a decade. And the enormous and worrying pandemic surge finally provided experts with the opportunity to see that something is deeply wrong, and the motivation to figure out what to do about it.
For all their prevalence, eating disorders are poorly understood. Most people give at least some thought to their weight, but Kathy Katella tells Yale Medicine that “for those with an eating disorder, however — a category that can include people of all shapes and sizes — their relationship with food, weight and body image is all-consuming and destructive to their health and the quality of their lives.”
Eating disorders can be fueled by any number of factors. Research shows that things like bullying, pressure to excel in school and feelings of ostracization can all kickstart an eating disorder. Recent data has confirmed a long-assumed link between social media use and things like poor body image and unhealthy diet culture. Studies also suggest that people experiencing food insecurity may develop an eating disorder.
Some of this might help explain the pandemic rise in eating disorders. Teenagers stuck at home, spending even more time on TikTok and Instagram than they were the pre-pandemic days got exposed to an ever increasing amount of messages about the ways in which their bodies don’t measure up, and develop an unhealthy relationship with food. Likewise, many families experienced new levels of financial insecurity, which in turn may have fueled a rise in existing eating disorders.
But quite possibly the largest contributor was a general loss of norms. For people suffering from any sort of mental and emotional illness, structure and stability is one of the strongest tools in their arsenal to keep it at bay. But Covid robbed the entire planet of such safeguards, removing a safety net many of us didn’t even know we were depending on.
“Eating disorders can develop at anytime,” Dr. Allison Chase, an eating disorder specialist and clinical psychologist with Eating Recovery Center, told Healthline. “When you add Covid-19 stress and uncertainty to the mix, the combination can be disastrous.”
Experts say that the surge in eating disorders has shown no sign of slowing, even as the pandemic has died down from its darkest days. It’s easier for an eating disorder to flare up than for it to turn back down, and just because the instigating circumstances go away doesn’t mean the lingering trauma automatically disappears. That is to say, the pandemic created a lot of new normals for everyone, and there is a very real possibility that a heightened number of young people dealing with an eating disorder is one of them.
Especially since so few of them ever seek help.
Much of the data we have about the rise in eating disorders comes from those who seek help, either because they’ve reached a crisis point, had a medical emergency or were convinced to reach out by friends or family. But experts know very few people with eating disorders actually reach out.
Researchers from Yale and the University at Albany crunched the 2012-13 National Epidemiologic Survey on Alcohol and Related Conditions numbers and found very few people ever seek help for eating disorders. Among the some 36,000 respondents to the survey with an eating disorder, fewer than half were attempting to get help for it. And those numbers were especially low among racial minorities and a new but growing demographic experiencing a rise in eating disorders: young men.
Eating disorders thrive in isolation. That type of isolation was easy to find during the pandemic, but there are a lot of ways to remain lonely even after lockdown ends and for many Americans, the WFH lifestyle has contributed to a lack of real life friends nearby who may notice that something is amiss.
And even friends who are close by may not always know what someone suffering from an eating disorder is going through. For many of us, our idea of someone with an eating disorder is a young, too-skinny girl with a ribcage visible through her T-shirt.
The fact is, eating disorders do not know age, gender or body type. Eating disorders have less to do with what food makes you look like and more to do with your relationship to food.
“Many adults report a range of disordered eating including behaviors such as binge eating, intrusive and distressing thoughts about eating, weight, or shape, and body image concerns,” Valentina Ivezaj, PhD, told Yale Medicine.
To turn this troubling trend around, many of us are going to have to unlearn some bad info on what eating disorders are and learn how to step in for our loved ones dealing with it.
A person who suddenly becomes far more furtive about food or secretive about when or what they last ate may be experiencing the beginnings of an eating disorder. Things like avoiding whole categories of food altogether or obsessively hoarding it can be signs that something is brewing.
This can look different for young men, who tend to talk about it less in terms of “getting healthy” and more in terms of “getting fit” or “getting in shape.” This might sound better on the surface, but it often comes paired with a very unhealthy obsession with calorie counting and carb avoidance that will do damage in the long run, both to their bodies and to their overall mental health.
The most important thing you can do for a friend with an eating disorder is provide them with support.
Eating disorders are often a manifestation of insecurity, anxiety and isolation, and while friendship alone won’t always be enough to provide those things, they can be a source of comfort when everything else is spiraling.