On Nutrition

To say that things have felt a little out of control for the past year or so is a bit of an understatement.

If you have a lot of inner resilience, you may be doing just fine, even in the face of pandemic fatigue. But many people are not doing fine. The effects of our lingering collective uncertainty may be especially harsh for people who struggle with disordered eating. Disordered eating may manifest as anything from restrictive dieting to stress/emotional eating to orthorexia (an unhealthy obsession with eating healthy) to clinical eating disorders such as anorexia, bulimia and binge eating.

It’s important to note that eating disorders aren’t just about food. They stem from many biological, psychological, social and cultural factors. And many people who struggle with eating disorders are also dealing with depression or anxiety — two conditions also on the rise during the pandemic.

Research on the impact of COVID-19 on eating disorders began almost as soon as COVID-19 did. A July 2020 article in the journal Eating Disorders warned that people with eating disorders would be disproportionately affected by quarantine. A study published in November in the International Journal of Eating Disorders that surveyed participants in the U.S. and the Netherlands found that many individuals with anorexia reported restricting their eating more, while those with bulimia and binge eating disorder reported more bingeing. The reasons included a sudden lack of structure to their days, social isolation, spending more time in a triggering environment, and anxiety about exercise. That’s something Seattle-area eating disorder professionals are seeing as well.

“I’m observing more people reaching out for treatment at this time because their old eating disorder behaviors are resurfacing,” said Seattle dietitian Kelly Martin, owner of Kelly Martin Nutrition Therapy. She said these behaviors were often a means of coping with past trauma, and the new collective trauma of the pandemic has brought them out again. “I am seeing more intense restriction and binge eating cycles since the pandemic started. People are struggling more with isolation and using food for a sense of control and comfort.”

“As a dietitian who has been on the clinical end of residential, partial hospitalization, intensive outpatient and outpatient levels of care for eating disorder treatment, there has been an undeniable rise of individuals seeking support for new or amplified eating disorders behaviors since March 2020,” said Seattle dietitian Tracey Kmiecik, owner of Humankind Nutrition. She said there are a number of triggering factors, including increased social isolation, inability to participate in activities that may have distracted from or masked eating disorder behaviors — such as sports being canceled — fear of going to the grocery store, elevated stress from being around roommates or family members constantly, and difficulty accessing healthful ways of coping.

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Eating disorders know no age boundaries, and adults, teens, adolescents and children alike may be struggling with new eating disorders or a resurgence or acceleration of preexisting eating disorders.

Lindsey Strandberg, a clinical dietitian at Eating Recovery Center in Bellevue, said her treatment center has seen a major increase in people seeking eating disorder care since the COVID-19 pandemic began, and has a growing waiting list for adolescent care — which is concerning because an eating disorder will likely worsen as someone waits for care. “Kids specifically have struggled with being isolated from not being in school, and many have had their eating disorders originate back in March 2020 when COVID-19 restrictions began,” she said.

Seattle dietitian Kailey Adkins, owner of Lavender Nutrition, primarily works with children and adolescents and said she’s seen not only an increase in numbers, but also in severity and speed of onset of eating disorders due to isolation and an increased need to have control. “I am seeing kids dive deeper into diet culture and internalize these messages at an alarming rate.”

Therapist Kerry Kirsch, owner of Ruah Counseling in Edmonds, said she’s seen a significant increase in adolescents and teens struggling with eating disorders as they struggle with heightened anxiety due to social isolation and stress. “The stress of the pandemic made it difficult for them to regulate their emotions and they turned to dieting, which quickly spiraled into an eating disorder,” she said, adding that in some cases, the eating disorders are so severe, they require hospitalization due to dangerously low weights and heart rates.

There can be a lot of shame around using food — or restriction of food — to cope, but all the eating disorder professionals I talked with pointed out that we’re doing the best we can right now, even if it doesn’t feel like we are.

“People with eating disorders often struggle when it comes to connecting with their own bodies’ wants and needs,” Martin said. “These behaviors are used as an attempt to regulate a person’s overly stressed nervous system, which feels like a sense of relief in the moment, but can cause significant harm long term. People do not choose to have an eating disorder, but I believe it is a choice to recover from an eating disorder. You are not alone, and support is more accessible now than ever through online platforms and telehealth.”

If you or someone you know is struggling with an eating disorder, you can contact the National Eating Disorders Association’s helpline by calling 800-931-2237. For crisis situations, you can text “NEDA” to 741-741  to connect to a trained volunteer at the Crisis Text Line.

Local eating disorder treatment centers

  • Opal: Food + Body Wisdom provides partial hospitalization, intensive outpatient and outpatient treatment for ages 18 and older in Seattle; opalfoodandbody.com
  • Center for Discovery provides residential treatment for adolescents and adults and partial hospitalization and intensive outpatient treatment for all ages via multiple locations; centerfordiscovery.com
  • Eating Recovery Center in Bellevue offers multiple levels of care for children, teens and adults; eatingrecoverycenter.com
  • The Emily Program offers partial hospitalization, intensive outpatient and other outpatient treatment services for adolescents and adults from their Seattle location; emilyprogram.com
  • Seattle Children’s Hospital offers all levels of care, including inpatient, for children, adolescents and teens; seattlechildrens.org/clinics/eating-disorders/