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April 8, 2020
“I was in and out of treatment for disordered eating through high school and college,” she said. “I thought I had put it behind me, but in the past few years it started to come back.” A champion obstacle racer and endurance athlete, Boone said that the reemergence of her eating issues caused her “body to break down” and kept her from competing. “So, about a year ago, I entered a three-month day program,” Boone said. “I was discharged in June of last year, and I’d been doing well.”
However, with the COVID-19 crisis, Boone’s old issues started to come back. “I have a long history with OCD that predates my eating disorder, and with the pandemic, it started to flare up,” she said.
Moreover, the official COVID-19 guidance on physical distancing has thrown off her treatment routine. For example, to deal with her eating issues, Boone tries to keep an abundance of food at home, makes sure she eats out often, and aims to dine with groups of people rather than alone. “But now we’re told that these are things we can’t or shouldn’t do,” said Boone. “I’m fearful that the progress I made through recovery may be limited because I don’t have more options.”
According to Holly S. Peek, MD, MPH, Boone’s concerns are not uncommon. Peek, the assistant medical director at McLean’s Klarman Eating Disorders Center, said that although every eating disorder is different, “a lot of people with disordered eating issues struggle with changes in routine and structure because structure and routine are central to their treatment.”
In addition, Peek explained, changes caused by the pandemic may exacerbate other issues facing people with eating disorders. “In most cases, eating disorders don’t exist in a vacuum,” she said. “There is the likelihood of coexisting conditions like depression, anxiety, and OCD with disordered eating, and increased stress and social isolation may lead to increases in this coexistence.”
Peek offered strategies to keep those with eating issues on track during the coronavirus pandemic. “If you are at home and your routines have been disrupted, it’s time to create a new routine and plan appropriately,” she said. “For example, for someone who is struggling with not being able to go out to restaurants or go to the grocery store regularly, it’s time to think outside of the box and come up with a new structure that might work.”
She recommended planning to go to the grocery store only once or twice a week and thinking ahead for what they can get—or looking into what area restaurants are offering takeout or delivery and planning meals around those options.
Peek also suggested using online resources that promote healthy eating routines and provide emotional support. “I’ve noticed an increase in free virtual supports, such as supportive meals on Instagram Live, online advice from nutritionists, and free virtual support groups,” she said. Peek pointed out that many helpful online resources, including virtual drop-in groups and meal and snack support, can be found on the Multi-Service Eating Disorders Association (MEDA) website.
Online support and new routines are some of the strategies that Boone is using to cope with her eating issues during the pandemic. “I’ve been heavily relying on my support system and trying to avoid isolation,” she said. She has been logging in to FaceTime and Zoom for virtual meals and for staying connected to family, friends, and her treatment team. In addition, Boone is “ordering more takeout and delivery to keep my food repertoire expanded so I don’t restrict.”
By adjusting to the new realities of the COVID-19 pandemic, Boone has been reminded that coping with disordered eating is an ongoing process—a process that requires occasional adjustments and constant vigilance.
“I’m trying to reframe this time to show me where I still need to work in recovery and not get complacent,” Boone said. “Even though the world has changed, there are still things I need to work on.”
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