Scarlett Parr-Reid investigates the impacts of a year of lockdowns on eating disorders and the lessons to be learned
A combination of social isolation, food instability and no face-to-face mental health support during the Covid-19 pandemic have created a slippery slope for those affected by eating disorders like nothing seen before.
Over the last year, urgent and routine referrals for NHS child and adolescent eating disorder services have almost doubled. With hospitality and retail open again and a gradual return to face-to-face appointments, the challenges faced by those affected by eating disorders are being exacerbated.
Learning from lived experiences
Abigail Rose, who’s 23 and from Southampton and is in recovery from an eating disorder said “it would have been helpful to have specialist information available for people with eating disorders in relation to Covid-19, such as what to do when you can’t get certain foods or how to deal with not being able to exercise”.
She adds “I was having to rely on charities such as Beat to give me help when, given that I was in a medical system, it should have been professional care teams giving me the help instead”. Beat is the UK’s leading eating disorders charity, providing helplines, support groups and resources to help those affected by eating disorders.
Abigail started a small business called BenessereGifts selling positive painted stones during the first lockdown to raise awareness about eating disorders. “I am so passionate about improving people’s wellbeing and realised that I could use my platform on Instagram and Etsy to educate people about eating disorders”, she reflected.
Social media and eating disorders
Annie Stevenson, who’s 24 and from Kent has been recovered for the last three years. She explains “I was more triggered being in the house and having fewer distractions. Increased social media use was a challenge because there is a lot of triggering content out there especially on platforms like TikTok and it always seems to find its way to you.”
In September 2020, TikTok announced that it would be improving its ad policies on weight loss and dieting products by banning adverts for fasting apps and weight loss supplements. This kind of content moderation is not enough, as videos such as weight loss routines and hacks are still out there, with users sharing them under misspelled hashtags such as #anoreaxia.
Because these videos are shown on TikTok feeds based on algorithms, you don’t even need to search for them to see them. This is worrying when harmful phrases like ‘lockdown weight’ and ‘summer bod’ are rife online. There are still helpful spaces on social media if you find them.
Annie adds, “reading self-help books, accessing body-positive accounts and mental health advocates on Instagram andYouTube and turning to friends and family really helped”. But she notes that she didn’t feel there was much choice and says, “it’s very difficult when you’re at a healthy BMI to get support, especially in a pandemic”.
New government calorie-labelling guidelines and eating disorders
Recently, the UK government announced its new obesity strategy to add calorie information on menus and food labels in restaurants from April 2022. The Beat charity surveyed 1,118 people currently or previously having struggled with eating disorders and found that 93 percent believed it would have a negative effect on them, such as relapse. 89 percent of participants said they don’t support the measure.
Abigail says “it would definitely not help to have calories on menus, as it perpetuates the emphasis on numbers and weight. I think they can be spending the same money on educating people about eating disorders”.
Seeing calories on menus exacerbates weight stigma, triggering food guilt and comparison to others’ eating habits. This can be psychologically damaging. The International Journal of Eating Disorders published a 2017 paper showing that of 719 female volunteers, those with anorexia ordered significantly fewer calories when labels were included on menus compared to when they were not. Those with binge eating disorders ordered substantially higher calorie food when labels were included compared to when they were not. There was not much difference in the number of calories ordered by those without eating disorders between the label and non-label groups.
A 2018 study in the Journal of the Academy of Nutrition and Dietetics looked at the effects of calorie labelling in restaurant menus on participants’ relationships with food. Of 1830 participants, over a third said they did not use it when choosing which food to order.
The weight loss industry generates $58 billion in revenue per year in the USA alone. Yet, there is no evidence to suggest that lowering caloric intake alone aids long-term weight loss in overweight or obese individuals.
Researchers at the Stanford University School of Medicine performed a study in 2018 involving 609 overweight volunteers, with half randomly placed on a low-carb diet and half on a low-fat diet, each without any calorie restriction. Over the year-long study, the average weight loss for the low-carb group was 13 pounds and for the low-fat group was 12 pounds. Whilst there were other factors at play here, the researchers found that neither genes nor the insulin hormone needed to curb blood sugar spikes were linked to the effects of the two diets on weight loss. Overall, the study suggests that this weight loss was achieved despite imposing no calorie restriction.
The future of eating disorder services requires prevention and accountability
Until now, services have mainly focused on spotting signs of eating disorders and signposting treatment services such as helplines. It’s time for prevention. Organisations like the National Centre for Eating Disorders in the UK are leading the way in adopting a whole school-wide approach with attention being directed to training staff, promoting emotional well-being and parental support.
Now that schools are open again, it is a vital opportunity to look closely at what can be done to tackle root causes of eating disorders, especially as the National Eating Disorders Association in the UK says its hotline experienced a 40 percent increase in the volume of calls during 2020 compared to 2019. From March 2020 to April 2021, almost three quarters of young people who gave their age on the hotline were 13-24 years old.
Eating disorders currently have the highest mortality rate of all mental health conditions. If the government are held fully accountable to the facts, prevention of eating disorders is possible.
Image credit: Pinterest
If you've been affected by any of the issues discussed in this article, please see the following links:
Beat eating disorders charity: https://www.beateatingdisorders.org.uk/
Young Minds advice and support for eating disorders: https://www.nationaleatingdisorders.org/
Mind eating disorder support: https://www.mind.org.uk/information-support/types-of-mental-health-problems/eating-problems/about-eating-problems/
Shout anonymous text services: https://giveusashout.org/get-help/?gclid=CjwKCAjwiLGGBhAqEiwAgq3q_tpTv9oz5Movkew2zLkzVFzMUIjW5J4TdYgJ4oZxCHnCYFjx6uWghBoCYu0QAvD_BwE
National Eating Disorders Association support services: https://www.nationaleatingdisorders.org/where-do-i-start-0
Preparing for your first GP appointment: https://www.blurtitout.org/2020/02/13/mental-illness-preparing-appointment/