Social distancing is particularly hard on those with eating disorders, experts say

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When Lauren Rowello, a 29-year-old freelance writer based in Moorestown, N.J., developed COVID-19 symptoms—a fever and severe cough—in early March, she didn't know that the infection would also disrupt the balanced, healthy routine she had established after 15 years of struggling with an eating disorder.

Rowello also lost her sense of taste—a hallmark symptom of COVID-19—which made foods she normally enjoyed eating take on a sour, chemical-like flavor, making it hard for her to get through mealtimes without anxiety.

Though Rowello has recovered from pneumonia due to the coronavirus, she still is short of breath during extended periods of physical activity, which limits her workouts to walks, stretching, and yoga.

"That also impacts my relationship with food," she said. "I'm not moving as much as usual, in the ways I want to be moving, so it's overwhelming how much I'm putting into my body."

Many people are struggling with feeling a due to the coronavirus pandemic, but those emotions can be particularly hard on people with eating disorders, experts said. The increase of depression and anxiety from social distancing and isolation can exacerbate disordered eating behaviors.

The National Eating Disorders Association (NEDA), which estimates that as many as 30 million people in the United States have a clinically significant at one point in their lifetime, reported a 56% increase in use of its instant messaging service over the course of one week at the end of April.

Alyson Nerenberg, a psychologist practicing in Chestnut Hill, said eating disorders are ways of coping with feelings that are out of our control.

"The act of restricting your food is often the only thing someone with an eating disorder has control over," Nerenberg said. "We may be losing our jobs. Family members may be sick. There is a lot of loss right now, and that can feel really paralyzing."

Kristin Szostak, clinical director at the Renfrew Center of Philadelphia, a residential facility for treatment of eating disorders, said increased anxiety to sudden changes like the stay-at-home order, may "increase a person's vulnerability to developing an eating disorder or relapsing."

Nerenberg said she's especially concerned about patients who live alone. Eating disorders often cause people to avoid social commitments for fear of revealing their restrictive habits, she said.

"So much of this happens in secret," she said. "Right now, there's less accountability, more food from people buying excessively due to the fear of not having enough, and more isolation."

Szostak said some people may also struggle with reaching out to their for help because they're aware that everyone is stressed by the pandemic.

"Eating disorders can trick people into thinking they don't need to tell anyone, that they need to figure this out by themselves," she said. "That's really dangerous, because they can become medically compromising very quickly."

Szostak recommends that patients reach out for help as soon as they recognize unhealthy behaviors or thoughts. Professionals can help them establish routines and meal plans, and they can join support groups that meet virtually. She also said parents who suspect that their children may be developing eating should first reach out to professionals for help.

"A lot of emotions can be involved when you're that close to the situation," Szostak said. "If you bring in a professional to be a mediator throughout the process, the conversation may land differently."

Rowello's family has been an important source of support. When she is too anxious to prepare a meal, her spouse cooks instead. She's also had conversations with her children, who are 7 and 10, about why mealtimes can be stressful for her.

For example, after she recovered, Rowello struggled to find her comfort foods—staples that calmed her when things felt overwhelming and out of control—at grocery stores for weeks as shelves were emptied due to panic shopping.

"Zucchini is my number-one food, and I know how to make it a million ways. It's something I rely on a lot," she said. So when it was out of stock for a few weeks, her anxiety increased.

"It's helpful to have another human who knows what's going on with you, whether it's a support person online, a professional, or your spouse," Rowello said. "But at the end of the day, it's about being really gentle and patient with myself."

©2020 The Philadelphia Inquirer
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