'Peculiarities of the pandemic' are trigger points for eating disorders

A Western Sydney University mental health expert has shed light on the ongoing, traumatic effects of COVID-19 for people living with eating disorders.

Professor Phillipa Hay is Chair of Mental Health within the University's Translational Health Research Institute (THRI) and School of Medicine.

In a recent edition of the Journal of Eating Disorders, Professor Hay has written about how the "peculiarities of COVID-19" can be particularly damaging for people with anorexia nervosa, bulimia nervosa, and binge eating disorder.

"People with eating disorders have a complex problematic relationship with food, and often have very rigid and inflexible eating behaviours," said Professor Hay.

"If the supermarket shelves are bare—and anorexia nervosa sufferers do not have access to certain accepted types of food, or specific brands—the impact can be significant."

Professor Hay said social connectedness is integral for mental health. For anorexia nervosa sufferers—who are already feeling isolated, both emotionally and physically—physical and social distancing can also profoundly affect their wellbeing.

"For people with anorexia nervosa, the mantra around the globe of 'staying at home' may trigger elevated feelings of uncertainty, anxiety and panic. They will be feeling even more isolated, which will likely lead to feelings of immense uncertainty and sadness," she said.

Professor Hay said being at home for 24 hours a day seven days per week, can also have significant implications for people with bulimia nervosa and binge eating disorder—as there is no escape from distancing oneself from food at home, and there are limited opportunities to leave home to buy food.

"For some, overall insecurity around the availability of food may trigger destructive hoarding behaviours. In others, bingeing on food when restocking is problematic and may lead to heightened family conflict as well as self-harm and depression.

"Then there's the effect of having a more sedentary lifestyle. For people with eating disorders, any interrupting to their exercise or other lifestyle routines, and any fluctuations in weight or self-care, can have significant consequences."

Professor Hay said the COVID-19 restrictions have meant that ongoing treatment programs for many people have been impacted—with group sessions cancelled, and face-to-face programmes turning to video conference or telehealth sessions.

"For many people, such significant changes to their regular treatment regime can be very unsettling, and can significantly impact their recovery," she said.

"We know that people are lapsing, and relapsing. While we are getting through as best we can, the telehealth sessions are not a good replacement for in-person sessions for many people. These services need to re-open as soon as possible, so that people can once again work toward their recovery."