obtain foods that fit their meal plans.
“While no one knows for sure what
causes eating disorders, a growing
consensus suggests that [they result
from] a range of biological, psycho-
logical and sociocultural factors,”
says Claire Mysko, CEO of the
National Eating Disorders Associa-
tion, who was not involved in the
study. She notes that many of those
who struggle with these disorders
have a co-occurring condition, such
as anxiety or depression.
The paper’s senior author Cynthia M.
Bulik of the University of North Caro-
lina at Chapel Hill notes that anxiety
and depression are on the rise for
many because of the pandemic—and
this increase can present specific
triggers to those with eating disor-
ders. Such triggers “are almost cus-
tom-made to exacerbate their illness,”
says Bulik, who is the founding direc-
tor of the U.N.C. Center of Excellence
for Eating Disorders.
One major provocation is social iso-
lation. “Eating disorders are some-
thing individuals usually keep private,
and there can be a lot of shame
around behaviors,” says Ellen E. Fitz-
simmons-Craft, an assistant profes-
sor of psychiatry at the Washington
University School of Medicine, who
specializes in eating disorder pre -
vention and treatment research.
These disorders “also thrive in isola-
tion, so it’s not surprising we’re seeing
an increase in disordered behaviors
and even some relapse among those
who were doing well prior to lock-
down,” says Fitzsimmons-Craft, who
was not involved in the new study.
To fill the void left by physical dis-
tancing, many people are logging
hours online—a phenomenon that
may actually be complicating mat-
ters for some with eating disorders.
“Social media messages about being
productive, effectively using time
in quarantine and avoiding the
‘COVID-19 weight gain’ have led
to in creased negative self-talk,” saysShiri Sadeh-Sharvit, associate direc-
tor of training at the Center for
m^2 Health at Palo Alto University.
Sadeh-Sharvit and her colleagues
published a paper in July that exam-
ined risks and recommendations for
people suffering from eating disor-
ders in this unprecedented situation.
Lead study author Marita Cooper, a
postdoctoral fellow at the Johns
Hopkins University School of Medi-
cine, says food-specific issues
related to the pandemic also play a
role. “Reduced food access, or food
insecurity, [has] been rampant,” she
says. “The need to stock a ‘quaran-
tine pantry’ can be a significant chal-
lenge, potentially triggering bingeingand compensatory episodes,” such
as self-induced vomiting, laxative
misuse, fasting or excessive exercise.
Sarah Adler, a psychologist at Stan-
ford University’s Eating Disorder and
Weight Control Clinic, says food scar-
city can create anxiety in anyone. But,
she adds, “the specific stress and
anxiety associated with decisions
about food and availability of food can
dramatically increase anxiety in folks
with eating disorders.”
Food is one part of the eating disor-
der equation; exercise is often an -
other. “For those whose disorder
includes compulsive exercise, either
they’re very anxious because they
can’t go to the gym or find themselves
exercising excessively at home
because there are no barriers to
doing so,” Bulik says, adding that
some people might even experience
both of these effects.
Rosey knows about this problem
firsthand. She says she has ramped
up her home exercise routine since
the pandemic began. “I knew I
wouldn’t be able to stick to my very
strict and regimented workout
schedule with gyms closed, which
sent my body dysmorphia into a
downward spiral,” she says. “I walk
or jog every day to know how many
calories I’ve burned.” GETTYIMAGESN EWS