Magnificat, April 2022
Boredom, loneliness, isolation: these feelings are unpleasant to experience, but generally do not last long. However, during the coronavirus disease 2019 pandemic, such discomfort persisted for months without any indication of return to normalcy. Hopelessness and detachment lead to psychological distress, amplifying feelings of loneliness and boredom. Prolonged exposure to such a gloomy and adverse environment promotes the development of eating disorders (ED), most commonly anorexia nervosa (AN) (Phillipou et al., 2020). Anorexia nervosa is a physical and mental disorder associated with deliberate weight loss that stems from anxiety and distorted body image (National Eating Disorder Association [NEDA], 2021). Increasing evidence indicates that the pandemic environment negatively impacts mental health, which translates to a rise in AN cases.
The interruption of daily functions causes loneliness and boredom, which are triggers for ED behaviors (Cooper et al., 2020). The lockdown’s uncertain environment not only forced individuals to spend time with themselves, but also to observe the routines of their family members. With time to pay attention to little details, people noticed body differences, which provoked anxiety over appearance and triggered ED cognitions. Post-pandemic studies show that 65.9% of participants struggled with obsessive ED thoughts during lockdown (Phillipou et al., 2020). As the days in isolation grew longer, these ruminations changed into anorexic behaviors.
In periods of loneliness and boredom, when individuals are left to their own thoughts, people often look to social media for social interactions, especially during times of crisis. However, there is a direct relationship between social media usage and ED symptoms (Cooper et al., 2020). Social media users emphasized that pictures of thin, athletic bodies made them self-conscious, and that the “Quarantine-15,” gaining fifteen pounds during the lockdown, provoked fear (Nutley et al., 2021). Scrolling through pages of model-like men and women, users began to check, compare, and criticize their bodies. Because people linked discomfort, negative body image, and fatphobia to their eating habits, individuals engaged in compensatory behaviors (Nutley et al., 2021). These behaviors can be seen as food restriction, dieting, and overexercising, some of the most common signs of AN, which have increased by 27.6% during the pandemic (Phillipou et al., 2020).
Individuals predisposed to ED risk factors, such as history of dieting, perfectionism, body image dissatisfaction, and anxiety disorders took doctors’ suggestion of maintaining a healthy exercise routine to the extremes. With gym closures and athletic competition cancellations, excessive exercise became a method for earning food (Matthews et al., 2021; Nutley et al., 2021). One-third of AN adolescents identified pursuing health goals, getting out-of-shape, and fear of gaining weight as the primary reasons for dietary restriction (Matthews et al., 2021). Patients specifically reported that lack of organized activities prompted them to get stronger and healthier. Overall, the general population increased exercise by 34.8% compared to pre-pandemic times (Phillipou et al., 2020).
Boredom, isolation, and anxiety fueled the increase in AN cases during the pandemic. Social media’s promotion of the perfect body provoked negative body image, and AN victims resorted to dieting and excessive exercise to manage their weight-related worries. Little did they know that the modified routines would develop into a severe disorder. The nutrient deprived body copes with AN behaviors and appears to function normally (NEDA, 2021). However, the deprivation ultimately slows body processes, which may cause serious medical consequences. As society emerges from the pandemic state, accumulating data will provide more insight into the long-term effects. Studying AN in the scope of the pandemic sheds light on the biological, psychological, and social risk factors discussed thus far. This understanding contributes to not only the current understanding of EDs, but also the approach of managing these physical and mental disorders.
Cooper, M., Reilly, E.E., Siegel, J.A., Coniglio, K., Sadeh-Sharvit, S., Pisetsky, E.M. & Anderson, L.M. (2020) Eating disorders during the COVID-19 pandemic and quarantine: An overview of the risks and recommendations for treatment and early intervention. Eating Disorders. doi.org/10.1080/10640266.2020.1790271
Matthews, A., Kramer, R.A., Peterson C.M. & Mitan, L. (2021) Higher admission and rapid readmission rates among medically hospitalized youth with anorexia nervosa/atypical anorexia nervosa during COVID-19. Eating Behaviors, 43. doi.org/10.1016/j.eatbeh. 2021.101573
National Eating Disorder Association (2021). Anorexia Nervosa. National Eating Disorder Association. Retrieved on Oct 19, 2021 from: https://www.nationaleatingdisorders.org/learn/by-eating-disorder/anorexia
Nutley, S.K., Falise, A.M., Henderson, R., Apostolou, V., Mathews, C.A. & Striley, C.W. (2021)
Impact of the COVID-19 pandemic on disordered eating behavior: Qualitative analysis of social media posts. JMIR Mental Health, 8(1). doi: 10.2196/26011
Phillipou, A., Meyer, D., Neill, E., Tan, E.J., Toh, W.L., Van Rheenen, T.E. & Rossell, S.L. (2020) Eating and exercise behaviors in eating disorders and the general population during COVID-19 pandemic in Australia: Initial results from the COLLATE project. International Journal of Eating Disorders. 53 (7), 1158-1163. doi.org/10.1002/eat.23317