Health: Eating disorders combine secrecy and compulsion

Dr. W. Gifford-Jones

It’s plainly evident that many people are eating too much. But several serious eating disorders can be harder to see, especially when they deliberately hide the problem. Recent research indicates that pandemic-related stay-at-home orders have ramped up anorexia, bulimia and binge-eating disorders.

With COVID capturing all the headlines, it’s easy to lose sight of the looming mountain of mental health issues that are changing our healthcare horizon. Mental illnesses are the leading cause of premature death in Canada. In the U.S., Johns Hopkins University estimates that 26 per cent of Americans ages 18 and older – about 1 in 4 adults – suffers from a diagnosable mental disorder in a given year.

Eating disorders are serious but treatable mental illnesses. Girls and young women are commonly thought to be most at risk. But research shows that body image and dieting attitudes are influential in young boys as well. Identifying those who are at risk or suffering these illnesses is challenging, as individuals tend to hide the problem from even their closest friends and family.

Ellen E. Fitzsimmons-Craft, an assistant professor of psychiatry at Washington University School of Medicine, says, “Eating disorders are something individuals usually keep private, and there can be a lot of shame around behaviors.”

The good news is that lockdowns might give us a better chance to keep an eye out for signs of an eating disorder. The bad news is that the stress of this COVID era may be making things a lot worse for people who are suffering from anorexia, bulimia or binge-eating.

A study published in the International Journal of Eating Disorders reports that more than a third of 1,021 study participants said their illness had worsened. They pointed to a lack of structure, a triggering environment, the absence of social support and an inability to obtain foods that fit their meal plans.

Even for the healthiest, pantries full of pandemic-preparedness foods could lead to binge eating. If this is a problem for you, get help in managing your cravings. There is nothing good that comes of extra weight gain. For habitual binge-eaters, these excess stocks of food can result in more episodes of self-induced vomiting and laxative misuse.

Adding to these factors is the effect of the pandemic on our level of physical activity. Numerous studies show that COVID has significantly increased the amount of time people spend sitting down each day. This is not good.

Prior to COVID, a comprehensive study of sedentary behaviour from 2001 to 2016, published in the Journal of the American Medical Association, showed that on average we are sitting longer each day, generally in front of a television or computer screen. As a result of COVID, the trends are steeply worse.

For people with eating disorders, the lockdown is a no-win situation. Cynthia Bulik, founding director of the Center of Excellence for Eating Disorders at the University of North Carolina at Chapel Hill, says, “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.”

Last year was an awful year for the health record books. It’s reasonable to bet that the statistics on global weight gain won’t be good. And it’s not over yet. This year and the years to come will see the reckoning – increased rates of obesity, diabetes and heart disease.

But mental illnesses are certain to escalate too. Among them, eating disorders. Unfortunately, there will be tragic increases in other forms of mental illness too.

We wish the news were better.

Dr. W. Gifford-Jones can be reached at contact-us@docgiff.com.

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