Wellness Wednesday: How disordered eating became a pandemic problem

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Now, a lot of people have been talking about the "the quarantine fifteen." I can speak for myself personally and say, yes, I've put on about ten pounds during the COVID-19 pandemic. But new research from the University of Minnesota Medical School says the most alarming eating behavior to emerge during the psychological and financial impacts of the pandemic is eating disorders. So we want to take some time this morning to talk about eating disorders, because eating disorders kill roughly just over 10,000 people every year, and so this is a real health concern right now during the global pandemic.

I have an expert here to talk with me.Dr. Melissa Simone is the lead researcher on a study that was put out by the U of M. I want to talk about that study so that you can learn to recognize some warning signs; and, we can have a conversation about eating disorder intervention and some treatment options.

Every Wednesday morning at 8:30 CST, Jill Riley connects with experts and local personalities for some real talk about keeping our minds and bodies healthy — from staying safe in the music scene, to exercising during a pandemic, to voting and civic engagement. Looking for more resources and support? Visit our friends at Call to Mind, MPR's initiative to foster new conversations about mental health. Subscribe to Wellness Wednesday as a podcast on Spotify, Apple, RSS, Radio Public, Stitcher, or Amazon Music.

Jill Riley: How has the pandemic affected the way we eat?

Melissa Simone: Since the beginning of the pandemic, we've seen a number of changes in the way that people are engaging in their eating behaviors. And the way that we see this is with some reported changes and general increases and decreases in dietary intake. And sometimes we've even seen reductions in intake that were specifically associated with pandemic stressors, such as fears of weight gain, but also fears of contracting COVID at the supermarket, or even from food that people make in the form of takeout.

Okay, yeah, that's interesting. I want to get into this study: the COVID-19 pandemic being linked with what has been kind of identified as six unhealthy eating behaviors.

These themes pertain to experiences of mindlessly eating and snacking over the course of the day. Because of the abrupt scheduling changes we saw, other individuals reported a general increase or decrease in what they ate. We also saw several participants reporting that they reduced their intake specifically because of pandemic-related stressors such as fear of weight gain, fears of contracting COVID at the supermarket or from takeout food, eating and response to stress from the pandemic, to help cope with job loss, uncertainty, and disruptions with daily life. And also the reemergence or increase in eating disorder symptoms among individuals who previously reported eating disorders.

Is there a distinction between disordered eating and an eating disorder?

So when we talk about disordered eating, this often includes behaviors such as less extreme unhealthy weight control behaviors, skipping meals and fasting. We also talk about more extreme unhealthy weight control behaviors such as laxative abuse or self-induced vomiting, binge eating behaviors, and eating to cope with stress. And those are the four behaviors that we looked at quantitatively in our study. And while individually, they are not a holistic eating disorder, when these behaviors become kind of predominant in an individual's life, and they have high levels of concern about their weight, and the amount of food they eat and that continues over time, we may see that individual develop an eating disorder. It's hard to say when an eating disorder first is onset, because it's a series of behaviors and symptoms that kind of build up and become patterned and ingrained paired with this concern about weight and shape.

Well, thank you for making that kind of distinction between the two because that really helps me wrap my head around it. So disordered eating really is the behavior and then eating disorder. I mean, really, that's the disease.

Absolutely. Right. And that's what we see when people engaged in disordered eating behaviors for a prolonged period of time, with the sole purpose of controlling their weight and shape and attaining some ideal.

When it comes to eating disorders, why are eating disorders one of the top psychiatric health concerns?

Eating disorders have one of the highest mortality rates across all psychiatric health concerns, and it's really important that we've been trying to make links between the consequences of the pandemic and disordered eating behaviors to help identify some ways that we may specifically target the prevention of eating disorders as they pertain to the pandemic.

If somebody identifies the behavior, what are some of those preventative measures?

Our findings from the study and reference suggested that mental health concerns, stress management, financial difficulties, and food insecurity were linked with disordered eating during the COVID pandemic. And I think it's often easy for us to think about individual-level interventions to address mental health, wellness, and financial factors linked with disordered eating. For instance, we might think about promoting stress management strategies like yoga, or even the dissemination of educational information about the harms of poor stress management. While of course these kinds of recommendations can be incredibly helpful for the individual, they do fail to address the structural barriers to well being that are at play specifically during the COVID pandemic.

Notably, we saw that financial difficulties and inadequate access to food due to financial barriers were linked with disordered eating during COVID, including among those who did not previously report disordered eating. So these findings to me suggest that financial support at the state and national level in the form of additional stimulus checks are really pivotal in the prevention of disordered eating behaviors, especially among young adults.

When you say financial barrier, would you say that there's a financial barrier to treatment of eating disorders?

I absolutely would. First of all, it is hard to find treatments that could be covered by traditional health insurance policies. And above and beyond that, access to private eating disorder treatments tend to be quite expensive if you're thinking particularly of residential care. And a lot of the times, some facilities will have sort of scholarships that individuals can apply to. But of course, review of those scholarships takes time. And that time may be pivotal for those who are struggling with eating disorders, because we know that there is such a high mortality rate. I think one of the ways that we're trying to move the field forward is to identify barriers to treatments for individuals struggling with eating disorders, as well as ways that we could reduce the cost of these treatments.

Where can someone start to look for help if disordered eating has led to a full-blown eating disorder?

There are a number of resources that are available at a national level for individuals struggling with eating disorders or friends and loved ones of individuals struggling with eating disorders that can be accessed online. One that comes to mind is the National Eating Disorders Association who provide resources and support. And I think it's always important to acknowledge that you only need access to the level of care that is required. So that's not to say if you're going to seek treatment for an eating disorder that you're immediately going to go into residential care. For some individuals, traditional psychotherapy and weekly meetings may be enough to help them overcome what they're struggling with. And for others, there's of course, higher levels of care.

In the Twin Cities alone, we saw up to 53% of people engaging in disordered eating behaviors during COVID, which is quite high. So it's a really timely topic, and it's going to be a growing concern as the effects of the pandemic trickle down.


Wellness Wednesday is hosted by Jill Riley, and produced by Anna Weggel and Jay Gabler. Our theme music is a portion of the song "F.B. One Number 2" by Christian Bjoerklund under the Non Commercial Share Alike 3.0 International License.


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