COVID-19 Crisis Support Needed for People with Eating Disorders

When facing stressful life events, eating-disordered patients are more likely to blame themselves for the problem, less likely to be masterful in response to crisis, and less likely to receive crisis support from others. In the wake of COVID-19 pandemic, they may need help to cope with stressful and sometimes traumatic events.

COVID-19 and Eating Disorders

Stressful life events or difficulties, such as death of a loved one, loss of job and other traumatic events during the pandemic, may cause or exacerbate eating disorders such as anorexia nervosa and bulimia nervosa.

Researches show some eating-disordered patients attempt to alleviate panic with food, and instead exacerbate both the panic and eating disorder symptomatology.

In one case, a 40-year-old female experienced panic attacks related to the dissolution of a romantic relationship and worry about a sick parent. Tending to fight the symptoms with food, she reported a cycle of panic, binge eating, momentary relief, renewal of panic triggered by fears of weight gain, that lasted until exhaustion. She dieted between bouts of binge eating.

Coping Strategies for Stressful Events

Coping refers to the thoughts and behaviors to manage, tolerate, or reduce internal or external demands, and usually come in three categories: practical response, cognitive response, and attribution of responsibility.

Practical responses

Tackling problem and seeking information/interest in understanding (with a view to obtaining relevant information).

Cognitive responses

  • Optimism: the degree of hope about the outcome of the crisis.

  • Overall downplaying: deemphasizing the negative implications and appraising the situation positively.

  • Cognitive avoidance: information is consciously pushed out of mind.

  • Cognitive rumination: the degree to which the person thought, worried, or obsessed about the problem.

Attribution of responsibility

  • Self-Blame involves self-reproach, guilt, or a sense of failure.

  • Felt responsibility involves acknowledging one’s own part in the problem. Responsibility can be felt for somehow causing the problem in the first place and/or for taking upon oneself the responsibility to solve it.

  • Blame of others and perception of others’ responsibility are the same as the above but directed towards others.

Why Eating-Disordered Patients Need Support

Coping and crisis support are two important factors that mediate between the occurrence of a stressor and the experience of stress.

A survey research finds women with eating disorders are significantly less likely to be masterful of the above coping strategies.

When facing stressful life events, eating-disordered patients are significantly less likely to be optimistic or to downplay problems. They either try to push the information out their mind (cognitive avoidance), or spend much time thinking about the problem (cognitive rumination).

The cognitive rumination responses may go further to affect their normal roles/functioning, such as sleep, work, and social life, and their inability to turn thoughts to something else.

Crisis support can come from a partner, a family member or a close friend. The eating-disordered patients need to have a high degree of confiding in the support person, who in turn gives a high degree of active emotional support (sympathy), and does not show any negative response (either verbal or behavioral).

Sources consulted:

Betty E. Chesler. 1997. “Eating Disorders and Panic: Four Cases of Pathological Coping.” In International Journal of Eating Disorders, 22: 219–222.

Nicholas A. Troop, Alison Holbrey, and Janet L. Treasure. 1998. “Stress, Coping, and Crisis Support in Eating Disorders.” In International Journal of Eating Disorders, 24: 157-166.