Inside Out : Institute for Eating Disorders

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COVID-19: Advice for people with an eating disorder and their loved ones

Here at InsideOut Institute for Eating Disorders, we know that what is currently happening in the world around us may be having a negative impact on people’s mental health and wellbeing and could be especially triggering for individuals with eating disorders.

We want to support you in any way we can to stay connected and to encourage you to continue to reach out for help.

There are many areas that people are finding difficult as part of managing the COVID-19 pandemic. We have listed some you might be experiencing and a couple of ideas about how you could deal with them.

Coping with physical distancing and social isolation

Until a couple of weeks ago, none of us had ever heard the term, ‘social distancing’. It has quickly become a new way of life bringing lots of new challenges to adapt to. Many of us are now working or studying from home, unable to have direct physical contact with friends and/or family and have had to cancel social occasions we were looking forward to.

Remember:

You can still stay connected. We live in a digital world where there are so many options to have regular contact with family, colleagues and friends.
Reach out for support early. Just because we are physically isolated, does not mean we need to be lonely. Make texts, phone calls and skype meetings a regular part of your day. Let people know how you are doing, let them support and help you even if it is just being a voice on the other end of a phone line. Maybe you could use facetime to help you manage meals when you are away from family and friends?
If seeing a GP or psychologist is part of your routine, it is important that you continue to do this if possible. Access telehealth services provided by doctors and mental health professionals if they are available to you and you can’t see them in person or call the Butterfly Helpline for support (1800 33 46 73).

This will pass. It may not feel that way at the moment but together, we will come out the other side.

Managing uncertainty and unpredictability

Right now, it feels like we are all living day-by-day. The COVID-19 situation is changing so rapidly, it is difficult to know what the immediate future holds. You may be feeling as if even basic aspects of your daily life are not predicable or within your control like being able to get the things you need from the shops, go to the beach or catch public transport.

This can be extremely stressful and a trigger for the eating disorder to ramp up and want to exert some control.

Now, more than ever, it is important to try to stick to regular, planned eating. If you notice eating disorder habits starting to creep in, seek support immediately.

Perhaps it is not helpful to be constantly checking the news for updates. Consider setting some limits e.g. checking a reliable news source once or twice a day. Look at distracting yourself from the 24 hour news cycle by practicing self-care activities with a focus on anxiety management e.g. mindfulness apps, or chatting with friends.
Rather than focusing on what you can’t control, focus on what you can control. You can’t control COVID-19 or the economy but you can control following health advice; prioritising self-care and reaching out for support.

Managing messages about an unpredictable food supply

Seeing empty supermarket shelves and people scrambling for toilet paper has had a ripple effect of anxiety throughout the community. The media has inundated us with messages about a questionable food supply and many have felt the need to hoard food as a result. This may mean you haven’t had access to the foods you would usually eat, are experiencing guilt around buying food, or have large amounts of food readily available at home.

For people who are dealing with bingeing behaviours, the idea and practice of stock piling food can be triggering. If possible, try to move extra food to an area of your home that is not easily accessible.
The notion that some foods may not be available is also distressing for many people living with eating disorders, as they may be concerned about accessing foods on their meal plan. If your normal foods are not available, focus on getting enough energy into your system with other safe foods that you can access. Work with friends or family to problem solve alternatives to help minimize anxiety.
Try to keep as much structure around meal times as possible, including setting a table and eating with other people - even if that means using a video conferencing app.

Coping with limitations and restrictions around exercise spaces

Many people might be finding that their regular exercise venues and routines have been affected with the closing of gym/pools and being restricted inside. If exercise was an effective coping strategy to manage stress, anxiety or urges around the eating disorder, this might be extremely challenging.

Consider looking at online class options – some also have a community focus which may be helpful
Discuss your concerns and worries with your friends and family and health professionals and brainstorm how you can manage this.
Schedule some exercise time into your week and a plan how you will do this

Uncertainty around work and/or financial strain

A major economic crisis is unfolding alongside COVID-19. As a result, many businesses and people are already facing financial and job insecurity. Although there is government assistance, navigating access to stimulus packages and immediate financial aid may be difficult and stressful.

Again, you are not alone in this struggle. Reach out for support to those who can assist in understanding this ever evolving situation.
If you have several worries and questions going through your head, write them down so you can process and discuss them with friends/family and make a clear plan.

Managing the direct impact of a suspected/actual COVID-19 diagnosis

We are all navigating the reality of a new pandemic and the potential diagnosis of ourselves or someone we know. This is unchartered territory and is likely to generate worry for everyone at some point. There are some strategies we can adopt to ease anxiety such as:

Know what you can control and be familiar with hygiene measures, social distancing, criteria for testing and guidelines around social isolation
Be clear about what a diagnosis actually means and what you need to do if you are feeling unwell
Be aware of the facts and make sure you are using reliable sources for your information such as information from the Federal Department of Health: https://www.health.gov.au

Changing access to medical and/or mental health treatment

The way in which we engage with medical and mental health services is also changing with many face-to-face consults now being conducted remotely via telehealth. You may be unsure what the correct protocol is for this and whether you should be going to appointments at all.

If in doubt, please ask your health professional rather than not turn up. It is critical we all continue treatment plans and don’t eliminate important supports. This includes continuing appointments with your GP (via telehealth if necessary and available).

For people who were planning on seeing a psychologist or health professional for the first time, don’t put this off! For further information about how to access treatment for an eating disorder go to: https://insideoutinstitute.org.au/treatment-services

Remember, your needs are important. COVID-19 has created a serious health pandemic however that doesn’t mean that treatment for your eating disorder is put on hold. It is more important than ever that it continues.

Take home messages

Remember your skills! Keep healthy routines and structure your day by scheduling activities both routine and enjoyable. Remember your toolbox of skills and strategies that you have used to manage your eating disorder and mental health in the past and put them to good use now
Seek help regularly and early. If seeing a GP or psychologist is part of your routine, it is important that you continue to do this even if it is not in person. Whether it is related to the eating disorder, anxiety or mood - don’t wait for symptoms to escalate (link to ‘Find a Psychologist/GP’)
Prioritise self-care. Meditation apps like headspace might be useful; maintaining regular connections with others; brainstorm with others what they have found helpful
Use the internet wisely! Being able to connect with people and services virtually will be an important tool in managing social isolation. At the same time, social media and newsfeeds can at times, bombard us with constant unhelpful messaging. If there are aspects of being online that can be triggering, establish a plan to manage this (i.e. limits around how often you watch the news etc).

Some Tips for Supporters:

If you have a loved one with an eating disorder or any mental illness, now is the time to check in with them – regular texts and facetime keep us connected. Be sensitive and kind. Understand that now could be a really anxious and uncomfortable time for people who are already struggling with day-to-day life. Ask them how you can help. Stay in touch.
Encourage and support them to keep up all their treatment at this time, via telemedicine if necessary. Health professionals are taking extreme hygiene measures so it may be safe to attend in person - check with their individual providers.
If there is someone in your life who you think may have an eating disorder, or has developed unhealthy behaviours or attitudes about body, weight or food – try to talk about it. If you need help in how to do this you can call one of the consumer organisations – Butterfly, Eating Disorders Victoria or Eating Disorders Queensland, all of whom have vast experience supporting loved ones.
Navigating difficult conversations with someone you care about can be tricky. But don’t avoid the conversation just because it is hard. One thing COVID-19 has allowed many of us is more time together so when things are not overly panicked and chaotic try to pick a moment to begin helpful and supportive conversation. The important thing is that you offer your support – it can make a big difference in making them feel less alone.
Try to support structured meal times wherever possible to give the person with the eating disorder an opportunity to participate if they are able.