Eating disorders can often stem from trauma or stress. Kelly L. Klump, professor in the Department of Psychology and fellow in the Academy for Eating Disorders, answers questions on eating disorders and how the pandemic may trigger or exacerbate this disorder.
Q: Is there any evidence that the pandemic triggers eating disorder behaviors among teenagers?
We have emerging data on risk for eating disorders during COVID-19. Although data are in the early stage, we are seeing increased weight-shape concerns, increased binge eating and, potentially, increased dietary restriction during COVID-19. These symptoms seem to be increasing in the general population, but results are more consistent in showing exacerbation of these symptoms in individuals with anorexia nervosa (increased restriction and potentially exercise) and bulimia nervosa (increased binge eating and purging).
Reasons for these increases aren’t entirely clear, but theories focus on increased stress, increased isolation and, for individuals in recovery, decreased access to care during the pandemic. There are also fears of weight gain due to less activity overall that may fuel concerns about weight/shape and later, eating disorder symptoms. Limitations in access to food during the pandemic also seem to be related to these symptoms. Although, how they are related may vary across eating disorder symptoms.
Q: What are some signs parents should be aware of that might indicate eating disorder behaviors or warning signs?
These signs would be similar to those that we watch for during non-pandemic times. Decreased food intake, increased exercise and increased discussion of weight concerns are early signs. In addition, if food that was present (particularly high fat/high sugar foods) comes up missing frequently, this could be a sign of binge eating. Because eating disorders are highly comorbid with depression and anxiety, increased signs of these conditions (e.g., sad mood, withdrawal, increased anxiety about a range of concerns) could be early signs, particularly if in combination with the weight/shape/binge eating early signs mentioned above.
Q: What should a parent who is concerned their child is exhibiting eating disorder behaviors do to address the issue?
The first step is to talk with your teen and listen. Check in on how they are doing generally, but then also let them know about the signs you are seeing and your concerns. Empathic listening is key in these conversations and letting them know that you would like to do whatever is needed to help. They may not be willing to talk the first time they are approached. It might take multiple conversations for them to open up and/or admit that they need help.
Q: What resources are available to parents looking to get help for their kids right now?
There are some websites that can help parents identify eating disorder specialists in their area, including:
Q: Are families facing obstacles in getting preteens and teenagers help for eating disorder behaviors because of COVID-19 measures?
A potential decrease in treatment resources appears to be present for eating disorders and other psychiatric illnesses. Treatment that is available may be in the form of telehealth, which some individuals may find very helpful, while others may feel is not enough. We are still collecting data on treatment availability during COVID-19, so we don’t have great data on availability. But early theories are that treatment access may be decreased.
Q: What advice do you have for parents who feel like they are seeing their teenagers’ past eating disorders either reappear or become more severe in light of COVID-19?
Seek help and do so early. Catching an increase or exacerbation of symptoms early in the process will increase the chances that you can catch the symptoms before they become more severe. Your teen may need “booster” sessions with treaters that can help them get back on track and help them cope with current stressors.