Eating disorders and lockdown – how to help
The UK charity BEAT Eating Disorders has seen a 50 per cent rise in demand for its Helpline since the coronavirus outbreak began.
This figure is unsurprising: the lockdown has destroyed any sense of routine and led to changes in the support on offer – two vital elements in eating disorder recovery.
Young people who suffer from an eating disorder, of any kind, may well be more affected by this period of uncertainty than most – so how can you help them?
What is an eating disorder?
Eating disorders are a group of complex mental illnesses that can affect people of any age, gender and background. The Dept of Health estimates that as many as 4 million people in the UK may be affected, but it’s hard to be sure, as many sufferers may hide their illness or struggle to seek help.
Types of eating disorders include:
Commonly known as anorexia, or ‘Ana’. Sufferers develop a deep fear of gaining weight, often stemming from an unforgiving urge to achieve control. You can read more about anorexia nervosa here.
Commonly known as bulimia or ‘Mia’. Bulimia Nervosa is often characterised by the eating of large quantities of food (binging) before vomiting, taking laxatives, fasting, or exercising excessively to try to compensate. You can read more about bulimia here.
Binge eating disorder (BED)
BED is characterised as a loss of control and eating large quantities of food on a regular basis. Binges are often distressing, with sufferers finding it difficult to stop, and even struggling to remember what they’ve eaten afterwards. You can read more about BED here.
Avoidant/restrictive food intake disorder (ARFID)
ARFID is a newly classified eating disorder, stemming from sensitivity to taste and texture, trauma and poor appetite. The sufferer may avoid certain foods or types of food, or restrict their intake (or both). You can read more about ARFID here.
Sometimes, a person’s symptoms don’t fit those for specific eating disorders. In this case, they might be diagnosed with an “other specified feeding or eating disorder” (OSFED), which is every bit as serious as its diagnosable counterparts. You can read more about OSFED here.
Why is lockdown particularly difficult for people with eating disorders?
The coronavirus lockdown has added complications for those suffering from eating disorders. Your child might feel like their mental state around food, weight and shape is worse at the moment.
Remember, while eating disorders are categorised by certain relationships with food, they’re really about feelings, and often control. Most people have lost some amount of control over their lives during the lockdown, so your child might search for it in their food intake.
As Mandy Scott, mental health nurse and co-founder of eating disorder charity PEDS, explains, “Eating disorders are often made worse by additional pressures and stresses. Currently, these [could include] anxieties around returning to school, being stuck at home with loved ones where the eating disorder is often more exposed, and restrictions on being able to shop for what is needed on a person’s eating plan.
“Then there is the need to exercise and the social media pressures that, in turn, can lead to anxieties around seeing people after a period of lockdown, and the person feeling or fearing they have gained weight”.
Clair Byrne, specialist support officer at eating disorder charity First Steps, agrees: “During lockdown there is a lot of uncertainty for children and young people.
“Sufferers may be sleeping more because of this, and limiting their dietary intake. Binging on foods or secret eating may also increase.
“For sufferers who have underlying sensory processing difficulties, parents [might find] that their child’s ‘safe’ foods are no longer edible for their ever-changing pallet, and see an increase in sensory meltdowns.”
How can you help?
With so much uncertainty about life right now, you may be struggling to know how to support your child – and you may also feel frustrated that their recovery has taken a step backwards. But there are things you can do to help.
It’s important to keep the conversation open and check in with your child regularly.
“It’s vital to ask the sufferer what helps and support them to ensure there is structure and routine to the day,” says Scott. “It can also be helpful if they list what they find most difficult about the current situation, together with any suggestions as to how these issues might be tackled and strategies to try to reduce the anxiety.”
While it’s tempting to step in and take over, particularly if your child is struggling to persevere with their recovery, it’s important that you don’t overwhelm them. Listen to them, ensure they are heard and try not to be judgemental.
Scott continues, “In situations where the person finds it difficult to talk, it can be useful to have a ‘communications book’ within the family household, or to set time aside where the family sits down together (outside of a meal, which can be stressful) and concerns are heard and solutions found.”
Byrne adds, “If they are unable [to communicate] verbally, then look at creative ways of doing this through play – such as drawing, painting and gaming.”
Plan and structure
Add structure to your day by following a routine. For example, waking up at the same time, eating meals together and scheduling social activities such as watching a movie, or calling friends. You can see an example of a daily routine on BEAT’s website. PEDS also provides a self-help toolkit so your child can draw on their coping strategies (such as listening to music), which can be added to the routine.
Your child may also have disordered habits that they use to keep their thoughts under control, such as exercise. It’s unrealistic to ask them to erase these from their routine, but you can mitigate the risk of hidden disorderly behaviour by implementing negotiated activity into their day.
Scott adds, “[You could come up with] a negotiable and a non-negotiable plan with the sufferer, which looks at what can be accommodated safely into the day, and where there needs to be boundaries.
“Acknowledge that activities such as overexercise might be an issue for them, and recognise that they are not expected to suddenly stop. Come up with an agreed plan whereby you know what exercise the person is doing, which minimises the risk of ‘secret’ exercise.”
Bryne continues, “When looking at food and nutritional input, encourage your child to be involved in the meal planning process and food shop. For children with sensory issues, the purchase of an exercise ball and allowing them to move and bounce while eating can help regulate their senses to allow them to tolerate foods.”
Avoid talking about appearance
It can be easy to make seemingly positive comments that might be misinterpreted by your child. For example, ‘You’re making so much progress during lockdown’ can sound, to someone with an eating disorder, as if you’re saying ‘You’re putting on weight’.
Your child’s eating disorder ‘achievement’ often lies in the control of their intake and not letting hunger ‘win’. The idea of ‘making progress’ might make your child feel extremely guilty and like they’ve failed their eating disorder.
Think carefully about how to discuss things. It’s important to be supportive, without placing too much emphasis on looks, or the progress of their recovery.
Remember you’re not alone
There’s a wealth of useful information and advice online for parents, carers and children.
- PEDS has multiple resources for your child to access, including the self-help toolkit, advice on managing thoughts and a recovery toolbox. For parents and carers, there’s an advice page plus a monthly support group that is currently taking place via Zoom.
- First Steps has resources for parents and carers that include a guide to recognising symptoms and eating disorders in boys and men. Your child also has access to tips for recovery and a young person’s self-help group that is currently taking place via Zoom.
- Eating disorder charity Seed has a page dedicated to managing eating disorders amidst coronavirus, including a downloadable PDF which includes support for your child, and a YouTube video. You can call its advice line on 01482 718130.
- BEAT has a dedicated page with advice for those who may be suffering as a result of the virus, as well as a page for those supporting someone with an eating disorder. Your child can also access The Sanctuary, an online group created in response to coronavirus and the anxieties it could cause. Its Helpline, Studentline and Youthline are all operating as normal.
There’s also plenty of useful advice on Parent Info, including articles on finding mental health support online during lockdown, and helping your child recover from an eating disorder.
Scott concludes, “Eating disorder services are still functioning, accepting new referrals and continuing their work with their patients, albeit in a different way currently.
“Any parent who is concerned about a loved one with an eating disorder can contact their GP and ask for a referral to the local Child and Adolescent Eating Disorder Service.
“The most important thing is helping the young person to know that they are not alone and to hold on to hope that things can improve.”
If you believe a child is in immediate danger, call 999
PEDS and First Steps contributed to this article