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Coping with an eating disorder during the COVID-19 pandemic

Breaking down misconceptions, red flags to look out for, and why the phrase 'quarantine fifteen' isn't something to joke about.

SAN ANTONIO — By now you’ve probably heard of the quarantine fifteen. 

If you haven’t, it’s the COVID-19 equivalent of the freshman fifteen, a phrase which references a weight gain of 15 pounds typically gained during a college freshman’s first year of school. But in this case, it’s the stress of a global pandemic rather than the stress of finals responsible for the weight gain. 

For example, “I can’t eat that! I’m trying to avoid the quarantine fifteen!”

For some, the phrase is a joke. For someone with an eating disorder, it’s a phrase that can be triggering.

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According to the Eating Recovery Center (ERC), an international center for eating disorder recovery, an eating disorder is defined as “a treatable mental illness that includes a number of different symptoms, including extreme emotions, attitudes, and behaviors surrounding weight and food issues.”

While anorexia or bulimia may be the first thoughts that come to mind when one hears the term ‘eating disorder,’ eating disorders include anorexia nervosa, ARFID (avoidant/restrictive food intake disorder), BED (binge eating disorder), bulimia, compulsive overeating, diabulimia, and OSFED (other specified feeding and eating disorder). 

The latest statistics show that 30 million people in the United States are suffering or will suffer from an eating disorder. 

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Eric Dorsa first sought treatment for an eating disorder nearly a decade ago.

Native San Antonian and former patient of ERC, Eric Dorsa is one of them.

As someone who identifies as being in long-term recovery and who now works as a recovery advocate, Eric Dorsa said he knows first-hand what it’s like to struggle with an eating disorder. 

“It’s very scary. It is very intense. And the behaviors of the eating disorder themselves are naturally isolating,” Eric explained. 

Add in a global pandemic, food scarcity, a disrupted routine, and a society obsessed with appearance, and it’s a mixture that as Eric said, “can be extremely triggering."

Landry Weatherston-Yarborough, the Clinical Director of the Eating Recovery Center (ERC) added, “I think that some people have found that even just the environment around food during the pandemic has been really difficult. Of course, in the beginning, we had people kind of rushing grocery stores and shelves were empty like the supply couldn't really keep up with the demand. That can be a really difficult experience for someone who has an eating disorder or who's in recovery, because it may increase feelings of food scarcity.” Feelings that Eric, a former patient of the ERC, acknowledged he felt in the first half of 2020. But rather than restricting or binging, Eric said he coped by connecting with loved ones.

“The most important thing is finding ways to connect with people that know you...all of you... that you feel you can open up to about where you're struggling. And I've had to do that. I've had to just schedule like face times and I go to support meetings,” Eric explained.

As for his thoughts on the quarantine fifteen… Eric said the phrase goes far beyond a joke. 

“It really points back to a deeper conversation, which is that we live in a society that is obsessed with finding worth and value in people based on how they look. That is not only unhealthy, it’s dangerous.”

Credit: Getty Images/iStockphoto

Landry echoed Eric’s sentiments pointing to research on eating disorders.

“Dieting and the diet culture that we live in is absolutely foundational to eating disorder development for people...So even these little comments here and there that are made in jest. If somebody already has maybe the genetic predisposition to an eating disorder or they're already starting to have some thoughts about not feeling comfortable in their own skin or not knowing how to cope with their emotions, you know, comments like the quarantine fifteen can really kind of be the straw that breaks the camel's back for people.”

Of the millions that grapple with this mental illness, statistics show that only 30% will seek treatment; the remainder fails to seek treatment due to the stigma, misconceptions, lack of education, diagnosis, and lack of access to care. 

But amid the pandemic, Landry stated that the Eating Recovery Center has seen an increase in people seeking services for eating disorder treatment. 

She believes that the additional time the pandemic has afforded people is a silver lining. 

“We're not doing the normal activities that we have always done. And so I think people do have more time to maybe be still and to notice what's going on internally with them or to notice what's going on with a loved one. When, you know, everybody was at basketball practice and soccer practice and dance and work and school. And we were just kind of passing each other in the hallway at night that we didn't get a chance maybe to see as clearly what was going on.”

This added time for self-reflection is helping people to not only seek help but also to reevaluate their goals. 

“When things are back to normal or we're in our new normal, I think that people have an opportunity to think about who do I want to be when I meet that new normal? You know, what's the best version of myself?” Landry said.

For someone struggling with an eating disorder, Landry explained that becoming the best version of one’s self starts with the first step. 

“Step one is reaching out for support from somebody in your life, talking about what’s going on, being honest, sharing your experiences with somebody that you trust, and who cares about you and your wellness.” 

Landry explained that oftentimes, people who have eating disorders are burdened by shame and keeping secrets. 

“They're not being honest about what's really going on. Their life from the outside might look like they've got it all together. Everything's like, totally perfect. And they're keeping all the balls in the air even when other people are dropping them. But in their own, you know, inner self, things are falling apart. And most people aren't aware of that until, you know, a long time down the road.”

Eric agreed and said that “[he] felt like [he] was gray in a world of color.”

If you are unsure if you or a loved one might be struggling with an eating disorder, here are some red flags: 

  1. Overvaluing your body shape and size and weight. 

“So saying, you know, this is how I look, how my body looks or doesn't look is the most important part of me. And it's like has the largest bearing on who I am as a person,” Landry explained. 

  1. Spending a majority of the time of your day and your mental and physical energy thinking about food or your body. 

“So being really preoccupied with whether it's, you know, what am I going to eat when I get home? What did I eat earlier? What am I not going to eat? How am I going to burn this off? How am I going to compensate for that thing that I ate earlier that I wish I hadn't?”

  1. General depression and anxiety. 

“Most people who have an eating disorder have comorbid anxiety or depression diagnoses. So they have that at the same time that they have an eating disorder. And so feeling even something like, you know, down in the dumps or feeling nervous to talk in front of a group of people, you know, those can be things that show up with eating disorders and eating disorders can actually exacerbate preexisting anxiety and depression diagnoses as well.” 

If you’re still unsure of whether you or a loved one may need to seek treatment, the Eating Recovery Center offers free assessments.

In addition to red flags, Landry and Eric wanted to break down some common misconceptions about eating disorders.

  • Misconception #1: To have an eating disorder you have to be really big or really skinny. 

Both pointed out that eating disorders don’t always look like the image people might have in their heads of someone with an eating disorder. 

“If I had to pick the biggest misconception about eating disorders, it would be that people who have eating disorders are always underweight or are very thin or emaciated. And actually, the most common eating disorder in the country is binge eating disorder. And so the majority of people who have eating disorders actually are average weighted or living in larger bodies, but they typically are not thought of as having a real eating disorder, even if they share that they're struggling because the stereotype of an eating disorders person is a very thin, kind of like bone showing emaciated individual,” Landry explained. 

Eric agreed, “A lot of people think that there's nothing wrong with them or the other side is that [they think] there is something wrong with them, but it's not an eating disorder when in fact, it is these very limiting beliefs around food, body weight and shape that completely isolate them within themselves versus allowing them to connect and feel a part of and belong in their lives.”

  • Misconception #2: Eating disorders are for vain people.

Another misconception Eric noted was the idea that people with eating disorders are doing so to be skinny. 

“It’s understanding fundamentally that eating disorders are not about vanity and they’re not moral issues. The eating disorder symptoms that you would consider the eating disorder-- those are the symptoms, they're not the actual problem.” 

Eric added that it was learning and understanding the science behind eating disorders that saved him.

“So much of what makes up an eating disorder is genetic. In terms of like personality and temperament, how we cope with stress, trauma, things like that, it's all kind of hardwired in there. [And] that has saved my life just knowing that, like my eating disorder wasn't some kind of moral failing, that it was actually biologically kind of hardwired in there as a way for me to cope with stress.”

  • Misconception #3: Only girls can have eating disorders.

Of the 30 million people that will struggle or are struggling with an eating disorder, 10 million are men. 

Landry explained that the symptoms of a man struggling with an eating disorder don’t necessarily look the same as the symptoms for a woman. 

“A lot of times women have or girls report having kind of a drive for thinness and wanting to lose weight, whereas men oftentimes are talking about wanting to be more muscular or wanting to get cut. And so they don't necessarily sound the same when you compare the commentary. And so that can sometimes lead to men or boys with eating disorders being overlooked and not being diagnosed appropriately and then not being able to access the treatment that they need because they're not. You know, getting the right diagnosis. And so I think that's another [misconception] just like not everybody who has an eating disorder is underweight. It definitely happens to boys a lot more frequently than we realize, too.”

When he started seeking treatment a decade ago, Eric said it was because of this misconception that there were a lot of barriers to treatment.

“A lot of treatment centers wouldn't take adolescent males. A lot of them still don't take males. So we've come a very long way. And Eating Recovery Center, you know, not only do they treat women and men, they treat everyone on the gender spectrum and honor that. And I think that's huge. And that's groundbreaking because what we know is that eating disorders don't discriminate. They affect everybody.”

  • Misconception #4: You have to throw up or not eat to have an eating disorder. 

While purging and restricting are behaviors that some people with eating disorders may engage in, Landry clarified other behaviors that are signs of an eating disorder. 

"It includes any sort of behavior that's meant to compensate or cancel out or burn off food that was previously taken in. So it can be vomiting and it's most commonly self-induced vomiting, but it can also be overexercising. It can also be laxative use or diuretic use. It can also be medication misuse. And so there's a lot of avenues through which people compensate. It can be fasting also. So lots of ways that people try to compensate for food that they've eaten in an attempt to prevent weight gain.”

Credit: Getty Images/iStockphoto

At the end of the day, Eric just wants anyone who may be struggling with an eating disorder to know that they are not alone. 

“There are millions and millions of people in the world who are also walking in recovery… And there is so much support out there. There are many free resources as well as virtual groups, virtual programs that insurance companies are paying for. This doesn’t have to be a life sentence. There is hope. There is recovery.” 

Even (especially!) in the midst of a global pandemic when people are more concerned about gaining or losing weight than wearing masks. 

Eric said, “It kind of makes you step back and go, man, I am so grateful that I'm in recovery because I can really hang on to what matters and who I am as a person is not determined by a plus or minus 15...The most important thing to take away is that you as a human being do not need to place value in how you look or what you weigh.”

For more information about the in-person and virtual services offered by the Eating Recovery Center, you can head over to their website here or get in contact with the ERC’s National Response Team by calling 1-877-825-8584.

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