With the spread of coronavirus in the United States, our lives are changing in ways we never anticipated. Along with feeling heightened emotions like anxiety, uncertainty or even panic, many are experiencing unprecedented changes to their daily lives. Mass unemployment and job insecurity have impacted millions of Americans, and many of whom are fortunate to remain secure in their employment have adjusted to a new work-from-home lifestyle. 

While such disruptions are harmful for everyone, quarantine has been particularly difficult for those who suffer from an eating disorder, such as anorexia nervosa, bulimia nervosa and binge eating disorder, and have already been in a particularly vulnerable state due to forced isolation.

An eating disorder is a mental illness that thrives in isolation — and those in recovery have been finding themselves in “survival mode” during this time. This unprecedented crisis has brought with it a sense of feeling out of control — from how to prevent ourselves from catching the virus, to how long we need to be in self-isolation, to food scarcity and insecurity caused by panic buying, this pandemic has been riddled with uncertainty from the very beginning. 

Diet culture has also infiltrated this difficult time, with nearly inescapable messaging that one should be worried about gaining weight due to “quarantine snacks” and increased sedentary time; news updates about COVID-19 are interspersed with how we should be “making the most” out of our newfound excess of free time. 

Those in recovery are also finding themselves identifying with old eating disorder thoughts, not because their body has changed, but because the emotions surrounding the coronavirus and social distancing feel so out of control. They are yearning for something to grasp on to that is familiar. 

Additionally, women in midlife are experiencing markedly unique challenges within the eating disordered population. According to the National Association of Anorexia Nervosa and Associated Disorders (ANAD), 13% of women over 50 experience disordered eating behaviors — and now, many of these women are struggling to manage their eating disordered behaviors and symptoms, along with the radical disruption of pre-COVID-19 daily routines.

Whether they are unemployed or working from home, women with children have had new roles thrust upon them during quarantine: educator and full-time child caretaker. School programming has moved online, and mothers have had to supervise and/or lead their children’s education during this time. School programming for the fall varies by state and district as to whether school will be online, in person, or a combination of both. Younger children must be entertained and cared for during hours of the day they’d typically be at daycare, and older children have returned from their college campuses, completing their schoolwork or internship from home. 

Panic buying and food insecurity have also shown to be triggering for women in midlife, even more for women responsible for the grocery shopping in their household. Concerns about being able to buy their children’s favorite foods (or foods for their picky eaters) and stock up on shelf-stable items while facing bare store shelves, all while job insecurity looms menacingly, leaves little opportunity for these women to ensure they are meeting their own nutritional requirements.

With the needs of their children weighing upon them, women in midlife are lacking adequate time to care for their own. Their symptom management or recovery plan becomes more difficult to maintain as familial responsibilities become the highest priority. 

Additionally, we live in a culture obsessed with thinness and youth, with constant media messages pressuring women of all ages, but particularly women in midlife, to alter their appearance or change themselves in some way to conform to that ideal. 

While certainly not necessary during a public health crisis, personal grooming appointments help us shape the identity we want to present to the world around us. The inability to maintain personal grooming routines has put pressure, on women especially, on something everyone can presumably do from home: diet and lose weight. Combined with the pressure to be productive at all times during this crisis, women in midlife are expected to not only adjust to working from home (or emerge from unemployment) and take care of their children full-time, but also prove they are able to not succumb to quarantine-induced weight gain. 

Eating disorders are particularly dangerous for women in midlife because they typically exacerbate or lead to other physical health problems. It is often considerably more difficult to seek help due to feelings of guilt because they often must leave behind family members or jobs that rely heavily on their presence every day in order to seek treatment. This guilt may be felt more acutely in quarantine, as these women may feel their families are relying on them more than ever or may face limited financial resources due to the reduction in jobs. 

But if there’s a silver lining to the pandemic, it’s the widespread adoption of teletherapy by many behavioral health providers that makes it easier and more convenient for people to get the help they need. Successful remote treatment for eating disorders existed before COVID-19 and has only grown in popularity and effectiveness as a result of shelter-in-place orders. By simply asking their primary care physician or treatment facility about what teletherapy options are available to them, busy moms and spouses can be finishing the family dinner at 6:25 and still make a 6:30 therapy appointment right from the comfort and safety of their own homes. 

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