Author: Cecilia Clementi, PH.D., Psy.D.
We are living in a very challenging and uncertain time: the COVID-19 pandemic made all the world face the same enemy and the multiple consequences of this health, financial, social, and spiritual crisis.
The impact of the COVID-19’s complex crisis on Mental Health is huge with a significant increase of anxiety and mood disorders, PTSD, addictions, eating disorders, and other kinds of psychological distress (See Vindergaard and Bernos, 2020 for more details).
PMCID: PMC72605
COVID-19 and Eating Disorders
There are two main consequences of the COVID-19 pandemic concerning eating disorders: a significant increase in the development of eating disorders (EDs) such as anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) and the exacerbation of symptoms on those people who already suffer from EDs or disordered eating behaviors.
According to the recent research of Rodgers and colleagues (2020), the exacerbation of EDs behaviors can be explained by three main pathways represented by the disruption to a daily routine, exposure to ED-specific media, and emotional distress. People with body image dissatisfaction and/or eating and weight concerns are particularly at risk.
The first pathway identified is represented by the disruption of a daily routine. This disruption could have a direct effect on EDs by impacting weight and body shape concerns through the restriction of outdoor activities and increased or limited access to food. Eating, exercise, and sleeping patterns are also impacted which increases the risks and the symptoms of EDs.
In addition to that, social restrictions caused by the pandemic have also limited protective factors such as access to social support, treatment, and care. All of these provide adaptive coping strategies, and when limited, can increase the risk for EDs or the exacerbation of symptoms.
The second pathway is the increased exposure to ED-specific or anxiety-provoking media in three ways: a) media/ social-media exposure to specific dysfunctional eating and appearance-related patterns, promoting thin ideal, diet culture, and weight stigmatizing messaging; b) effect of general media consumption and the consequent exposure to stressful and traumatic news; c) prevalent use of video-conferencing during home-working with the consequent increase of weight and image concerns, especially by those who avoid body- exposure.
The third pathway is the fear of contagion which may result in certain eating and food-specific anxieties or elicit diets focused on immunity. Moreover, the negative effects of generalized stress, traumatic experiences, social isolation, or its opposite--living every single day together--may contribute as risk factors. In particular, stressful and traumatic life events (e.g., illnesses, losses, abuses, financial, and relationship crisis) have been identified as predictive of EDs onset, maintenance, and relapse (Degortes et al, 2014).
Furthermore, during the pandemic there has been an alarming surge of domestic violence, abuse, race discrimination, and social injustice, all of which negatively impact the well-being, and represent risk factors for the development, maintenance, and relapse of people struggling with EDs or other mental disorders.
Finally, perfectionistic expectations and gender role stress have been considered by Cooper et al (2020) as other potential risk factors which can be exacerbated during the pandemic.
Different types of interventions have been more widely used during the COVID-19 pandemic such as Telehealth, online consultation and therapy, and self-help groups as ways to increase protective factors from professional or peer support.
The Role of Mindfulness and Mindful Eating
Mindfulness represents an effective tool for “full catastrophe living” – as Jon Kabatt-Zinn (1990) described in his book because we can learn to surf the waves of these challenging and uncertain times without getting overwhelmed by them. With awareness and a mindful attitude, we are intentionally present to the moment by moment experience, in an open, curious, and non-judgemental way, building up a solid foundation to effectively cope with difficulties in life. Being grounded in our body and noticing the sensations and the rhythm of the breath can represent the board by which we can firmly surf the waves of suffering in a gradual process of transformation, healing, and growth.
Mindful eating brings all the qualities of mindfulness and self-compassion into the whole experience of eating and food choice. The practice of mindful eating creates “the soil” in which to fertilize self-care and grow a joyful, healthy, and nourishing relationship with body, food, and eating.
Therefore, mindful eating may have an important role in the prevention and treatment of eating disorders and disordered eating behaviors, especially during these times of the COVID-pandemic.
But in which ways?
One way may be through the re-connection to the body signals, such as hunger-satiety, stomach fullness, taste satisfaction, and also other physical sensations. All of these are sources of inner wisdom that can be listened to and trusted, instead of the rigid rules of food restriction and the consequent loss of control over them.
Secondly, mindful eating helps us to recognize reactiveness toward urges and cravings, allowing people to pause in order to respond with awareness, making more effective choices.
Moreover, mindful eating helps us to become aware of our self-judging inner critic about the eating experience and our body image. This means recognizing thoughts and emotions without being identified with them. Mindful eating also promotes validation, acceptance, and nurturing with compassion and kindness.
Indeed, from a weight-inclusivity perspective, mindful eating does not promote dieting and weight loss; which can easily trigger the yo-yo vicious cycle. Instead, it supports health and well-being.
As a TCME board member, psychotherapist, mindfulness, and mindful eating teacher, my important mission has been to help people who suffer from eating disorders.
World Mindful Eating Month, an annual online community-based event open to all TCME memers and the public, was found to be particularly important in January 2021 during the COVID-19 pandemic. The aim was to develop or strengthen a daily mindfulness and mindful eating practice for everyone in order to support each other in the path of building a joyful, healthy, and nourishing relationship to food, eating, body, and ourselves. (Learn more and get updates.)
There is still a long way to go in terms of fulfilling our TCME mission of transforming the suffering that grows out of a dysfunctional relationship to eating, food, and body, but the intention is to continue planting the seeds to make it happen.
Additional Resources
Mindfulness Resource Library
A collection of guided meditations and practices. Many are provided FREE to the public.
Exploring Mindful Eating, No CE
Mindful Eating and Disordered Eating
Foundations Series, 2 CE Credits
Mindful Eating for the Treatment of Binge Eating Disorder
Foundations Series, 2 CE Credits
Find more in the online store.
Member's may access many titles for free or at a discounted rate. Login to access the Member Library.
About the Author
You can follow her on Facebook: Mindful Eating Italia or contact her at cclementi@tcme.org
References
Rodgers, RF, Lombardo C, Cerolini S, Franko DL, Omori M, et al. (2020). The impact of COVID-19 pandemic on eating disorders risks and symptoms. International Journal of Eating Disorders, 1 : 10.1002/eat.23318.doi: 10.1002/eat.23318
Degortes, D. , Santonastaso, P. , Zanetti, T. , Tenconi, E. , Veronese, A. , & Favaro, A. (2014). Stressful life events and binge eating disorder. European Eating Disorders Review , 22(5), 378–382. https://doi.org/10.1002/erv.2308 [Crossref], [PubMed], [Web of Science ®], [Google Scholar]
Cooper, M., Reilly, E.E., Siegel, J.A., Coniglio, K., Saden-Sharvil, S. et al. (2020). Eating disorders during the COVID-19 pandemic and quarantine: an overview of risks and recommendations for treatment and early interventions. Eating disorders,https://doi.org/10.1080/10640266.2020.1790271
Kabatt-Zinn, Jon (1990). Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness(1st ed.). Dell Publishing
Vindegaard N and Benros M E. (2020). COVID-19 pandemic and mental health consequences: systematic review of the current evidence. Brain Behav Immun. 2020 Oct; 89: 531–542. Published online 2020 May 30. doi: 10.1016/j.bbi.2020.05.048