EATING DISORDER COUNSELING DURING COVID-19

As Covid-19 has ravaged the world, so too has it negatively impacted those who suffer from eating disorders. Eating disorder recovery faces many challenges during the pandemic, and as a result eating disorder counseling may look different here lately.

As a therapist specializing in treatment of eating disorders in Plano, TX, I have noticed my clients with anorexia, bulimia, and binge eating disorder having a harder time since this pandemic began. We now have research to confirm this phenomenon. In this blog post I explore the reasons eating disorder recovery is so challenging during Covid-19, and ways to address this in eating disorder therapy. Read on to discover how my sessions with clients have shifted with the emergence of Covid-19.

Eating disorder counseling focuses on managing anxiety and depression

This has always been true, but it's even more true now. Most clients with eating disorders deal with another mental health challenge such as depression or anxiety. With so much change forced upon us this year- isolation, lost jobs and wages, changing work and school environments- our resilience has been pushed to the limit. I've had to help clients get creative with ways to supercharge their coping skills.

I now place more emphasis on working with multiple health professionals such as a psychiatrist and dietitian, as well as a general practitioner. I focus more on teaching anxiety reduction techniques that can be done alone, cost-effectively, at home. And I talk about the importance of the basics like sleep, taking meds as prescribed, and not running out of them. I've encouraged clients to talk more with their doctors about adjusting meds when their tried and true coping skills aren't working anymore. And I talk in EVERY session about using skills to "cope ahead," to make sure they are proactive in keeping depression and anxiety at bay if possible.

Eating disorder counseling focuses on improving structure

We've all experienced a lack of structure in many aspects of our lives since Covid began. For those in eating disorder recovery, this structure is essential to recovery. A lack of access to food, having more food on hand at home, and anxiety about both of these can trigger restriction, purging, or binge eating behaviors. I have been encouraging my eating disorder therapy clients to take advantage of grocery delivery or curbside grocery pickup to help maintain the structure of keeping the kitchen stocked.

Time management skills have been a bigger focus this year. With more time on our hands, many have fallen into bad habits such as not eating at regular times, skipping meals, or solely relying on eating to soothe negative emotions. Working or learning from home, as well as having to oversee kids' online learning, has been incredibly challenging to our sense of structure and control over our time. I help moms brainstorm ways to find a few moments of recharging alone time. I help others who work from home, sitting in front of a computer screen in the same room all day, find ways to take short breaks to do mindfulness exercises, or set stronger boundaries on work/life balance. It all seems to run together these days, and our brains need a break.

Eating disorder counseling focuses on triggering environments during Covid-19

Many of my clients are young adults who have had to move back in with parents for various reasons. Most have found this to be incredibly challenging, despite it being helpful financially or for offering structure. Old conflicts reemerge. Often there's a whole house full of folks not doing well emotionally. I have been helping clients brush up on healthy communication skills, and practice setting forth effective boundaries with family members.

One of the most challenging issues facing those with eating disorders during Covid-19 has been the increase in time spent online. Social media has offered more opportunities for comparison to others, especially as it relates to appearance. Discussions abound online about Covid's negative impact on our weight, eating, and exercise habits. More disturbing is the explosion of weight stigmatizing conversations, erroneously highlighting the danger of Covid for those at higher weights. Nowhere but the eating disorder professional community did I see any counter-arguments to this. As a result, I've been working harder to help clients find ways to spend time OFFline. I've worked harder to help them find creative ways to manage their time online or create a more life-enhancing social media feed.

Another trigger I've noticed as an eating disorder counselor relates to exercise. For some who have more time on their hands lately, they've spent this time engaged in unhealthy amounts of exercise to offset their sudden sedentary months. For others, a lack of access to the gym has increased body dissatisfaction,

Eating disorder counseling focuses on social support during Covid-19

The hardest challenge of all during this worldwide crisis has been finding ways to connect and avoid the dangers of social isolation. For those with eating disorders, it's essential to lean on others for support and accountability. This includes their treatment providers, friends, family, and support groups. Luckily the treatment world responded fairly quickly with video platforms that allowed us to continue eating disorder counseling and other supportive services. But this has still not been enough for some. I believe in-person therapy offers a healing interpersonal experience for folks, and a human staring back at you on a screen just doesn't cut it for some. Again, this challenge has pushed us to become more creative. Some eating disorder therapists are doing outdoor sessions. Others, like myself, are doing in-person sessions with precautions like masks and air purifiers.

For all clients, though, I have been recommending finding some way to maintain contact with others, even if virtually for now. I remind people that just seeing other humans out in the world can be helpful for cultivating a sense of belonging. I advise folks drive through Starbucks and drink coffee in their car while they watch others come and go. Or take it to a park. Or get out for a walk and notice the other people out and about.

Unique treatment challenges call for creativity

Above all else, we've all had to get creative with handling this virus. I highlighted some of the ways I've done this above. I've also been teaching my eating disorder clients the art of acceptance skills. These come in handy anytime, really, but especially during a time of uncertainty. It's the idea that you can dislike something and still accept that it's reality.

If you could use help in managing your eating disorder during Covid-19, let's talk. I'd love to help you get creative about your recovery, too!

If you are considering help overcoming an eating disorder, I’d love to help. I have over 20 years of experience helping adults improve their mental health. I specialize in anxiety and eating disorders like binge eating, emotional eating and overeating, anorexia and bulimia. I offer in-person sessions at my Plano office and online therapy in Texas. Contact me for a free 15-minute phone consultation and take the first step toward recovery. If I can't help, I can connect you to another great therapist!