Deprivation Binge

Pandemic has fueled eating-disorder surge among teenagers, adults

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Many hospital beds are full. Waiting lists for outpatient treatment are bulging. And teenagers and adults seeking help for eating disorders often find it takes months just to get an appointment.

The coronavirus pandemic has led to a surge in eating disorders and relapses that isn’t abating as restrictions are loosened and the number of COVID-19 cases falls, doctors and other experts say.

“We are absolutely seeing massive increases,” said Jennifer Wildes, a University of Chicago associate psychiatry professor and director of its outpatient eating disorders program.

Some people are waiting four to five months to get treatment such as psychotherapy and sometimes medication. Waits before the pandemic usually were only a few weeks, according to Wildes, who said the program is treating about 100 patients — a near-doubling since before COVID.

The Emily Program, a University of Minnesota-affiliated eating disorders treatment program, is experiencing the same thing. The number of daily calls from people seeking treatment has doubled, from roughly 60 in 2019 to up to 130 since the pandemic began, according to dietitian Jillian Lampert, the program’s chief strategy officer.

’’We know that anxiety and isolation are typically very significant components of eating disorders,” Lampert said.

Some people say ’’my life feels out of control” because of the pandemic and that they’ve resorted to binge eating as a coping mechanism, Lampert said. Others have taken the message ‘’don’t gain the pandemic 15’’ to the extreme, restricting what they eat to the point of anorexia.

Her program offers in-patient treatment and outpatient programs in several states, which switched to teletherapy when the pandemic began, though some in-person treatment has resumed.

”We’ve seen an increase across the board,” in patients of all races, adult, teenagers and sometimes even young kids, she said. That includes LGBTQ people, who tend to have higher rates of eating disorders than other groups.

Peyton Crest, an 18-year-old from Minnetonka, Minnesota, said she developed anorexia before the pandemic but has relapsed twice since it began. She was feeling under pressure when school went online and social distancing began last year.

’’It was my junior year,” she said. “I was about to apply for college.”

Suddenly deprived of friends and classmates, she would spend all day alone in her room and became preoccupied with thoughts of food and anorexic behavior.

With her parents’ prodding, she got treatment in June but relapsed again in September and spent almost two months in a residential treatment center in Arizona.

Her school recently returned to in-person classes, she was accepted at Rhodes College in Memphis, and Crest said she’s doing much better.

“My mental health has improved immensely,” she said.

Wildes said her program hasn’t seen a slowdown.

“People haven’t really gotten back to their routines,” she said, predicting the surge won’t subside until the fall.

The Alliance for Eating Disorders Awareness, which started offering virtual, therapist-led support groups for adults during the pandemic, also has seen a surge. Since January, more than 7,000 people from every state and 32 countries have attended their support groups, said CEO Johanna Kandel.

’’It’s like nothing we’ve seen before,” Kandel said.

Hospitalizations also are up among teenage girls with severe complications from eating disorders, mostly anorexia.

Eating disorders affect at least 9% of people worldwide. They will affect nearly 30 million Americans in their lifetimes and cause about 10,000 U.S. deaths each year, according to the National Association of Anorexia Nervosa and Associated Disorders.

Anorexia, one of the more common eating disorders, typically involves restrictive eating habits and extreme thinness. It can cause abnormally low blood pressure and organ damage.

Signs of bulimia — eating large amounts of food followed by self-induced vomiting — can include frequent use of laxatives and immediate trips to the bathroom after meals.

An analysis published in April in the Epic Health Research Network journal that looked at electronic medical records data from about 80 U.S. hospitals found a 30% increase starting after March 2020 compared with the previous two years. There were 1,718 admissions for girls 12 to 18 through February but no increase among boys.

“The COVID pandemic has presented society and in particular adolescents with very, very significant psychological challenges,” said Dr. Dave Little, a family physician and researcher at Epic who led the analysis. “It may be months or years before we see all of the true impacts.”

He said the data should put parents and healthcare providers on the alert.

’’Talk to your kids, talk to your patients,” Little said. “Ensure that eating behaviors remain healthy, and the sooner you get an indication that there may be an issue, the sooner you respond the better.”

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