Several months into the worst public health scenario featuring infectious disease we’ve experienced in over a hundred years, virtually everyone in America has been affected. Millions are working from home, unemployment is rising, and cities are eerily empty as we wait the crisis out. Worse, our medical community and mental health care providers are hard-pressed to keep up their normal services as the virus continues to rise and demand an appropriate response. 

Especially in the field of mental health treatment, more people than ever are reporting depression and anxiety. It’s a natural reaction to a frightening situation – who hasn’t had moments of fear and worry about the future during these hard times? Even though there has been an upswell in efforts to support each other via social media and Zoom meetings, isolation can worsen those mental health issues. 

All these factors combine to increase the risk of relapse for people who are undergoing or have completed anorexia nervosa treatment.

Anorexia Nervosa Recovery Means Continuing to Avoid Disordered Eating 

 As most people know, anorexia nervosa is a dangerous mental health disorder in which people suffer from a distorted body image that makes them feel overweight, and severely restricted food intake to counteract those feelings. The physical consequences of long term anorexia nervosa can be severe. Without enough food, weight loss can be extreme, and the body’s organs can fail to function. Anorexia nervosa is the leading cause of death among mental health illnesses.

The mental health aspect of anorexia nervosa also requires long-term treatment, even after the physical symptoms have been reversed. Relapse is common – as much as 41 percent of people who’ve completed anorexia nervosa treatment will return to disordered eating patterns within two years of completing treatment. 

With the current crisis, there are several factors that can trigger a return to food restriction and other disordered behaviors.

#1 Group Therapy Sessions Might Be Restricted

Group therapy is a central part of most eating disorder treatment programs and their aftercare plans. It’s cathartic and eye-opening to find the courage to discuss mental health issues with people that share the same disorder. It validates people and creates a sense of support that can impart the strength to cope with triggers for disordered eating. The rise of social distancing during the pandemic means that in most cases, group therapy can only be achieved via teleconference. Although these conferences are better than nothing, many patients miss the connection of face-to-face meetings.

#2 Restaurants Are Closed

Most people with anorexia nervosa are deeply uncomfortable in social situations where eating is requires, or at least is the central activity, which is to say, a huge number of social situations. Eating disorder treatment programs often incorporate restaurant trips after their clients are stabilized, to help their charges get back to a “normal” eating pattern. After treatment, many recovered people continue to visit restaurants as a way to maintain a balanced relationship with food and eating. Without this opportunity, isolated anorexia nervosa sufferers might backslide into a restrictive eating pattern.

#3 Grocery Shopping Is a Nightmare

Treatment centers also often include grocery shopping excursions, teaching clients how to plan nutritious meals and overcome hesitance or fear of being around food, which is common in restrictive eating disorders. The coronavirus pandemic has led to widespread social distancing at grocery stores, as well as shortages in some kinds of food. This can be a trigger for a relapse – the individual might look at the hassle of braving a supermarket these days and simply say, “No way.” This, of course, might lead to the resumption of calorie restriction and other disordered eating patterns.

What Can We Do to Maintain Recovery

It might seem hopeless – but it’s not. Many of the coping techniques and other lessons taught at eating disorder recovery don’t require entering a social situations. Mindfulness exercises like yoga and structured journaling, which help people with anorexia nervosa identify and remove negative feelings, can be performed at home and in isolation. Also, the family and friends can continue to provide emotional support or volunteer to help keep meal logs with their loved one. Finally, as we mentioned, many eating disorder treatment centers are providing telehealth services to continue aftercare and outpatient therapy sessions. 

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