Eating Disorders During the COVID-19 Crisis: The Importance of Engagement & Outreach

Woman concerned with her eating disorder and the upcoming holidays

A huge life-change or world event will impact individuals to varying degrees. Eating disorders during COVID-19 are no different. By late-May 2020, one-third of Americans were showing signs of clinician anxiety, presumably related to the outbreak of COVID-19 [1].

For some populations, the impact is predictable, and we have seen that in the way the COVID-19 pandemic is affecting those with eating disorder diagnoses.

Multiple countries have assumed that “factors related to COVID-19 will affect mental health in the general community, but may have greater adverse effects on individuals with pre-existing mental illnesses” and that responses to the impact of COVID-19 should absolutely consider this [1].

There has been little time to conduct official research on this impact. However, a few studies have been sanctioned that are expanding our awareness.

COVID-19 and Eating Disorders

One of the above-mentioned studies surveyed 1,021 individuals in the United States and the Netherlands and found that “results revealed strong and wide-ranging effects on eating disorder concerns and illness behaviors [1].”

Many are referring to the outbreak of COVID-19, and subsequent global changes relating to it, as a “perfect storm” of triggers for individuals that struggle with disordered eating, exercising, and body image.

The study mentioned seems to support this, providing insight that those with eating disorder diagnoses are struggling more intensely than before. Individuals surveyed that struggled previously with Anorexia Nervosa (AN) self-reported “increased restriction and fears about being able to find foods consistent with their meal plan [1].”

Those diagnosed with Bulimia Nervosa (BN) and Binge Eating Disorder (BED) experienced “increases in their binge-eating episodes and urges to binge [1].” Overall, those surveyed reported increased feelings of anxiety [1].

Crises Colliding

Woman struggling with eating disorder during COVID-19For those that struggle with challenges related to food, nourishment, body image, exercise, self-view, and the concepts of power, control, perfection, worth, and emotions, things were already difficult.

These individuals exist in a world rife with diet culture messages geared toward convincing consumers that they are not enough, that their worth is based on their appearance, and that their bodies are the key to “fixing” this.

Recovery warriors that bravely engaged in this world on a daily basis, determined to create new belief systems for themselves that kept them safe and healthy, are now finding themselves in the dark due to the COVID-19 outbreak.

Previous recovery skills such as engaging socially, reaching out for support, using distraction skills, exploring identity with activities, challenging disordered behaviors with eating and grocery shopping are all infinitely more challenging.

Many are socially isolating at home, cannot physically go to work or to see loved ones, struggle to safely go to the grocery store, and, even if they do, may not find foods they have become comfortable with in their recovery meal plan.

If you are not directly experiencing this challenge, please consider how frightening it must be. For this reason, engagement in treatment and outreach to those vulnerable is crucial in these times.

Just as we reach out to our elderly loved ones to make sure they are engaging in behaviors to keep themselves safe, so should we support and check-in with those we care about that struggle with disordered eating.

How to Engage & Reach Out

Woman calling to check in on her friend with an eating disorder during COVID-19For eating disorder treatment professionals, engagement involves checking-in with clients on how to best reach them. During this season of our world’s history, the best option may not be to continue face-to-face treatment or services. In fact, that option may not be possible even if it is the “best” choice.

Treatment professionals should remain open and flexible to their client’s needs, considering providing teletherapy or video therapy. These are not the ideal conditions to foster huge change. However, clients that are medically stable can continue to grow in their recovery more by receiving therapy over technology versus not at all.

If you are not capable of providing treatment through these avenues, ask yourself if your client would be better-served transferring to a professional that can. For those with a loved one struggling with disordered eating beliefs or behaviors, reaching out is just as simple as it sounds.

Check-in with those you are worried for. Without judgment, assumption, or expectation, ask them how this pandemic, and the changes related to it, are impacting their thoughts, emotions, daily routine, feelings of control and stability, and anything else related to their recovery.

Just beginning this conversation can be enough to remind them that their recovery and their safety is something others care about. It can remind them that they are not their eating disorder. It can remind them that they are not alone.

We have all been challenged in some way or another during this pandemic. We must all take steps to flexibly reach those we have sworn to help and take care of one another.


[1] Termorshuizen, J. D. et al. (2020). Early impact of covid-19 on individuals with eating disorders: a survey of ~1000 individuals in the United States and Netherlands. Retrieved from

About the Author:

Image of Margot Rittenhouse.Margot Rittenhouse, MS, PLPC, NCC is a therapist who is passionate about providing mental health support to all in need and has worked with clients with substance abuse issues, eating disorders, domestic violence victims, and offenders, and severely mentally ill youth.

As a freelance writer for Eating Disorder Hope and Addiction Hope and a mentor with MentorConnect, Margot is a passionate eating disorder advocate, committed to de-stigmatizing these illnesses while showing support for those struggling through mentoring, writing, and volunteering. Margot has a Master’s of Science in Clinical Mental Health Counseling from Johns Hopkins University.

The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published September 24, 2020, on
Reviewed & Approved on September 21, 2020, by Jacquelyn Ekern MS, LPC