Trigger warning: The following article discloses experiences of those struggling with eating disorders from mild to severe. Please be advised. 

One year ago, on March 16, coronavirus erupted and the world went into quarantine. Schools closed down, families stayed in their homes, and people waited for things to get better. But the virus left us in turmoil for longer than anyone anticipated. While COVID-19 left its mark, killing millions of people, it also left casualties beyond death. Mental health cases rose to astounding new heights, and among them, eating disorders. 

According to the National Eating Disorders Association, eating disorders have increased dramatically nationwide, reporting a 78 percent increase to its helpline since March. Locally, the University of California, San Francisco Medical Center (UCSF), reported double the number of its patients seeking eating disorder treatment since COVID-19.

 Even prior to COVID-19, eating disorders in Marin have been a prevalent problem. The Marin Magazine estimated that Marin has twice the amount of eating disorder cases than the national average and COVID-19 has only increased the number of people struggling. While eating disorders include anorexia, bulimia, and orthorexia (having an unhealthy obsession with eating “healthy” according to healthline.com ) etc., unhealthy relationships surface in the form of disordered eating. While harder and more complex to identify than an eating disorder, disordered eating includes a spectrum of behaviors such as frequent dieting, meal skipping, chronic weight fluctuations, and rigid routines surrounding food and exercise. In addition, having feelings of extreme guilt and shame after eating is also associated with disordered eating. 

The Tam News posted an Instagram poll asking young adults aged 12-25 if they had changed their eating habits since COVID-19, 300 people responded. 245 voted yes and only 45 voted no. Out of those 245 people who answered yes, 190 of them were girls and 55 were boys. 

Eating disorders can appear anywhere on the spectrum from mild to severe. Lori Lavinthal, specialized eating disorder therapist touches on behaviors that are associated with mild eating disorders, “There’s a cognitive piece which shows people weighing themselves frequently or checking parts of their body as a way to reassure themselves things haven’t changed and they haven’t gained weight,” she said.

On the severe side of the spectrum, eating disorders can lead to enormous harm. They have the highest mortality rate among mental illnesses, with 10,200 deaths each year—that’s one death every 52 minutes, according to the National Association of Anorexia Nervosa and Associated Disorders. 

A team senior under the pseudonym of Jack spoke to the detrimental impact of eating disorders on his own life. 

“The eating disorder is never going to be satisfied. Even if you get to your goal weight, you are still going to look at yourself as fat and [think] that you look shitty. It’s not going to compromise until it basically kills you,” he said. 

Prior to COVID-19, Jack didn’t struggle with eating whatsoever. He ate whatever he wanted whenever he wanted without focusing on his weight. Then around September, he noticed he had gained weight over the pandemic. 

“I was never someone who weighed myself regularly, but I decided to weigh myself because I was curious and that number kind of took me aback, it was way higher than I thought it was going to be. So then I was like, ok shit, I should lose some weight, even though the number wasn’t anything crazy,” Jack said. 

Jack started intermittent fasting — alternating cycles of eating and fasting, generally involving 16 hours of fasting in order to restrict your eating to an eight-hour window according to healthline.com —which spiraled into calorie counting. Jack began eating less and less each day, evolving into what he called “full-fledged anorexia.”

 “When I was going through it I was thinking, ‘oh this is my choice’, kind of like an addict like I can quit anytime I want to, but it wasn’t true. It’s just as addictive as a drug.” 

Jack said his breaking point was when his mental illness got in the way of his physical wellbeing. “It’s going to sound funny, but when I was really restricting what I was eating and overexercising it felt good … And then there was a point where that slipped …  I started to notice I was seeing stars all the time and in the shower my hair was coming out in my hands and I was like f*ck this is doing me no good,” he said. 

Jack had lost 25 pounds in around two or three months. After realizing the extent he was harming himself, Jack sought help in his family first and is now working with a therapist for eating disorders and a dietician. He has found the recovery process difficult and not always linear. While Jack’s support network helps him stay on track, aggregators like social media play put stress on his anorexia.

“Part of the reason I feel like I am dealing with this sh*t more during quarantine is that you’re not seeing people as much. The only bodies you’re seeing are the ones on the internet you get a really distorted idea of what a normal body shape and type is. On Tik Tok, there are these really hot guys and a lot of them are all disordered eaters. That’s not what you want to hold yourself to. It’s not real and it’s not natural, but it gets in your head,” he said

Another element that makes recovery difficult is the social isolation that has come with COVID-19. “It’s been difficult because oftentimes the way we support someone in an eating disorder recovery is not available because of the social isolation component,” Lavinthal said. “I think this is a piece of why eating disorders have increased. Before Covid[-19] you would eat with other people as a strategy. You would eat because you wanna appear ‘normal’ with family and friends and so you wouldn’t overeat or restrict like you would do when you are alone.” 

Lavinthal, touches on the reasoning behind why COVID-19 has spurred eating disorders in people who had not experienced it priorly. While the surface level causes include body image or dysmorphia, control plays a large factor.  “People are trying to achieve some control in a stressful or uncertain or unknown environment – and that is so Covid … During quarantine there has been this constant flux and change. People with eating disorders are drawn to having a schedule and routine, and so COVID-19 disrupting folks routines serves to exasperate this mental illness,” Lavinthal said. 

“You are not witnessing as many people in eating in a healthy way, and not as much access to other aspects of your life that would serve as a distraction whether that is social, or sports or entertainment, or just getting out of the house where you are not stuck at home with all of your thoughts,” Lavinthal said

Tam junior under the pseudonym Victoria found a shift in her routine eating habits since lockdown. She explained how the additional time gave her the opportunity to fixate on food, and like Jack her obsession with food escalated.

 “It started with skipping a meal every day and then it came down to where I was barely eating and I was saying I’m not hungry or hiding snacks and throwing out food … And when that didn’t feel like it was working I did a lot of calorie deficit stuff and then I started losing a shit ton of weight. It was really bad. My mind thought it was good for me but it was bad,” she said. 

Prior to quarantine, Victoria had always struggled with body image but it hadn’t really affected her eating habits to this degree. “Before I wanted to lose weight, but I didn’t really know how to do it in a healthy way. I would skip meals occasionally but there it didn’t affect my weight. It was more hating my body but not doing anything about it,” she said. 

Around December of 2020, Victoria’s eating disorder had an impact on her physical health. She got sick (with an unknown illness) resulting in hospitalization. Her body was too malnourished to heal by itself. 

“Getting sick was a huge wake-up call for me,” she said. Her doctors recommended for her to return to therapy, as well as participate in a UCSF Medical Center program. Victoria declined to take those steps and instead decided to face her eating disorder on her own terms. 

She has also turned to intuitive eating, which involves “the idea is that you should eat when you’re hungry and stop when you’re full,” according to Healthline.com. Victoria said,  “Having the control of knowing what you’re putting in your body really helps me. The thing I had to get in my mind is that you have to eat no matter what, like you can’t just not eat. You can eat and it can be healthy but you have to eat something.” Victoria explained how once eating three meals a day stressed her out, eating healthy has made this task easier. 

Like Victoria, senior Stella Waters had a hard time eating three meals a day. “In my mind, I would think, if I eat all three meals today I will gain weight, so I would only eat two,” she said.

Waters’ eating disorder was spurred when quarantine began to impact her mental health. “So I got really, really depressed during quarantine … When I get sad like that, I just won’t eat. There was a week where I barely ate and because of that week I noticed how much weight I lost, and I kind of liked that I lost weight, but I didn’t want to,” she said.

When Waters got to a point where she couldn’t play lacrosse, she realized she needed to do something to improve her relationship with food. “I was like oh shit, you definitely need to eat all three meals, and have snacks, and listen to your body when it says you should eat because you’re hungry,” she said. After reaching out to her doctor on Feb. 1, Waters is expecting to be cleared for sports March 22

While COVID-19 spurred Waters’ eating disorder, she explains that she has been conscious about the food she puts in her body since she was around 15 years old. Waters is not alone, in fact, according to breakbingeeating.com, around 50 percent of young 13-year-old American girls reported being unhappy with their body. This number grows to nearly 80 percent by the time girls reach 17 years of age. 

Regardless, body image consciousness has no clear-cut age range. A senior under the pseudonym of Sadie has been conscious of her body since elementary school.  Despite her negative body image, hating eating was never something Sadie experienced until quarantine. “I noticed how my diet started changing my body for the better during quarantine, in my opinion, and that’s when it started to become a real issue … I had dropped to 100 pounds and I had loved it,” she said. In order to lose weight, she had been eating three very small meals a day, which she had described as a portion size of less than a snack. While her own body image fueled Sadie’s desire to have a restricted diet, she explained how her friends and people she surrounded herself with had an impact on her eating habits as well.

“When I started losing weight I got all these compliments from other girls saying how good I look, and how skinny I was. I could see the girls complimenting me were wanting to do something more drastic to become skinnier,” she said. 

Currently, Sadie has gained back seven pounds, and while she recognizes it is healthy for her, gaining weight remains difficult to put in positive connotation. “I am already pointing out all the things about my body I hate,”  she said. 

Apart from getting healthy, opening up about her eating disorder is difficult, “I haven’t admitted to anybody that I have an eating disorder. I just say I am not eating because I don’t like food. But I definitely see aspects where I am like this is a problem, and I really don’t want a problem,” she said. 

Victoria speaks to the difficulty of opening up to someone about her eating disorder “I have one friend that I have opened up to, but it’s difficult because I feel like eating disorders are very personalized and everyone has different reasons for them. Some come from control, and some come from body image issues. I try not to tell people about it because it gets complicated and people just don’t understand,” she said.

For Jack, using others for support has been critical in his recovery, “I really didn’t want my family to find out, but eventually I told them … They help now, like, it’s easier to eat breakfast if my mom is making it for me so I don’t have to motivate myself to make it,” he said.

“Part of recovering is letting go of the control over intake, and building flexibility. Oftentimes in adolescents, family support is really important in helping diversify what kids are eating and preparing their meals for them,” Lavinthal said. 

Senior Piper Rutchik, who has struggled with a fluctuating relationship with food and her body weight has her own method for motivating herself to eat, “When I have periods of anxiety I have weeks where I just can’t eat because my stomach hurts so bad, and I am so hungry, but I feel like I can’t keep anything down. Yogurt is really good for me. If I get to this point, I know I can eat yogurt apples, or blueberries and feel a lot better and be able to eat more … I found something that prompts me to eat because I know it makes me feel good,” Rutchik said. 

Something Rutchik uses to positively impact her relationship with food is support from her loved ones, “My boyfriend had really picked me up, he helped me realize no you’re beautiful stop it. I was that insecure with how I looked, and how I had been treating myself… even just subtle reminders from a loved one were something that made me get out of the mentality of hating my body, and hating the way I looked,” she said. 

Jack reminds himself, “Food is essential, it’s medicine, it’s not something you can stop doing. You deserve to eat, and you deserve to feel okay. That stuff is so much more important than how you look … starving yourself — it’s not worth it,” he said. 

Lavinthal explains that another important element on the path to recovery is normalizing discomfort. Many of her clients avoid behaviors- eating their full portion for example- out of fear. “The one way to get through discomfort is to experience it, the more we avoid a certain situation the more we reinforce the idea we can’t handle it,” she said. 

Victoria shares wisdom from her experience, “I would say take a step back and think about all the other aspects about yourself that are admirable,” Victoria said. “I feel like when people have eating disorders it’s a big focus and they forget about all the things that make them great. Just remind yourself that you’re a bad bitch and you don’t have to starve yourself, you deserve to eat. You deserve to have a meal and not feel guilty about it.”