It seemed positive — people turning pandemic isolation into motivation to exercise and eat healthier —– but, for an alarming number of youth, it progressed to obsession that triggered eating disorders.
“Some kids got caught up in the health craze and continued to an unhealthy point,” said Jennifer Downs, MD, a child psychologist at the Institute of Living, part of the Hartford HealthCare Behavioral Health Network, and assistant medical director of child psychology at Connecticut Children’s Hospital. “We are seeing unprecedented numbers of patients with eating disorders since the beginning of the pandemic.”
Typically, there are one or two adolescents with eating disorders in the hospital. Since October, she said there are four or more, some of whom have been there for months. For reference, she said the hospital cared for 54 malnourished patients with eating disorders in fiscal year 2019 and 84 in fiscal year 2020. In the first quarter of the current fiscal year alone, there have been 32 patients, which could total more than 120 by year’s end.
Patients, Dr. Downs explained, fall into two categories:
- Those who have never struggled with eating disorders before but became fixated with weight loss during the pandemic. “These kids got too thin over the summer and began going to the doctors in the fall,” she said.
- Youth who already struggled with eating disorders and mental health disorders like anxiety or depression, and worsened in the pandemic. These are more severe cases often requiring feeding tubes for adequate nutrition and are hospitalized longer because it’s hard to find transitional care to treat both eating and mental health disorders.
Dallis Kehoe, a college sophomore, said downtime when school went remote last year gave her time to stew in negative body image thoughts that had festered inside. A former ballerina and track competitor, she didn’t see an athletic body in the mirror but one larger than everyone else.
“I thought my legs were gigantic. As I got older, it was my arms and then my entire body,” she admitted, saying the distortion led to eating disorders. She had been improving until COVID-19 hit. “During the pandemic, the only way to connect with people was through social media. I saw only perfection, and you just compare yourself and hyperfixate on yourself.”
An eating disorder, Dr. Downs explained, is a psychological illness in which patients are not in control and feel compelled to avoid eating. Disorders like anorexia nervosa, bulimia and binge eating are the most deadly mental health conditions with a death every 62 minutes. Patients with eating disorders, she explained, are six times more likely to die than others with mental health conditions, four times more likely than someone with major depression.
The thinking of youth like Kehoe becomes distorted, Dr. Downs said.
“We talk about externalizing the disorder, like it’s another entity living with them,” Dr. Downs said. “We ask them, ‘Is that you thinking that or the eating disorder?’ Then we help them identify healthier thoughts.”
Finally realizing social media isn’t realistic, Kehoe began to shower herself with “radical self-love.”
“I realized food is not the enemy, my intrusive thoughts are the enemy,” she said, adding she also sought professional help for a problem that’s “more universal than people think.”
Some youth — those who like to be in control or are overly focused on personal appearance — are more prone to eating disorders, Dr. Downs said.
“These kids were losing control during the pandemic. Eating was something they could control,” she said.
Parents can look for these signs of eating disorders:
- Commenting more about personal appearance.
- Changing eating habits such as cutting out entire food groups or eating alone.
- Skipping meals.
“It starts off innocently enough and then goes to the extreme,” Dr. Downs said.
For help, parents can call the pediatrician who can check the youth’s weight and talk about their relationship with food. There might also be referrals to a therapist, nutritionist or a treatment program. Without access to such care, she said patients risk relapse, hospital admission and readmission, and even death.