The coronavirus pandemic has disrupted daily life for people across the globe, especially those with eating disorders, for whom a set routine is often imperative during recovery.
At least 30 million people in the United States have an eating disorder, according to the National Association of Anorexia Nervosa and Associated Disorders.
Those in recovery often rely on their set routines to maintain a sense of control over their lives and stave off anxiety — something made all the more difficult because of the pandemic, Dr. Dorie McCubbrey, an eating disorder and addiction expert, tells PEOPLE.
“Sometimes it’s about control,” she says, going on to explain the potential internal dialogue one might experience: “‘I feel out of control in my life, so I’m going to use not eating, or I’m going to use binge eating. I can control what I put in my mouth or don’t put in my mouth. I’m going to use exercise — how much I do or how much I don’t.'”
When someone can’t maintain a sense of control during the coronavirus outbreak, an “eating disorder makes it much, much worse,” she says.
In addition to closed gyms messing up exercise routines, another thing heightening anxiety now is trips to the grocery store, which can already be “paralyzing” for those with eating disorders.
McCubbrey says empty grocery store shelves can be triggering, as people either fear taking food away from others, or they want a certain food that’s unavailable, like fresh vegetables.
On the opposite token, the food situation has also made things difficult for those with bulimia or binge-eating disorders, as they’re now inclined to stock up and hoard food for fear of a supply shortage.
“Sometimes people who are really in the throes of their eating disorder went out, and they were panic buying… This is not by choice, this is out of the disease,” McCubbrey says. “It’s panic buying because, ‘What if I need to binge as a way of coping during this pandemic? How am I going to get my so-called drug?’ [And then] their family members have it stockpiled. So here’s someone who’s trying to make peace with food. And everywhere they look, there’s food… they can’t get away from it.”
The expert says that one method of working through increased anxiety in times like these is recognizing that many fears — including, “We’re all going to get coronavirus and everybody is going to die” — are fiction.
Learning to separate those thoughts from fact before spiraling into despair can make a difference.
“Try to get in touch with [what you’re] feeling,” she says. “A big part of our fears and our worries and our stresses is future-based.”
As such, she advises people to “mindfully bring ourselves back to here and now.”
McCubbrey also stresses that eating disorders happen in isolation, while recovery happens in connection — something made all the more difficult as officials continue to encourage social distancing and self-isolation to stop the spread of the virus.
She has launched a virtual, HIPAA-compliant support group via the video-conferencing platform Zoom on Monday nights, aiming to reach those who need it most right in their living rooms.
“That’s how I’m rising up,” she says.
For people whose loved ones may be struggling, McCubbrey recommends being understanding, and knowing that saying things like, “Can you just eat?” will not help.
“It is not up to the friend and family to be the therapist,” she says. “One big thing is to ask the person [what they need]. So rather than trying to mind read… ask, ‘How can I really help you with this?’”
Because grocery shopping can be difficult, she suggests also asking, “Would you like to go grocery shopping together?”
She adds, “You have to have a lot of patience, and if the person needs to engage in their behaviors as a way of coping, then you just let them do what they need to do to the degree that helps them calm down, understanding that they can’t [experience a] perfect recovery overnight.”
As of Friday morning, there have been at least 85,381 cases and 1,271 deaths attributed to the coronavirus in the United States, according to The New York Times.
If you or someone you know is battling an eating disorder, please contact the National Eating Disorders Association (NEDA) at 1-800-931-2237 or go to NationalEatingDisorders.org.
As information about the coronavirus pandemic rapidly changes, PEOPLE is committed to providing the most recent data in our coverage. Some of the information in this story may have changed after publication. For the latest on COVID-19, readers are encouraged to use online resources from CDC, WHO, and local public health departments and visit our coronavirus hub.
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