This article was originally published by the BBC on 1 April 2020.
You may have seen a meme going around about “the Covid 19” – a reference to gaining 19 pounds while observing social distancing.
These types of jokes can be triggering for people with disordered eating. Yet they also reveal more general anxiety about the coping strategies of people cooped up inside. “A lot of people are struggling with their eating right now – and probably in different ways than they’re used to,” says Las Vegas-based clinical psychologist Cortney Warren. “There is certainly a great deal of research to suggest that when people are in a crisis situation, when they are highly stressed, one of the first things that will change is their eating behaviour.”
There are physiological reasons for turning to food when the world has turned upside down. The body tends to crave high-calorie and high-sugar foods during stressful times, as these foods provide short-term bursts of energy. Stress leads to elevated cortisol levels, which can increase appetite. And sugary foods generate dopamine, the neurotransmitter associated with motivation and reward. Like other distracting behaviours, Warren says, disinhibited eating “can activate the pleasure centre of your brain but also can psychologically remove you from the negative emotion that you’re feeling at the time”.
Seeking out pleasure via food is a common strategy. Of adults surveyed by the American Psychological Association in 2013, 38% reported that they’d overeaten or eaten unhealthy foods in the past month due to stress. Jim Quick, a management professor at the University of Texas at Arlington, says that (along with badly managed conflict) the main factors in occupational stress are uncertainty and a lack of control – two things which are in high supply right now.
Thus, sometimes emotional eating is “the only coping toolkit we have in our bag – especially during times like now”, says Katherine Kimber, a registered dietitian and spokesperson for the British Dietetic Association. “It’s okay to give yourself some slack.”
Unique stressors
It might seem insensitive to talk about stress eating now, with so many people worrying about food and money due to Covid-19’s massive economic disruption. Yet worrying about food can itself transition into emotional eating. Kimber explains that “restriction, whether it be a physical restriction (not physically being able to access food) or an emotional restriction (perceiving foods as bad), can have a backlash effect and increase disordered eating behaviours”.
This sense of restriction, if people are experiencing it, will now be interacting with other unique stressors linked to social isolation and sheltering in place. One of these stressors is the loss of routine for the many people whose work and social lives have been overhauled. For instance, an office worker whose weekday is partly structured around a cold meal before commuting, a purchased meal midway through the workday and a hot meal after returning home has lost that familiar way of ordering the day. Having to expend more mental energy on each of these decisions, from the timing to the possible shortages, can lead to higher anxiety.
Another stressor at the moment is increased boredom, which is linked with emotional eating. At the same time, people have become untethered from many of their usual coping strategies, such as meeting up with friends and spending time in nature.
Caroline Kamau, an organisational psychologist at Birkbeck, University of London, whose research links burnout to binge eating, points to five risk factors that might now make someone especially prone to this common form of disordered eating:
1) Mental health problems, especially anxiety and depression
2) Body image issues, including frequent dieting and weight changes pre-pandemic
3) A highly impulsive personality, which might take the form of excessive gaming, gambling or drug use
4) Emotional eating, for instance reaching for food when upset
5) Friends and relatives who have disordered eating
“Most people probably binge eat once in a while but wouldn’t be classified as having binge-eating disorder,” Kamau is careful to point out. For instance, it’s common to devour a whole pizza once in a while, and this wouldn’t be concerning. Yet a milder form of this may be becoming more frequent now, even if it doesn’t reach the threshold of a disorder. “When you’re in a situation where you’re highly stressed, you’re more prone to engage in disinhibited eating,” Warren says.
While over-eating can feel good in the short term and provide initial comfort, this doesn’t last. That first flush of feeling good is often followed by guilt, which increases distress.
Connect with family and friends
So how can we maintain a healthy relationship with food at a time when there are limited avenues for fun and higher levels of stress?
The US Substance Abuse and Mental Health Services Administration has a fact sheet on coping with stress during infectious disease outbreaks. Though it was published in 2014, and specifically mentions Ebola, many of the recommendations remain relevant for Covid-19.
A key suggestion is finding social connection. In my WhatsApp group of fellow vegans, we’ve been sharing photos of our “corona cupboards” and some of our meals. It’s a way to practise photography and exchange practical tips, but also to continue connecting by means of food – the very thing that brought us together in the first place. It’s a means of making food a more social experience, especially for those of us who live alone or live with non-vegans.
Kimber also suggests continuing to celebrate milestones like birthdays with food. This could involve, for example, sharing photos of cake for people who can’t connect in person, cooking the same favourite meal from different corners of the world, or gifting restaurant vouchers to be used in a post-coronavirus world.
On a daily basis, Kamau emphasises the importance of structure as a way of boosting wellbeing. “It is important for people to carry on with having aroutine, to try to wake up at set times and go to sleep at certain times,” she says. “People shouldn’t be tempted to sort of have a chaotic lifestyle because of the freedom that working from home comes with.”
Routines should incorporate sleep, exercise, socialising, meditation/prayer/therapy (for people who practise them), and of course food. It’s obvious that a healthy diet should include plenty of fruit and vegetables, but there are other rules of thumb for nourishing our psyches.
“Evidence suggests that working from home can improve what we call synchronicity in family eating: having mealtimes together,” Kamau says. Having three family meals a day is associated with fewer symptoms of depression – part of a chain effect between disrupted routines and depression. And as a low-fat diet can be associated with a risk of depression, adding in healthy fats may be helpful.
This may not be feasible for everyone, including people temporarily separated from their families and those experiencing financial distress. Kimber acknowledges “the huge amount of class privilege that comes with being able to follow specific dietary advice, and even more so during these uncertain times. Some people can’t even eat consistently, because they can’t afford it.”
More generally, Warren advises people to lean into their emotions rather than stuffing them down by means of food. Of the Covid-19 world, she says: “This is a ‘crisis situation’ that is unlikely to end soon. We’ve got to develop some longer-term coping strategies for dealing with it.”
Manage your triggers
One tool could be “worry time”, where you take up to 30 minutes to bring up all the negative emotions you can about the topic that’s worrying you. You allow yourself this period to feel your emotions as intensely as you can – screaming, writing in a diary, calling a friend or doing whatever else is necessary. Afterwards, as Warren describes it, “you just put it to the side until your next scheduled worry time, because you really can’t potentially sustain that amount of fear and pain and negative emotion for a whole day”. This technique won’t work for everyone, but Warren encourages experimentation.
Another tool is an exercise Kimber uses with her clients to find alternatives to emotional eating. This involves writing down:
- five people you can call when you feel down (e.g. a friend)
- five ways you can relax (e.g. take a bath)
- five places you can go to calm down (e.g. to a cosy corner)
- five things you can say to yourself (e.g. “this feeling will pass”)
- five activities you can use for distraction (e.g. start a puzzle)
The aim is to understand what’s driving your craving for a chocolate bar, for example. It might not be the chocolate itself, but a desire for relaxation or a change. “If you find yourself looking for food when you know you’re not physically hungry, and you know you’re not restricting [food], then this is great information. Your body is asking you for something. So this is a good time to ask yourself, what is that?” Kimber explains.
Related to this, it’s important to know our triggers. Mine is reading the news online. Mindlessly chewing and scrolling, I might barely register what I’m eating until the crisp bag is empty. So for people like me, eating a satisfying meal before clicking over to a news site (or simply checking the news less often) might be helpful.
Food can be a source of comfort and connection during turbulent times. But your health, and more importantly your relationships, will be stronger if you reach for the phone rather than for a biscuit the next time you’re looking for comfort. And if you know someone who might be struggling with self-judgement over their eating, Warren says, “reaching out while we’re socially distancing, still trying to stay connected to people, will be very beneficial probably to all of us”.
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