COVID baking and ‘instagood’ bodies triggered eating disorders in pandemic

Eating disorder referrals increased during the COVID-19 lockdown, according to an eating disorder treatment specialist who runs the Dar Kenn Għal Saħħtek (DKS) centre in Mtarfa.

Biologist Dr Lucrezia Cipolla, who specialises in eating disorders, said DKS had received an increase in calls from both ex-patients with relapses, and new cases.

DKS is an eating disorder treatment centre in Mtarfa.

“Restrictions due to COVID-19 were drastically and unexpected, so people found themselves at home with their life totally changed. No school and sport for teenagers, no social life for everyone, no occasions. It’s the opposite of what we suggest when recovering from an eating disorder,” Cipolla told MaltaToday.

The lockdown prompted a social media onslaught on people advised on how not to gain weight, overeating, the inability to move around enough, as well as images cooking and exercises at home. “This could be a real trigger for a person with an eating disorder or someone susceptible to those diseases,” Cipolla said.

The COVID lockdown created a perfect storm for persons with eating disorders, who lacked a structure on how to deal with staying at home.

“I agree it’s not easy for teenagers or young adults not to have hope and plans for the future: anxiety increases and bad thoughts overcome happiness,” Cipolla said, who saw many former patients in recovery suddenly triggered into relapse during the lockdown.

“Everyone was speaking about food, body shape... everyone was afraid to gain weight, time spent on social media was increasing and as we know, social media can be both a good but also a terrible influence.”

Cipolla made special mention of social media ‘challenges’ in which teenagers were instigating eating disorders. “One was a challenge where teenagers put their face mask on their waist to see if they are thin enough to tie it. Of course, it’s quite extreme.”

She said even the COVID restrictions themselves mimicked the symptoms of an eating disorder – not trusting people, social distancing, stopping all social life. So it was easy for those already suffering from eating disorders to have a relapse. “Whatever they learnt and the strategies to fight the disorder, such as going out, trying not to stay at home alone, trying to eat at a restaurant and join social events, going out to avoid the binge or the excessive exercise, were stopped due to COVID restrictions.”

Left: Dr Lucrezia Cipolla, right: Roxanne Mangion

DKS has already changed some methods to its recovery plan, such as working without outings or visiting hours for parents. “But we are still working with the patients for a future without COVID so they can be prepared for the social life they have lost because of their eating disorders,” she said.

For now, the only solution to this emerging problem is giving an accurate idea of diet which does not restrict one’s lifestyle – not educating people on “good” or “bad” foods, but that people should eat different portions and frequencies depending on the product.

Cipolla said it was also essential to teach youths that the persons behind photos seen on Instagram are indeed different in real world without smartphone filters and photo-touching.

“Beautiful doesn’t mean skinny. Food is not calorie but tradition, memories, sociability and sharing. It’s not the piece of cake of our birthday or the Christmas lunch or the wedding of our best friends that make us fat, but bad lifestyle choices throughout the rest of the year.”

Eating disorder survivor Roxanne Mangion, who has been battling the disorder since the age of 15, told MaltaToday that the COVID-19 pandemic caused a change in eating patterns and habits and prompted higher food insecurity, poverty, and malnutrition. “Apart from this, there will be higher levels of anxiety, loneliness, guilt feelings, self-criticism, and lack of self-esteem,” Mangion said.

It remains a problematic situation and several strategies are needed to counter the effects of the lockdown. “One of the most effective strategies is to increase awareness of mental health and eating disorders through outreach programmes, informal talks and discussion, and disseminating accurate information through social media platforms. Movements and programmes that debunk the stigma associated with mental health conditions would be an asset,” Mangion said.

Reappraisal and a process of self-acceptance can also act as valuable strategies after the pandemic. “There should be more services offered online to offer professional mental health assistance to people who ask for help for such service that ideally, is communicated through an online platform.”