When the COVID-19 pandemic began, the world was forced to adapt to a new reality. It comes as no surprise that this disruption has had a drastic impact on mental and physical well-being around the globe. Over the past year, clinicians and mental health experts have seen a rise in mental health disorders among all age groups. Of particular concern is the exponential increase in the number of eating disorders being seen in preteens and adolescents.
According to the National Eating Disorder Information Centre (NEDIC), there has been a 43% increase in the number of calls to their anonymous helpline in the past year. The number of calls from preteens and adolescents to this helpline has more than doubled during this time. This surge in cases is being seen all over the world, with hospital admissions for youth with eating disorders increasing by 30% to 40% in the last year.
In addition to the volume of eating disorder cases, primary care providers and specialists are also seeing a significant jump in severity. A particular concern for patients with severe eating disorders is a low heart rate. At the Children’s Hospital of Eastern Ontario (CHEO), cut-off for inpatient admission is a heart rate below 45 beats per minute, which is considered quite serious. According to CHEO, there were 67 admissions from April to October 2020, which is a 63% increase from the same period in 2019. This suggests a drastic increase in high-risk patients.
What is going on?
Eating disorders thrive in times of uncertainty and isolation – something that is not uncommon during the pandemic. For many, eating is a form of control – a coping mechanism tied to stress. When everything feels as though it’s spiralling, this is often the area where individuals feel that they can regain some control.
Specifically in preteens and adolescents, school disruptions, social isolation and a lack of structure have been pinpointed as key stressors largely responsible for the spike in eating disorders that we are seeing. Additionally, limitations have been placed on physical activity as a result of lockdown orders, a lack of access to fitness facilities, and cancellation of recreational and varsity sports. Such constraints, coupled with increased social media engagement due to the lockdown, may lead to heightened shape and weight concerns, as well as disordered eating and exercise patterns.
What can I do?
The most important thing is to be aware of the signs and to routinely check-in with your child to see how they are doing. Eating disorders thrive in isolation so it’s crucial that preteens and adolescents know they are not alone. Many practitioners have embraced online resources to provide more accessible treatment options during the pandemic, such as therapy via video or telephone. Depending on the age of the individual, there are a few different types of therapy available. Currently, the main treatment indicated for adolescents with eating disorders is family-based therapy (FBT). In this form of therapy, parents are charged with helping their child establish normal eating and exercise patterns. Part of this step involves creating a plan for when and what your child will eat, as well as a steadfast routine for mealtimes. Here are just a few suggestions from experts and other parents about how to create a supportive but firm routine for your child during and around mealtimes:
- Stick to a meal plan – Do not allow negotiations or discussions around what/how much your child will eat.
- Use distractions while eating, such as listening to music or watching television. This is also helpful after mealtime to prevent purging.
- Eat every meal and snack together – this helps to both ensure they are sticking to the plan while also showing that you are there every step of the way.
- Secure the kitchen after a certain time every night (i.e., lock the cupboards and fridge) – this is helpful if your child is struggling with bingeing.
- Do not allow your child to escape to the bathroom after a meal.
If you are interested in hearing more about how to create a routine and modify your environment to best support your child with an eating disorder, please take a look at this helpful resource guide here. It is important to remember that every child is different, so there is no one solution. Part of the process is experimenting at mealtime to see what works for everyone. Over time, as problematic behaviours and the triggers behind the disorder are addressed through FBT, control will slowly be given back to your child as they work to create a healthier relationship with food, exercise and themselves.
References
https://www.medpagetoday.com/special-reports/exclusives/91483
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300468/
https://www.theguardian.com/society/2021/feb/11/doctors-warn-of-tsunami-of-pandemic-eating-disorders
