Medical providers braced for a wave in eating disorder cases when the pandemic first took hold in early spring. What they didn’t expect was for that surge of cases to continue lingering through fall.
Eating disorder requests for treatment this year are on track to surpass 2019 totals, both in the St. Louis region and nationwide. Experts say anxiety and stress from the pandemic can trigger unhealthy eating behaviors in people who struggle with eating disorders. These disorders, including anorexia nervosa, bulimia nervosa and avoidant/restrictive food intake, most often start in adolescence.
Doctors and treatment programs say they prepared for upticks in referrals and hospitalizations as states imposed coronavirus-spurred lockdowns. Since spring, the demand for eating disorder treatments have remained stubbornly high, even as coronavirus-related restrictions loosened.
Part of the reason is eating disorders worsen in isolation, eating disorder specialists say.
Eating disorder hospitalizations have increased this year by 86%, compared to last year, at St. Louis Children's Hospital. Outpatient visits have more than doubled — at 130%.
Dr. Sarah Garwood, a pediatrician at Children's Hospital, is seeing patients as young as 11 years old with eating disorders.
“Eating disorders can sometimes worsen or pop up because a person is trying to regain control when they feel really out of control with everything happening,” said Garwood, who also teaches at Washington University’s medical school.
Schools and doctors have swapped in-person interactions for virtual visits during the pandemic. But virtual settings can eliminate accountability and support for teenagers struggling with eating disorders, Garwood said, creating “kind of a perfect storm.”
Providers say they are seeing cases increase both in volume and severity.
Alsana is the largest center treating adults with eating disorders in the St. Louis region. Chief Medical Officer Margherita Mascolo said an influx of patients are coming in sicker than before the pandemic. Most people at the St. Louis County center are between 20 to 40 years old.
Anorexia nervosa is the second deadliest mental illness, behind opioid addictions, because of health risks and high rates of suicide, according to a 2014 study from the University of Oxford.
Malnutrition from serious cases of eating disorders could put people at higher risk for complications if they do contract the coronavirus, Mascolo said. People with severe eating disorders can have fewer white blood cells, which help fight illnesses such as COVID-19.
Calls and texts are flooding into eating disorder helplines.
The National Eating Disorders Association says traffic to its helpline has nearly doubled from March to September, compared to last year. The hotline is on pace to take more calls in 2020 than in any other year in its 19-year history, a spokesperson said. So far, 30,000 people nationwide have reached out for help through either phone calls, social media, email or text messaging.
References to gaining the “quarantine 15” (pounds) and an increased interest in diet culture on social media has concerned researchers at the University of Missouri’s Center for Body Image Research and Policy.
The center’s director, Virginia Ramseyer-Winter, said eating disorder experts and doctors need to nail down what is behind the surge and move into intervention work quickly.
The National Eating Disorders Hotline is 800-931-2237
Alsana’s Eating Disorder Helpline is 866-224-2040
Correction: Dr. Sarah Garwood is a pediatrician at St. Louis Children's Hospital, which has seen eating disorder hospitalizations increase this year by 86% compared to last year. A previous version of this story misattributed which hospital had recorded those increases and where Dr. Garwood works.
Follow Kayla on Twitter: @_kayladrake
