10 Simple and Science-Based Strategies to Cope with Binge Eating During COVID-19 by Deborah Lynn Reas, PhD

 

Bibliography of Author:

Deborah Lynn Reas, PhD, is a licensed psychologist in the US  and Norway who has spent the past 25 years working within the field of eating disorders. She has published over 50 scientific articles on the assessment, prevention, and treatment of eating disorders. She moved to Canada about six months before the outbreak of COVID-19. She lives in Ottawa with her husband, daughter, and cat. 

Within months of the global outbreak of COVID-19, concerns were raised regarding a shadow pandemic involving mental health. In the eating disorders field, initial studies from 2020 found that roughly one-third of those battling binge eating experienced a significant worsening of symptoms following the outbreak of the pandemic.^1,2 Although data is still lacking regarding how many people in the community have experienced a new onset or a re-occurrence of binge eating since the beginning of the pandemic, it is clear that clinics are now seeing more individuals with more severe problems. 

The pandemic has had a profound impact on our daily lives, disrupting routines and becoming a major source of stress. Eating disorders thrive in isolation and are often driven by underlying anxiety. Coping mechanisms, access to treatment, and support systems have become less available. Lockdown measures have exacerbated existing triggers and introduced new ones that may be uniquely challenging for persons with eating disorders .^3,4,5 Exposure to potentially triggering media content has increased. The intermittent stay-at-home orders and school closures have heightened pressures on parents and increased responsibilities related to food preparation. The experience of food insecurity, and stockpiling the pantry, all may be uniquely challenging for individuals who battle binge eating. 

Binge eating is a common behavior and can occur across the entire spectrum of eating disorders.  A binge is typically defined as eating a large amount of food while feeling a loss of control (e.g., a feeling that one cannot stop or control what or how much one is eating).⁶ Although a “classic” binge may constitute an objectively large amount of food given the circumstances, binges that are small in size can also be quite distressing and/or impairing. Binges may be planned in advance, or occur in response to an identifiable trigger, such as a negative emotion, unstructured time, relationship difficulties, or a period of fasting or otherwise chaotic eating pattern. People often report feeling dazed or “zoned out” during a binge episode, which may negatively reinforce the pattern by providing temporary relief from a difficult moment. A binge may or may not be followed by compensatory behaviors depending on the overall presentation.

Other defining features can include: 

-Eating much faster than normal

-Eating until feeling uncomfortably full

-Eating large amounts of food when not feeling physically hungry

-Eating alone due to embarrassment 

-Feeling shame, depressed, or very guilty afterwards

Encouragingly, 2020 data also suggests that some individuals, in fact, have experienced significant improvements in eating during the pandemic, perhaps due to increased time for self-care or increased family connectedness.^1,7 Effective treatments for binge eating exist, many of which are scalable and can be delivered via telehealth, guided self-help, or even pure self-help. As vaccines are slowly being rolled out and we start to imagine a brighter future, this is an ideal time to focus on health and well-being. 

In this blog, I have listed 10 simple, science-backed strategies to cope with binge eating behavior with the pandemic in mind. These strategies are cost-free and can be implemented immediately to strengthen coping and boost resilience during these (hopefully) final months of the pandemic.  Some strategies are binge-focused, while others are focused on ways to elevate mood and reduce anxiety. As binges are often are triggered by feelings of BLAST (boredom, loneliness, anger, stress, tiredness), developing strategies to elevate mood and wellbeing can have important spill-over effects on eating.

1. Write it down. Self-monitoring is a very powerful tool which can lead to greater awareness of your patterns, triggers and vulnerabilities. The aim is to identify and break up self-defeating patterns of thinking and behavior. If you are struggling, put it on paper. Detail what, when, where, with whom, and what you were feeling and thinking before and after a difficult eating episode. Do this for a few days, aiming to identify not only what went wrong, but to document and learn from the times when things go right. It is hard to overstate the value of this tool in working toward recovery, managing lapses, and tracking successes. 
   
   
2. Eat meals regularly. Longer days of unstructured time, less external structure, and blurry boundaries between home and work have complicated eating schedules during COVID-19. Going long stretches of time without eating, or conversely, snacking throughout the day, is significantly associated with the risk of binge eating. Sticking to a regular pattern of 3 meals and 2-3 snacks spaced evenly apart is more important now than ever. Set an alarm if you need help staying on a schedule.
   
   
3. Dealing with urges. Research shows that even the most powerful urges to binge will diminish, typically peaking in strength after just a few minutes. For some, practicing mindfulness, observing, breathing, and using mantras to stay in the moment while the urge passes is incredibly powerful. For others, having quick and easy strategies to delay or distract while riding out the urge can successfully interrupt a negative chain of events. Going outside, sitting in the car listening to music, taking a warm shower, making a phone call. Know yourself and keep a list handy of whatever works for you. 
   
   
4. Increase self-directedness.  A study from August 2020 found that deterioration in eating disorder symptoms during the COVID pandemic was associated with lower “self-directedness”.² One take-away might be that we can boost our resilience by setting goals, including concrete, daily goals which are easy to achieve, as well as longer-term goals that are aligned with our priorities and values. Striving towards a purpose- and priority- driven life can help us adapt and navigate ever-changing circumstances and increase our sense of self-efficacy, control, and sense of direction, even during a pandemic.
   
   
5. Embrace flexibility and learn to tolerate uncertainty. Life during a pandemic has been unpredictable and riddled with disruptions. Individuals with eating disorders often get stuck in highly rigid routines, with self-worth hinging upon how successfully rules and routines are adhered to. Tolerating uncertainty and having to adjust to new routines may be extremely difficult for many individuals. Despite this difficulty, the pandemic can teach us that we are strong enough to adapt and survive, to live under a different set of rules, to change, and to embrace new ways to cope. Shifting our perspective and embracing the flexibility of this moment can offer a unique opportunity for learning and growth with benefits lasting beyond 2020-21.
   
   
6. Actively seek out social support and connectedness. Social support has been identified as a major buffer and resilience factor during stressful times and is key to managing or reducing disordered eating. Open yourself up and be proactive in reaching out. Even small, seemingly trivial acts can boost our feelings of being connected. Reach out. A phone call to an elderly relative, writing a quick text message, joining a live webinar or work-out, joining an online community dedicated to a passion or interest, or joining a virtual support group. Especially if you are someone who tends to avoid or be socially anxious in face-to-face situations, or if you live in a remote area, now is your moment to take advantage of the world´s virtual connectedness. 
   
   
7. Be active and get outside. The science is powerful when it comes to the mental health benefits of being active and of being in nature. Even small bouts of walking can do wonders for your well-being, self-esteem, body image, sleep quality, and decreasing anxiety. Physical activity also offers a refreshing break from screens, social media, and exposure to the 24-hour news cycle. If over-exercise is a problem, you will need to actively strive towards moderation and balance. (The cardinal signs of excessive exercise include exercising despite injury or illness, exercising at inappropriate times and places, experiencing guilt when you are unable to exercise, and continuing to exercise despite it interfering with important activities or relationships.)
   
   
8. Practice gratitude. Over the past two decades, the field of psychology has found evidence of immediate and lasting benefits of gratitude for overall health, wellbeing, and happiness. Simple acts like writing a gratitude letter, paying it forward, saying thank-you, or keeping a gratitude jar, can provide a boost of joy and happiness to crowd out negativity and critical thoughts. An exciting off-shoot of this research in our field is the practice of being grateful for our bodies.  Cultivating body appreciation can be incredibly beneficial for improving body esteem, as well as lowering depressive and disordered eating symptoms. It is hard to think of a better time than a pandemic to step back and marvel at how miraculous our bodies truly are.
   
   
9. Practice the art of anticipation. Having something to look forward to post-COVID can help out with pandemic fatigue or burnout. Borrowing from the science on happiness, anticipation can be a surprisingly valuable source of pleasure and optimism. Use visualization techniques to create a rich and detailed moment of anticipation—of that party or vacation you have been postponing. Anticipating a positive post-pandemic future event can be a surprisingly effective coping strategy to deal with stressful times, boosting motivation and energy, and providing a source of happiness to draw upon during difficult moments.  
   
   
10. Practice self-compassion. Above all, be kind to yourself. Researchers in Ontario and BC have pioneered the science of practicing self-compassion in our field, and a recent meta-analysis has shown this approach is robustly effective in reducing eating and body image concerns.⁸ Show yourself the same love and encouragement that you would automatically show others. As we are all affected by this pandemic, there is no better time to recognize that we all share a common humanity, and it is OK to struggle.

Further Reading:

Termorshuizen, JD, Watson, HJ, Thornton, LM, et al. (2020). Early impact of COVID‐19 on individuals with self‐reported eating disorders: A survey of ~1,000 individuals in the United States and the Netherlands. Int J Eat Disord.  2020; 53: 1780– 1790. https://doi.org/10.1002/eat.23353

² Baenas, I., Caravaca‐Sanz, E., Granero, R., et al. (2020). COVID‐19 and eating disorders during confinement: Analysis of factors associated with resilience and aggravation of symptoms. Eur Eat Disorders Rev, 28, 855– 863. https://doi.org/10.1002/erv.2771 

³Weissman, R.S., Bauer, S. and Thomas, J.J. (2020), Access to evidence‐based care for eating disorders during the COVID‐19 crisis. Int J Eat Disord, 53, 639-646. https://doi.org/10.1002/eat.23279

 

⁴ Cooper, M., Reilly E., Siegel, J., Coniglio, K., Sadeh-Sharvit, S., Pisetsky, E., & Anderson, L. (2020). Eating disorders during the COVID-19 pandemic and quarantine: an overview of risks and recommendations for treatment and early intervention. Eat Disord. DOI: 10.1080/10640266.2020.1790271

 

⁵Rodgers, R., Lombardo, C., Cerolini, S., et al. (2020). The impact of the COVID‐19 pandemic on eating disorder risk and symptoms. Int J Eat Disord, 53, 1166– 1170. https://doi.org/10.1002/eat.23318

⁶ American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

 

⁷ Brown, S., Opitz, M., Peebles, A., Sharpe, H., Duffy, F., & Newman, E. (2021). A qualitative exploration of the impact of COVID-19 on individuals with eating disorders in the UK. Appetite, 156. https://doi.org/10.1016/j.appet.2020.104977

⁸ Turk, F. & Waller, G. (2020). Is self-compassion relevant to the pathology and treatment of eating and body image concerns? A systematic review and meta-analysis. Clinical Psychology Review. https://doi.org/10.1016/j.cpr.2020.101856