Here’s a blog post I never thought I’d write.
Let’s be honest, the last few weeks have been pretty crazy, but I feel like they’ve gone from 0-100 in a very short space of time. It feels like barely any time ago that this disease seemed abstract, something that was happening on the other side of the world but not to me. How quickly that changed.
At day patient, every Thursday we have an anxiety management session. The last Thursday I was there, we spent the session focussing on coronavirus. We covered various topics. What if I can’t get my safe foods? How will I exercise? How do I manage this anxiety? Since the virus made it to the UK, I’ve been bracing myself that my treatment might change. What I didn’t expect, is that I’d turn up last Monday and be told an hour later that the entire clinic was closed to face to face contact.
It happened so quickly and I felt like I’d been run over. This service has been a lifeline to me. There was a time towards the end of last year, especially when I was landed in hospital, that I thought anorexia was going to kill me. Day patient gave me a second chance at life, and I felt like I was finally on the path to sustainable recovery. I’ve been battling eating disorders since I was 12, and throughout day patient, outpatient and inpatient, I’ve doubted whether I could ever be free from it. I finally felt, with this intensive support, that I could be.
Last Monday I turned up as normal, got weighed as normal. We had breakfast with our tables split up, sat two metres apart from each other. We couldn’t access the lounge, instead sitting in the group room, two chairs between each of us. In the same room as each other but feeling like there were caverns between us. Not long later, the leaders of the programme walked in and told us that was the end, for what they were estimating was at least 12 weeks. I am due to be discharged in around 8.
My future feels uncertain. I have pressed them for answers: will I ever be back? What if I can’t gain weight alone? Will I ever have face to face contact again? They have no answers.
I am lost. I feel like the floor has fallen away beneath me. This is what I felt like was my last chance at full recovery, and I am struggling to manage alone. With that in mind, I thought I’d combine some tips, both for myself and for you. How do we manage an eating disorder in the midst of a pandemic?
Almost all of us struggling with any kind of eating disorder will have ‘safe foods’; the foods we know that we can eat and that we trust. The ones that don’t make us feel sick with anxiety. Back before I started the programme when I was at my most unwell, I was eating only fresh fruit and vegetables, meaning I was going to a shop every two days. I cannot comprehend how I would have navigated this whole situation going back a few months. The thought of walking into a store and staring at empty spaces where the only foods I could eat were supposed to be fills me with dread and my heart breaks for everyone out there who is in this situation. Thankfully, my repertoire of things I can eat has greatly expanded over the last few months, but I still have certain foods that I know I can fall back on during days where I just don’t have it in me to challenge myself, and there have been days where I’ve had to go to four or five shops to find them. It’s easy to sit back, now that I am more well, and to say that this is a good opportunity for us to challenge ourselves, to expand our range of foods and fight back against the eating disorder. But many people out there simply wont be well enough to do that right now, and as a result may end up with nothing. That’s an incredibly scary thought. My advice is that if you find your safe foods – buy them. Please don’t worry about buying too much. You need to eat, even if you can only eat certain things.
Eating disorders are already associated with huge levels of guilt. Guilt for eating, guilt for not eating. Guilt for hurting people around you. This has only been amplified by all the headlines of people stockpiling food and how selfish they are. This follows on from my last point – if you need to stock up on more of your safe foods to make sure you have them, then please do. Yes, we all have a role to play in shopping responsibly in the current climate. But that doesn’t mean depriving yourself. Eating disorders will use any excuse to deprive you of food – don’t let it trick you into thinking you’re restricting for the benefit of others.
Talk to people:
Tell people how you are feeling. Let them play a part in your recovery. Eating disorders thrive in isolation and many of us have been forced into this position due to the new government guidelines in place. Reach out to those around you – let yourself be accountable to someone if you’re not managing to be accountable to yourself. And if you don’t want to talk about your eating disorder that’s okay, but still keep up your communications with other people. Facetime, Skype, Zoom, social media, group chats. However you do it, please just don’t struggle alone.
I already have a meal plan that I follow as I am still under treatment but I realise this isn’t the case for everyone. Some of you may have used them previously, and some of you may never have had one. If you think it will be helpful, don’t consider it a set back going back to one. Not only does it help me to structure my food and make sure I’m having enough, it also really helps with food shopping.
I’m sure many of you are having the same fears as me – how will I exercise if I am in lockdown? How can I eat if I’m not exercising? There are lots and lots of anxieties around this. I have a couple of points to make. Firstly, as it stands we are allowed outside to exercise once a day, and there are lots of home workouts floating around. BUT, this is not an excuse to increase the level of exercise you are doing – especially if you find you now have more time on your hands. Secondly, you do not need to exercise to justify eating. Our bodies need fuel even if you are just sitting all day, and doing less exercise does not mean eating less.
It has been recommended that we go to the shop as little as we possibly can. If you are someone prone to bingeing, you may go to the shop frequently and keep less food in the house to try to minimise the risk. That may now have all changed, in a time where we are being encouraged to buy enough food to last us each time we shop in order to social distance as much as possible. I have struggled with this in the past but thankfully it’s a behaviour I have been free from for years now. However, that doesn’t reduce my fear of it, and having more food around the house has raised my anxiety. This is a particularly difficult one if you struggle with both bingeing and restriction as it is important for you to make sure you have your safe foods around where possible, and that may include stockpiling and having far more food in the house than you are used to or comfortable with. My advice is to go back to the meal planning section and consider making yourself one. Portion out your days worth of snack in advance if you need to. And probably the most valuable thing I can tell you – which I promise you I did not believe myself but is definitely true – is that eating regularly massively reduces your risk of bingeing.
These are strange times. There will be some of you who are keyworkers and are still going to work as ‘normal’ (as normal as things can possibly be right now), some of you who are working from home, and some of you who currently aren’t working. This could be because like me you are off sick, maybe you are self-isolating, maybe you weren’t working prior to the pandemic or maybe you have recently lost your job. For those of us at home, we suddenly have a lot of time on our hands. Having lots of time can be very dangerous for people with eating disorders. There’s a lot of time to just think, and lots of time to fill can also increase behaviours such as exercising or bingeing. I would highly recommend doing some activity scheduling. I’ve got mine up in my kitchen – it covers a whole week and has something slotted in for every hour. You might want to do yours differently: breaking it down into bigger or smaller windows, doing one day at a time etc – whatever works for you. I use mine as a guideline – if I don’t feel like doing something on there I’ll do something else. It’s not prescriptive, more just a prompt to stop me wallowing in my own thoughts all day. Something I would really recommend is not deviating away from your usual routine too much. Try and eat at the same times, sleep at the same times, get dressed and wash every day. Sooner or later we are going to go back out into the real world, and the more we can try and replicate normal life the better.
There are a lot of jokes floating around the internet right now about how much weight people are going to gain during lockdown (the Covid 19, the quarantine 15 etc). I’m not going to lie, these have really got under my skin and I’m sure a lot of you could say the same. I would encourage you to ignore them as much as possible – mute the words you need to, tell your friends that you don’t find them funny, do whatever you need to do to minimise your exposure to them. Really, there is so much going on in the world that gaining weight is probably the least of our problems (easy for me to say I know). And realistically, if you are keeping busy and to a routine, there’s no reason why this would happen. Don’t let the fear of it lull you into restriction.
The root of many (though not all) eating disorders is thought to be about control. This situation that has been sprung on us is scary, and something we have no control over at all. Having my treatment ripped away from me, having to self isolate, watching the news and seeing people dying every day – it’s terrifying and I admit over the last week that a lot of negative anorexic behaviours have ramped right up. But this will end at some point, and me exercising or eating less isn’t going to change a single thing, and the same goes for you.
Remember why you want to recover. Write a list, look back over old resources you have, set goals. Do whatever you need to do to keep you on track. When this ends, and it will, you don’t want to be back at square one. Take things one day at a time. We will all get through this and come out the other side.
I hope this has been helpful for some of you. If you have any other tips then please do share them in the comments. I would love to read them and I think we all need as much advice and support as we can get right now.
Thank you for this. I feel so ashamed because I threw some bread and butter away yesterday. I got it when I came home from hospital with good intentions of eating a sandwich for lunch. It was in the freezer but I just couldn’t cope with having it there because I binge sometimes and I just love bread and butter. I ate 3 slices last night so threw the rest away. I’m feeling so guilty because of what’s happening right now. I feel I have no control and agree with you that it’s so hard having extra food in. I feel like it’s taunting me !
I live alone and had to self isolate due to compromised immune system due to malnutrition. So that’s 2 weeks in hospital and 3 weeks at home now !
I’m keeping to a routine and keeping busy but as a full time wheelchair user it’s just another challenge I face
Love and hugs
I’m sorry you’re hurting. 😦 Try to make yourself freeze it next time if you can. I’ve gotten myself to yhe point if freezing food then I can’t eat it right away so it’s not there in my face to stress me out.
I think making up single portions is a really good thing that everyone can do during this pandemic. Sending you my best wishes 🌞
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This a great post full of useful tips and advice. Particularly like the ‘reaching out to someone and them holding you accountable if you can’t manage it alone.’ I agree also Cara, it’s important that you have a strong support system of friends and family that you can chat with. It doesn’t have to be about food.
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Thanks so much xx
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You welcome, my lovely x
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Great post! Sending you lots of love x
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Thank you xx
Almost word for word what my therapist told me on video chat yesterday!
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Superb advice throughout this Cara, and plenty there for me to remember.
Just want to say how proud I am of you for taking these thoughts and putting them down at a time when you felt so scared. It’s a credit to your strength and durability.
Awesome advice throughout Cara, thank you. Some stuff for me to bash into my own head for sure.
Massive respect to you for getting all this down at a time which must be scary for you. A measure of your strength and durability.
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Thanks Simon. Hope you’re okay, sending lots of love and good vibes your way 💗
I have no one offline to talk with about this. 😦 My family just ignores the problem.
Many of the recovery forums online are gonelike somethingfishy.com go look. 😭
I’ve had to go to the pancakes website instead.
[…] Coping With An Eating Disorder During a Pandemic – my thoughts on what could be helpful once day patient closed and coronavirus struck. […]