This page was created in response to some of the questions people with eating disorders have asked about coronavirus. Those supporting someone with an eating disorder may find it helpful too. We have also created a page for carers.
People with eating disorders don’t necessarily have lower immunity but, per Government guidance, you should limit your contact with other people anyway. It’s also worth speaking to a healthcare professional if you’re worried about your immunity – they can give you more tailored advice and things like recent blood test results may provide more information.
Eating disorders often work to downplay your worries, or make you feel as though your experiences aren’t as serious as other people’s. Feelings like this may be magnified by the huge focus on coronavirus, especially if you’re finding it harder to access regular treatment services. You may also have heard a lot about the pressure on healthcare services at the moment, and be worried about adding to this. But other health issues are no less important than coronavirus, and those experiencing them still deserve treatment and support. The NHS website stresses that it’s still important to get medical help if you need it.
Many organisations are advising that people consider their mental health at this time, even if they don’t have a specific mental health issue. It is very understandable that your eating disorder might feel even more difficult to manage right now. It’s essential now as much as it ever has been to be kind to and take care of yourself. It may be helpful to think of ways that you can practice self-care, and you always contact the Beat Helpline if you need some extra support.
Your therapist may offer telephone- or video-based appointments even if you can’t see them in person. If this hasn’t yet come up, ask them about what plans they have in place. We know it isn’t a replacement for therapy, but please remember Beat’s Helpline is also available if you need someone to talk to – visit our support services page to see what we can offer you.
If you need help urgently, get in touch with your local crisis team, or a service like the Samaritans.
Many services have changed how they work during the pandemic – for example, changing face-to-face appointments to phone calls. Some services considered “non-urgent” may be reduced, and we know this is really concerning. If you’re worried about any of the changes around GP appointments or treatment, get in touch with your GP or a relevant member of your healthcare team as soon as possible to ask them about what they have put in place to accommodate patients’ needs. It’s also worth checking their websites for up-to-date information.
If you have anxieties about using the phone, you could send an email asking if there are other ways they can support you – they may be able to offer a video appointment, for example.
If you’re having to stay in the house and can’t get out to pick up prescriptions, see if someone can do this for you, or ask whether your pharmacy has a delivery service. Remember that if someone picks it up for you they will need to confirm details such as your address.
The NHS offers further advice on how to access healthcare services at this time.
It has become easier to get hold of many foods in the last few weeks, but some things could still be difficult to find. It’s very understandable to have concerns about this, but there are things that you can do. It could be good to talk to people in your support network about meal planning, what foods you feel comfortable with, and what support you can put in place during mealtimes. They can also help you to think about substitutes for things you’re really struggling to get hold of.
Planning in advance and writing things down can help reduce anxiety and encourage you to stick to your plans. You could try a traffic light system on your meal plans, noting which foods you consider to be safe (green), challenging but manageable (amber), or very challenging (red) – meals involving more red or amber foods could require more support, and you could plan to have someone with you during those meals, over Skype or FaceTime if they can’t be there in person, if you think this would help.
Think about which safe foods have a long shelf life – while we know there are issues with getting hold of non-perishable food in many areas, by planning as far ahead as you can, you may be able to gather the food you need more slowly. You could make a backup plan if you do have to buy more perishable food, and make things in bulk and freeze them. You could also let a group of trusted people know what foods you’re missing so they can pick them up for you if they see them.
If you find having your meals affected is causing you lots of anxiety and making you want to purge or over-exercise, it could be helpful to make a note of distraction techniques to use during and after a meal.
Lots of advice around avoiding the urge to binge is still helpful when thinking about coronavirus. You may find a meal plan helpful, and limiting the likelihood of bingeing due to hunger by eating three regular meals and three regular snacks a day. If your binges are triggered by emotions, you may find it helpful to think through BLAST – are you Bored, Lonely, Angry, Stressed, or Tired? Try and make a list of distractions for each of these categories so you have an action plan for each of these scenarios. It may be that someone is in lockdown with you and will be able to help take your mind off the idea of bingeing, but there are lots of things you could do on your own, from reading to laundry to playing a game.
Think about whether you could keep food somewhere less accessible – would it help if it was stored in a lockable cupboard that someone else has the key to, for example, or could you even think about storing some food at the houses of friends or family members and picking it up from their front door as and when you need it? You may want to try a few different things, and different methods may work at different times. Be kind to yourself and give yourself time to figure out what works best for you. You could also consider some things that will help distract you from negative feelings if you do binge. Try not to be too hard on yourself if this happens – things are very difficult right now.
If you have noticed that you are binge eating more since lockdown started, you could see if it’s helpful to keep a record of what you’re eating, when, and what you are feeling before you binge. Are your binges happening at certain times of day? We know that the most effective way to stop bingeing is first to look at whether you are hungry. If you have lost structure to your eating (three meals and three snacks ideally), think about who you can open up to and reach out for support to get back into regular eating. You might feel lonely due to self-isolation at certain times of day. Try and think of ways you can connect with people so you’re not using food as a way of soothing your distress around being on your own. Make a list of ways you feel connected to people and plan these in at times when you know you’re vulnerable.
Having to step outside your comfort zone or having to put your food shopping in someone else’s hands can be really scary. If you write your anxieties down or talk about them with another person, this could help the anxieties feel less powerful.
There are a few different ways to get hold of food without going to the shops yourself, including getting someone you trust to go for you or ordering online. It’s becoming easier in many areas to get delivery or collection slots, and many smaller supermarkets are delivering via food delivery apps now as well. There may also be a scheme in your area where you can ask a volunteer to collect food for you. Think about what you would feel the most comfortable with. If someone goes to the shops on your behalf, you could speak to them on the phone while they’re there if it would help.
Giving yourself permission to rest during lockdown or if you have to self-isolate is important, but we understand that this can be really challenging. It could be helpful to make a list of reasons why it’s important not to compensate if you’re not able to exercise – remember your body still needs nutrition to carry out its normal daily functions. You could also refer back to anything you’ve found helpful in your journey so you can remind yourself why it’s so important to sustain positive changes you have made. This may include things like mantras, recovery goals, and mindfulness techniques. Rest and nutrition is essential – the pandemic has really highlighted the importance of good health.
A number of people have mentioned to us that their exercise has increased due to anxiety around being ‘stuck at home’, as well as listening to the Government’s messages around being able to exercise every day. Some people have said that this has driven them to exercise more. It might be worth sitting down and looking at what activity you’ve done over the last few weeks and setting some limits around this. You could also try planning your exercise for the day or week, which could help you avoid doing exercise in response to emotions or food, and also help with routine.
Remember, it’s important to define what health means for you – it could look different to what it means for other people. Remind yourself that your wellbeing is the priority. Your treatment team may have given you guidance on how to manage urges around exercise, so refer back to this if you need it, or ask them about it if you haven’t been offered this.
The effects of being isolated from others are really understandable worries for everyone, and could be especially challenging if this is something that triggers your eating disorder. Try to keep some structure to your day where possible – things like getting up at regular times and getting dressed can help you feel better, but you may want to consider a more detailed structure with activities you enjoy or will find a positive distraction like the example below.
|Before 08:30||Wake up||Get dressed|
|09:30 - 10:30||Academic Time||Suduko, crossword, Journalling etc.|
|11:00 - 12:00||Creative Time||Needlework, drawing, play music etc.|
|13:00 - 14:00||TV Time||Box set episode|
|14:00 - 15:00||Chore Time||Laundry, minimal cleaning|
|15:00 - 15:30||Fresh Air||Garden if you have one, sit by open window|
|16:00 - 17:00||Support Time||Phone helpline|
|17:00 - 18:00||Planned Exercise Time||Yoga video|
|19:00 - 21:00||Social Time||Phone friend/ online book club|
|21:30 - 22:00||Wind Down Time||Listen to music/ watch film|
Think about the early warning signs that things are becoming more difficult for you and let other people know – then you can ask them to check in with you each day to see how you’re doing. Think about organising regular catch-ups with loved ones regardless of how you’re feeling, and make use of safe online spaces such as the Beat support groups. We’ve launched a new group, the Sanctuary, to help you stay in touch with people who may share your concerns, and this is open for the same hours as our Helpline, from 12pm – 8pm weekdays and 4pm – 8pm weekends and bank holidays.
Try to see the goal as to ‘tread water’: take each half day or less at a time, which may feel less overwhelming.
During lockdown, we’ve encouraged people with eating disorders to create a routine and structure to their day. This can still be helpful even while the specific lockdown rules change over the coming weeks, but you may want to look at the potential challenges that might arise week-to-week as lockdown begins to ease. Try to keep focusing on planning manageable chunks of time – just today, or just the next few hours. If you are expected to return to work, you could contact your employer and ask if you could do this as part of a ‘phased return’ so you start one day this week, then two days next week to help cope with the change.
Try not to ‘overload’ yourself with challenges and only commit to one challenge a day or three challenges per week. It’s okay to be nervous about the changes and to need time to adjust to a new way of doing things.
Announcements about different areas of society opening back up can cause worry and this is really understandable. When restaurants and cafes reopen you may feel anxious about eating out again. It’s okay to be worried; this is an area of your recovery that you’ve not necessarily been able to work on over this time.
Try and be kind to yourself, and think through the steps you need to take to get back to eating out again – it’s important not to rush, as if you feel overwhelmed, it may really knock your confidence. You may also have concerns about the coronavirus, so remember you don’t have to start going out for meals as soon as this is allowed if you’re worried about your health, or if anxieties about the eating disorder combined with anxieties around the pandemic don’t feel manageable yet. However, be aware that things like going out to eat could start to become more daunting the longer you leave them, and it could be easy to treat coronavirus concerns as a reason to avoid going out when it may be something you’d find helpful for your recovery.
Perhaps you could talk to a friend or family member and discuss some goals around this. Initially, maybe set some small goals – for example, you could start by ordering food in, so that someone else is preparing your food but you’re still within the comfort of your own home. Meeting someone for a drink might help you to focus on getting used to being ‘out and about’ again. The next step could be arranging a snack out or a picnic with a friend. Try and think through all the steps that would lead you to your end goal and think through making these goals realistic to your recovery plan. Remember to ensure that you follow government guidance on social distancing.
Some people with eating disorders may be anxious about whether their body has changed during lockdown. It’s important to look at whether any unhelpful body checking behaviours have crept in over this time, such as obsessively looking at photos, taking videos or pictures of yourself, mirror gazing or trying clothes on multiple times per day. We know that these kind of behaviours actually increase concerns about body weight and shape. It might be helpful to seek support if you think this may be becoming an issue for you, or if you’ve noticed these behaviours increasing. If you’re able to start identifying some of these behaviours, try and write down some goals to minimise them. For example, one goal around this issue could be choosing your clothes the night before and not allowing yourself to change outfits during the day.
There may be lots of talk in the media or social media around losing weight after lockdown. Remember to take breaks from the news or social media if you feel like they are increasing your worries around food, weight and shape.
The pandemic and lockdown has been an incredibly challenging time. We know that it is important to try to focus on the positives of a situation or event. The very fact you have made it this far and are reading this guidance means you are still reaching out for information and support. That is something to be proud of. Try making a list of things that you’ve achieved or coped with during lockdown. These don’t have to be big. Keep adding to this list and look back at it when you feel low.
Everyone’s recovery is individual to them and what helps one person may not help another. It’s therefore important to think about your own recovery and things that you have previously found helpful and supportive, and to try to implement these where possible. It may be that some of these techniques are difficult to do at the moment, but try to adapt them where possible, and think about what other things you could try too.
One tool that could be helpful to think about creating is a Wellness Recovery Action Plan (WRAP). This tool aims to help support you in moving forward with recovery and encourage hope around the future. To develop a WRAP, consider writing down points about the following topics:
Once you have had a think about these points, it’s important to try to put into practice what you have identified as being helpful if things feel more challenging.
It’s okay and very understandable if you’re finding it hard to manage your eating disorder during such a difficult and strange time. It is very important, though, that you keep talking honestly with your family and friends or treatment team and let them know if you need help. Some things to ask yourself might be:
If any of these warning signs resonate with you or you feel like you are experiencing a setback, recognising this is a really important first step. Sometimes people may feel guilty or ashamed if they experience a setback, or frustrated at themselves and like they are back to the start – it’s important to recognise that this is not the case. It’s likely that you are more aware of things that have helped in the past so can draw upon these. Setbacks can be seen as learning points and can strengthen recovery through identifying things that are still a challenge and learning new ways to be able to manage these.
If you feel you are experiencing a setback, it’s important to reach out and seek support for this. This may be through speaking to those around you and sharing what support would be helpful for you at this time. It could also be helpful to reach out to your treatment team if you are still receiving support, or your GP to gain support from them. The Beat Helpline is also there to support you and to help you think about next steps too.
Remember to be compassionate with yourself if you’re struggling – this is a really difficult time.
The coronavirus pandemic is an unprecedented event and has brought so much change to how we live our lives. As restrictions gradually lift, some things may look different to how they did before the lockdown, and this can cause worry and anxiety. This is perfectly understandable but there are positive ways to cope with this.
Often we see that people tend to cope with change in a couple of different ways, though they may use a combination of both of these:
One way to feel more in control is by making sure you understand the changes that are happening. Often a helpful way to do this is through trying to take things one step at a time, particularly at the moment when things are so uncertain. We can’t know yet how everything is going to change in the future, so we can only work with the information we’ve been given. If it helps, write down the facts (as you know them at the moment) to keep you focused on ‘one thing at a time’.
It’s natural to be worried, but dwelling on the unknown can cause a lot of distress and anxiety without doing anything to help. You could try writing down your worries as a way of ‘getting them out of your head’. The worry tree diagram below could also be helpful.
You may also find our information about routines on this page helpful in managing these anxieties.
We will update this page as guidance changes and other questions come up. Here are some other resources you could find useful: