Post-pandemic predictions for disordered eating

Prior to COVID-19, the prevalence of disordered eating was already a pretty hot topic, both in popular media and academic research. Once COVID hit, that topic got a lot more press in both popular and academic spaces. It was widely said that disordered eating was on the rise due to the pandemic. Now that the world is beginning to return to normal, what will happen to the subclinical eating disorders and ill-informed diets that many of us spent the last year perfecting?

It likely won't surprise you that I have an opinion. But first, I want to tell you what I mean by disordered eating. It has been defined elsewhere as "... the full spectrum of eating-related problems, from simple dieting to clinical [eating disorders]." That definition is pretty broad. In this post, I'm using the term "disordered eating" interchangeably with most dieting. I'm referring to any attempts to consciously regulate and exercise control over certain processes, such as the consumption of proper nutrition and the maintenance of a setpoint weight. These are processes that, at least for well-resourced folks, can occur unconsciously, intuitively, and automatically. Disordered eating is typically accompanied by fixation on food, body, or both.

Now, back to the ol’ crystal ball. What can we predict for the prevalence of disordered eating after COVID?


Disordered eating before COVID


Let’s (briefly) review the reasons why disordered eating was on the rise to begin with. I do mean briefly; I can’t be the only one who gets exhausted by thinking about this. First, and probably most importantly, disordered eating was on the rise due to an intense, culturally-sanctioned fear of fatness. This fear is reflected through every possible public-facing medium and bankrolled both by profit-driven companies and by the government. Anti-fatness is also modeled during every key developmental period, beginning abruptly after babies are praised for their “baby fat,” and ceasing only when the old lady in the nursing home is refusing her Ensure.

Disordered eating is also common due to the practically universal struggle for meaning and the paradox of freedom that has us continually looking for digestible and socially acceptable goals. You know the goals I mean: lose a few pounds, kick a "sugar addiction," eat only "whole foods." Then, there’s our human desire to be “good” (which, from an evolutionary perspective, means “safe”), and the constant conflation in Western culture of being a physically healthy person with being a morally good person. And last (I mean, probably not last, but we have to stop somewhere), there’s the fact that some of the most chemically rewarding, least satiating, and most fattening food is also the cheapest and most accessible food -- so we are practically guaranteed a fraught relationship with it.

Disordered eating during COVID


Now, people say (and research bears out) that disordered eating increased during the pandemic. I’ve heard several theories for why this might be the case. On the less-credible end, we have the rise of TikTok. People suggested that this purveyor of thin teenagers recording complicated dance routines left viewers more inclined to control their weight and shape. I call this reason “less credible” because, while it’s true that staring at idealized images of thin women contributes to the prevalence of disordered eating, these images were pervasive long before TikTok. Remember Instagram? Remember Netflix? Remember every advertisement ever? Even if TikTok died tomorrow, our cultural diet would still be total garbage. It would still ensure that disordered eating remains a problem.

More compelling, I think, are the existential reasons for the increase in disordered eating during COVID-19. And no, I’m not talking about fear of death, although that certainly has its place during a pandemic. I’m talking about freedom - What should I do with my short time on earth? - and meaningless - How can I make that time matter? During the pandemic, those questions became all the more relevant, and perhaps harder to answer. Take it from a lifelong disordered eater: those existential questions are handily answered (or at least, totally obfuscated) by a shiny new diet.

Existential questions are handily answered (or at least, totally obfuscated) by a shiny new diet.

How? First, the process of dieting, regardless of whether it results in long-term weight loss (which it rarely does), delivers structure to one’s life. A diet is a ready-made answer to the question, “What should I do with my short time on earth?” Dieting tells us when to work out, when to eat, and offers “tips” for “staying busy” in the interim. (That’s right: the rest of your life becomes “the interim” between meals and work outs.) Dieting also grants access to rewards, from seeing the number on the scale drop, to the dopamine hit of a new purchase - an Apple watch, an exercise bike, a magically low-sugar protein bar, and any number of or a weight-loss or “lifestyle change” apps.

The anticipated outcomes of dieting - weight loss, better health - offer a tantalizing answer to the second question: How can I make my life matter? Weight loss and better health are widely accepted as reasonable goals and, more insidiously, often perceived as morally right goals. In this way, dieting provides a shortcut to meaning. How will I make my life matter? Well, I’ll become as fit and healthy as I can be, in a culture where the best thing one can be is fit and healthy. And if that sounds a little shallow to you, never fear: the self-help genre has managed to build a bridge between dieting and self-love, dieting and professional achievement, even dieting and spiritual wholeness.

There’s another, oft-forgotten existential concern at play: not death, not meaning, not freedom, but isolation. Before the pandemic, we had to worry that the total lifestyle upheaval of a new diet would result in social isolation. Disordered eaters were typically more lonely than their peers. Dieting is isolating. But the pandemic offered built-in and socially-acceptable reasons to decline every brunch invitation, every anxiety-ridden trip to the movies. Hell, during the pandemic, we could even avoid grocery stores; Deborah from Instacart would skip the candy aisle on our behalf. The drive for connection has long been a protective factor against disordered eating. During the pandemic, connection took a backseat to all the things we can do alone -- among them, eating and not eating.

Disordered eating post-COVID


So, with all that in mind, what can we expect from dieting and disordered eating post-pandemic?

As the world returns to normal, so too will our relationships with food. But unfortunately, “normal” has long ceased to mean “rational,” let alone “beneficial.” Those who developed obsessive dieting or subclinical disordered eating during the pandemic will hopefully experience a gradual remittance. Hopefully, we will look for less harmful ways of answering the questions, “What should I do with my time on earth?” and “How can I make that time matter?” We may feel reluctant to see the built-in excuse for isolation stripped away, to again have to face the question: “What is more important - seeing my loved ones, or reaching my step goal?” (No, grandma doesn’t want to join you on a walk.)

Personally, I think it’s a great thing that disordered eating will once again be competing with grandma for our mental real estate. But, in truth, it's a sad competition; and as long as food and body are viable competitors, we are vulnerable to relapse. The pandemic, while immensely stressful, acted similarly to other environmental stressors on disordered eaters: it triggered a need for control. If the pandemic found you suddenly attempting to exert control over food and body, chances are that subsequent life stressors will take you there, too. If you struggled with dieting and disordered eating during the pandemic, perhaps aim higher than a "return to normal."

Of course, in order to change your relationship with food, the fear or change must be less than the fear of staying the same. If you are lucky enough to be more afraid of staying the same - if you are afraid of spending the next several years equally obsessed with food or body, or being constantly vulnerable relapse - check out my many posts on disordered eating recovery, as well as the resources below. These were instrumental to my own recovery from disordered eating and chronic dieting.

YouTube

Kayla Rose

Stephanie Buttermore


Podcasts

Food Psych by Christy Harrison

Any podcast interview featuring Isabel Foxen Duke (just type her name into the podcast search bar)


Websites

Health at Every Size by Linda Bacon