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Realities Of The Pandemic Are Triggering Eating Disorders

AUDIE CORNISH, BYLINE: Eating disorders will affect nearly 1 in 10 Americans over their lifetime, whether it's binge eating or severely restricting food. As NPR's Yuki Noguchi reports, the combination of stress, social isolation and food insecurity is triggering for many people.

YUKI NOGUCHI, BYLINE: The pandemic made Stephanie Parker realize she's had an eating disorder for most of her 34 years.

STEPHANIE PARKER: My eating disorder started when I was 6. It could have started sooner, and I just don't have the memory.

NOGUCHI: Initially, she starved herself. At other times, she ate vast quantities. This spring, it all came to a head. Confined and alone in her New York City studio apartment, she watched as COVID-19 ripped through the city. It fomented fear, past trauma and her obsessive-compulsive disorder. She realized then her relationship with food was life-threatening.

PARKER: The OCD and the anxiety I also have just made my eating disorder more intense. And for me, that meant I would become obsessed with cleaning everything and then checking in with myself to see if I deserved to eat.

NOGUCHI: It wasn't just that cleaning frenzies on an empty stomach left her with no energy to pick up a fork.

PARKER: I would become scared of food. I'd be - I got scared that food would make me sick because it wasn't clean enough.

NOGUCHI: Eating disorders are thriving during the pandemic. Hotline calls to the National Eating Disorders Association are up 70% to 80% in recent months. For many, eating is a form of control, a coping mechanism tied to stress. Food scarcity and stockpiling help trigger anxieties over eating or overeating. Claire Mysko is CEO of the association.

CLAIRE MYSKO: We know that eating disorders have a strong link to trauma. Many people with eating disorders have past experiences with trauma. And this is, you know, a collective trauma.

NOGUCHI: It's also a lethal threat. Eating disorders have the second-highest mortality rate of any psychiatric diagnosis, outranked only by opioid use disorder. A recent survey found nearly two-thirds of those with anorexia saw symptoms worsen. About a third of those with binge eating disorders, which are far more common, reported more episodes. Christine Peat is a co-author of that survey, published in the International Journal of Eating Disorders in July.

CHRISTINE PEAT: Many people in our study were talking about concerns that their eating disorder would get worse because of a lack of structure, a lack of social support, living in a triggering environment. And now that sense of structure has just kind of gone out the window. And with that can go the structure you had around your meals and your snacks.

NOGUCHI: Despite a boom in teletherapy, Peat found that isn't reaching everyone.

PEAT: We know, unfortunately, that people of color are only receiving treatment at about half the rate of their white counterparts.

NOGUCHI: That had been true until recently for the New Yorker, Stephanie Parker, who is Black. She says her race was a big reason she didn't recognize her problem until recently.

PARKER: The language used around eating disorders was about white girls having eating disorders. It was about the emaciated-looking type girls or the girls that I heard throwing up in the bathroom.

NOGUCHI: And she looked relatively healthy. So for decades, she ignored it.

PARKER: For me in my head, I felt like I'm just not one of those girls. I don't fit into any of those categories, so therefore this is not affecting me.

NOGUCHI: Even for those further in recovery, the struggle remains real. Grace Segers is a political reporter for CBS. She spends her days working near a stocked fridge that makes it hard to keep her bulimia in the past. She nearly had a flare-up recently.

GRACE SEGERS: And I was literally sitting on the bathroom floor saying to myself over and over again, you know, I don't want to do this. This isn't going to make me feel better.

NOGUCHI: She staved it off. But...

SEGERS: It's always there if the conditions are right, or wrong, rather, for me, to have a relapse. And so I feel like I can't let myself become complacent about it.

NOGUCHI: That daily battle, she says, is exhausting.

Yuki Noguchi, NPR News. Transcript provided by NPR, Copyright NPR.

Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.