National Eating Disorders Association

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COVID & health issues triggering ED

TL/DR - COVID has worsened my stress related health issues (some autoimmune) and the weight loss from one of them has triggered an ED crisis and strong urge to relapse.

When COVID and shelter at home started, I unexpectedly lost weight, which I only noticed because my pants were looser than normal. I have digestive issues (IBD, IBS, and others) and I saw my gastroenterologist who had me make med changes in hopes of stopping the weight loss and other digestive health symptoms (sorry, trying to not be triggering or gross by listing them). But my weight loss has continued, though it's slowed. There's been several problems with this situation:
1) I don't own a scale as I get triggered by knowing exactly how much I weigh. But now I had to start being weighed. I tried to only have it happen at doctor's offices because I ask them to not tell me the number and let them monitor it. But that's less possible now with COVID and I've had to weigh myself and record the weight.
2) There's been too much discussion about my weight by everyone - doctors, friends, family, and it means I think about it more and more. Just 2 days ago, a friend expressed great concern with how I looked (too thin). (I am still in the healthy BMI range.)
3) With COVID, I'm anxious about going to stores unnecessarily and when I do my every other week grocery shopping, I refuse to buy the foods I used to binge on. I recovered from the restricting anorexia I had in my teens twenty years ago, but I never got over the disordered eating of binging unhealthy foods and then restricting after to prevent weight gain. I've been successful at maintaining a constant "normal" weight, so I've just left my recovery linger there. But now, when I want to emotionally eat, I can't unless I want to risk getting COVID for a food binge run. So I don't eat anything (I'm not saying I skipped a meal but that I don't eat the extra I normally do - I'm choosing to shut down and numb instead of eating my emotions).

At first, I thought I was fine. At the start of COVID, I was at my sister's helping with my nephews (her and her husband are essential workers in healthcare) nearly everyday from mid-March through the end of May and they were feeding me, so I ate normally. But that's also when I lost the most weight, though it happened pretty rapidly right at the beginning, again when I was eating regular meals and not paying attention to amount or content because I was just having a nice family meal. But now, I'm home alone most times and I've grown to really like how much weight I lost. I also notice the loose skin and untoned arms, etc. I'm pretty sure I've started eating less, on top of not bingeing, so now I don't know if the continued weight loss is my health issue or my eating behaviors. I see my gastroenterologist on Monday, so I've been thinking about it a lot, but I wasn't concerned until my friend expressed so much concern about my weight and if I am truly honest with myself, my face looks gaunt, not healthy. I've noticed I've been exercising more, though it looks healthy because I'm walking my dog, but I'm choosing hilly areas and sometimes doubling the length of walks. But what's really concerned me is that I finally broke down and bought my favorite binge food to go with a food my sister made me from scratch. But, I'm barely eating it. Even when I'm emotional, I see how much I have a smug satisfaction that I'm not eating the binge food. When I have a very small serving, I find myself satisfied I had so much restraint. I see me sliding down a slope where I try to control COVID by controlling my weight and what I eat and how much and when. I am starting to worry about where this leads. I'm trying to figure out my next step. But I can say that I don't want to go back to my "normal" weight. I like how I look and I want control over wanting to eat and I feel good about life. But I'm also pretty sure there's a darker side because I don't want to say anything to my therapist or too much to my gastroenterologist or to reach out to my PCP. I want to see how much less I can eat and how much "healthier" I can eat and if I can lose even more weight. I feel like I'm at that fork in the road between health and relapse and I'm not sure I'm capable of picking the healthy path. It's not that I've never come close to or actually briefly relapsed, it's that I always had people around who were kind of silently keeping tabs and I had reasons to enjoy food and I wasn't so afraid of everything that's happening in the world and so very desperate for control over something. If I'm not going to binge and eat my emotions, then I feel I need to restrict to numb them, to control them. This time, it will be much much harder to choose to eat. It's always a choice, every time I eat, there's that evil voice in my head encouraging me to restrict, but everyday, nearly every meal, I've overcome it for years. But right now, I don't want to. It will be so much energy to overcome those thoughts. I don't know how to pick the better path right now. This seems like the perfect solution to all sorts of problems. I need support.

Dear pursoul

Welcome to the forums! We are concerned with some of the symptoms, behaviors, and emotions you have described and would want to encourage you to reach out to your physician or other medical professionals. If you need assistance finding resources in your area please reach out to the NEDA Helpline at 800.931.2237 M-Th 11am -9pm ET and F 11am-5pm ET or you can chat with us online M-Th 9am-9pm ET and F 9am-5pm ET. The following are just some of the signs of a serious problem that demands immediate medical attention: 

  • ·            accidentally or deliberately caused themselves a physical injury 
  • ·           become suicidal 
  • ·           confused thinking and is not making any sense 
  • ·              delusions (false beliefs) or hallucinations (experiencing things that aren‟t there) 
  • ·              disoriented; doesn‟t know what day it is, where they are or who they are 
  • ·              vomiting several times a day or has uncontrollable vomiting or diarrhea 
  • ·              experiencing dizziness or fainting spells 
  • ·              too weak to walk or collapses 
  • ·              painful muscle spasms 
  • ·              complaining of chest pain or having trouble breathing 
  • ·              blood in their bowel movements, urine or vomit 
  • ·              a body mass index (BMI) of less than 16 
  • ·              an irregular heartbeat, and fast heartbeat, or very low heart beat (less than 50 

beats per minute) 

  • ·              cold or clammy skin indicating a low body temperature or has a body
  • ·              temperature of less than 35 degrees Celsius/95 degrees Fahrenheit 
  • ·              experience dizziness, nausea, fever 
  • ·              wounds/cuts heal slowly 
  • ·              feel tingling in the hands or feet 
  • ·              blurred vision 
  • ·              Or for any other medical concerns. 

Seek medical help soon on an outpatient basis if you: 

  • ·              have significant heartburn and/or a burning sensation after eating 
  • ·              have other gastrointestinal concerns 
  • ·              have high blood pressure 
  • ·              struggle with significant joint or muscle pain 
  • ·              have difficulty sleeping (falling and/or remaining asleep) 
  • ·              struggle with fatigue, sudden weight gain, and/or hair loss 
  • ·              have frequent urination or unquenchable thirst 
  • ·              have gained and lost significant weight repeatedly 
  • ·              have gained significant weight in a short period of time 
  • ·              struggle with chronic diarrhea or constipation

    We hope you continue to post on the forums! Stay well and take care!