Disclaimer: This resource provides information, not advice. Please read the full disclaimer at the end of this resource.
The way we live our lives has changed since the outbreak of COVID-19. We are all now required to stay home to reduce the spread of infection, and only go out if absolutely necessary.
As COVID-19 is a new infection, we don’t know yet whether or not people with eating disorders are more likely to develop serious problems than anyone else. But if you have an eating disorder, you need to be careful and reduce your risk of COVID-19 infection.
It’s important you follow the government guidance about social distancing, handwashing and other ways of preventing the risk of infection. Smoking increases the risk of more severe complications if you are ill with COVID-19, so doing this should be stopped as much as possible. Nicotine replacement therapy is offered by the NHS if you need help with this.
If you have not been informed you are on the NHS’s list of shielded patients, but believe you should be because of significant health problems (either related to your eating disorder, or additional conditions, such as diabetes or asthma), you should speak to your GP or a specialist.
For many people, the first signs that they are infected with COVID-19 are a high temperature (fever) or a cough.
But if you have anorexia nervosa, you may not develop a high temperature. You may still experience other symptoms of COVID-19, such as noticeable tiredness or lack of energy, loss of smell, taste, or abdominal pain and diarrhoea. If you have these symptoms, you should self-isolate and seek advice from a health professional or your treatment team on what to do next.
During the pandemic, there may be limited availability of some of the food you normally eat. The government advice to shop for food as infrequently as possible may result in some patients stockpiling food, and possibly a binge–purge cycle. Gyms are closed and exercising outside of the home is currently restricted to once a day. You also may not be able to see your friends and family, which could lead to you feeling more isolated. There are also many unhelpful messages about exercise and weight loss on social media which may be triggering. This could all make it more difficult for you to manage your eating disorder. So, it’s important that you:
- keep in touch with your friends, family members and health professionals though telephone and video contact. This can help improve your mood and distract you from unhelpful thoughts and ruminations.
- follow a daily routine. Plan regular meals so you get the nutrition you need to stay well. Try to stick to your plan as far as possible and talk to your treatment team about how you can manage your eating disorder during this time.
- use self-monitoring and distraction strategies to challenge intrusive thoughts and unhelpful behaviours
- try to limit your use of social media to helpful sites only, such as eating disorder charities.
During the current COVID-19 pandemic, most out-patient appointments are arranged remotely (as telephone or video calls). Communicating in this way can be as effective as face-to-face contact.
This will apply to most routine appointments, such as meetings with your care coordinator, key worker or psychiatrist. Psychological treatments, such as cognitive behavioural therapy or family therapy, can also be delivered remotely. If you don’t have access to a smartphone, tablet or computer, a telephone consultation may be arranged.
If you need a physical examination and/or a blood test and have any concerns about these, speak to your treatment team beforehand. During physical examinations, staff will wear personal protective equipment (PPE) and you will be asked to wear a face mask. To reduce the risk of spreading COVID-19, the doctor or nurse will likely limit conversation with you. You will receive your results by telephone or video call. Your team may also ask you to help with some physical monitoring at home to reduce the chance of COVID-19 infection.
The way you get your regular medication might also be different. We have published information on accessing your medication to help you understand these changes.
The current COVID-19 situation has meant that day patient services for people with eating disorders have temporarily stopped. This, and the loss of routine home visits or face-to-face consultations, may make you and your family feel less supported. Your treatment team can speak to you about other ways of supporting you, for example through remote consultations.
All in-patient services are focused on preventing the spread of COVID-19. In a hospital, the virus could be passed on very rapidly from staff or patients being close to each other for long periods of time.
If you have to go to hospital to receive in-patient care, you may be tested for COVID-19 and be required to self-isolate in your bedroom for a minimum of 7 days after admission. The risk of COVID-19 infection also means that you may not be able to receive visitors in hospital and go on home leave. You should try to stay in touch with your family and friends – you can use your smartphone, tablet or hospital telephones to do that.
Social distancing means that in common areas, such as dining rooms, you will need to keep a distance of 2 metres from other people. You will be asked to wash your hands regularly and you might be asked to wear a face mask in communal areas. It is important to have access to fresh air, but you will need to stay 2 metres away from others at all times when outside.
Staff will be wearing personal protective equipment (PPE) on the ward to protect themselves and patients from infection. You will receive care in your own bedroom as much as possible.
Group or individual therapy will sometimes be provided remotely or with a 2-metre distance in place. Ward rounds and other review meetings may be carried out remotely, too, by using appropriate technologies.
- Charities, such as BEAT provide further information on eating disorders and COVID-19, including health, treatment, food, exercise and links to other available support.
- To help you manage your low mood, the University of Exeter produced the Get Active, Feel Good booklet.
- Feast, the global support and education community for families of those with eating disorders, has pandemic-related resources.