Isolation, social media use, and lack of control are a few reasons experts believe eating disorders have increased among teens during the pandemic. Here’s how they say parents can help their children get through this difficult time.

By Anna Halkidis
April 09, 2021
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The pandemic has created a mental health crisis among teens with a rise of anxiety and depression. But experts are also bringing attention to another mental health issue: an increase in eating disorders.

An image of a plate with a fork and knife wrapped in green measuring tape on top of it.
Credit: Getty Images. Art: Jillian Sellers.

The National Eating Disorders Association (NEDA) says its hotline has experienced a steady 40 percent increase in volume compared to 2019. And from March 2020 to date, 71.4 percent of people who disclosed their age are between 13 to 24 years old. Overall, a survey in the International Journal of Eating Disorders in July 2020 found Americans with anorexia, binge-eating disorder, and bulimia nervosa had worsening symptoms due to the pandemic.

Risk Factors for Eating Disorders

Experts say the pandemic has unfortunately created an environment enabling these issues. And for teens with a history of an eating disorder, the pandemic has also brought upon triggers.

Isolation

The pandemic completely altered routines and regular schedules. The outcome became isolation. "Having an eating disorder in general is a pretty isolating issue and then add on top of that the isolation that's been forced upon people—with a lack of social supports they normally have, the lack of regular therapy, nutritionist appointments—it just makes things worse," says Michael Enenbach, M.D., board-certified adult and child and adolescent psychiatrist and clinical director and associate medical director at the Child Mind Institute, a nonprofit helping kids struggling with mental health and learning disorders.

Anxiety, depression, and uncertainty

The increase in anxiety and depression plays a role since those are also risk factors for eating disorders, says Dr. Enenbach, and so does the uncertainty of the pandemic. "One of the main things about most eating disorders is that there's a sense of wanting to gain control," says Dr. Enenbach. "There's so much uncertainty right now that everyone's looking to try and gain control in some way and so that can also be a triggering reason."

Social media

Another issue? The increase in social media use among teens during the pandemic. A study from March 2021 shows additional use of social media and TV watching is associated with higher chances of binge-eating disorder. That's not to say social media is all bad. Another March 2021 survey found 43 percent of teens and young adults say social media "makes them feel better when they're depressed, stressed, or anxious," up from 27 percent who said the same two years prior. And virtual support for eating disorders can be found via social media.

The issue is youth who spend more time on social media become more susceptible to societal and peer pressure as they are bombarded with feeds of unrealistic images.

"This exposure to idealized appearances, combined with social isolation, and online attention-seeking, is directly linked to eating disorders or emotional eating," says Lauren E. Alon, licensed clinical social worker and counselor with Daybreak Health, an online counseling platform for teens. Social media platforms are a place where teens can easily access triggering content. TikTok is one of the apps that has come under fire for videos that may lead to eating disorders with users promoting diet culture.

Chelsea Kronengold, NEDA's associate director of communications, says, "These types of messages can contribute to shame and anxiety around potential weight gain during COVID and can be a trigger for those experiencing body image and eating concerns."

Screen time

The overuse of screens for FaceTiming and virtual learning isn't helpful either. "For someone with body image and eating concerns, being on camera for hours on end might be anxiety-provoking; they might spend more time body checking rather than paying attention to the important conversations and people on the other side of the screen," says Kronengold.

How Parents Can Help

Recovery from an eating disorder is possible, though. While early invention is key, it can be tricky to start a conversation about such a sensitive topic—particularly if your child isn't open to treatment or denies there is a problem. Here's what experts recommend.

Send positive messages

Since negative body image can contribute to eating disorders, experts stress the importance of parents being mindful about the language they use when it comes to food and body image. And it's never too early to start sending these positive messages. Research shows girls especially begin to express issues with their weight around the age of 6 and up to 60 percent of elementary school girls are concerned about their figure or gaining weight.

"When parents make comments about how they were being 'good' because they didn't eat X, Y, or Z, it teaches children that avoiding certain food is good. On the flip side, comments about why you or someone else shouldn't eat something because 'it will make you fat,' children internalize the message that being fat is morally wrong," says Kronengold.

Focus on language

It's critical to be nonconfrontational and approach the conversation in a respectful way. Use "I" statements (I'm concerned about you because you refuse to eat breakfast or lunch) rather than "You" statements, which can feel accusatory (You have to eat something! You're out of control!), advises NEDA's Kronengold.

Opening conversations in a general manner is an effective strategy, says Dr. Enenbach (I'm noticing this and curious what's going on) and always offer support whenever you can (Is there anything I can do to support you?).

Keep tabs on internet use

"If a kid starts losing weight or seems to be restricting their intake it might be a good idea to look at their browser history to make sure they're not looking at sites that are promoting eating disorders because those sites do exist," says Dr. Enenbach.

Same goes for their social media use. Social media platforms, including Instagram, Facebook, TikTok, and Pinterest, have been working with organizations like NEDA to raise awareness about eating disorders and making tools easily accessible to those in need. But experts say it's still important for parents to pay attention to their child's social media habits and encourage them to follow positive content, including pages promoting healthy nutritional tools.

Seek outside help

Don't hesitate to contact a professional at any point if you're aware your child has an eating disorder or you notice symptoms of one, such as preoccupation with weight, refusal to eat certain foods, skipping meals, seeming uncomfortable eating around others, frequent dieting, withdrawal, and extreme mood swings. Make a trip to their pediatrician who can refer you to a therapist.

If you or someone you know is struggling with body image or eating concerns, you can contact NEDA's toll-free, confidential Helpline at 800-931-2237. NEDA also offers an eating disorders screening tool for ages 13 and up to determine if someone is at risk of developing an eating disorder and if it's necessary to seek professional help.