What COVID-19 reminds us about eating disorders

I am a psychotherapist, licensed clinical social worker and faculty member at the University of North Carolina at Chapel Hill. I have been in recovery from an eating disorder for 16 years.

As I picked up my iPhone one night in late 2020, the screen landed on an obituary photo. The face looking out from the screen was the image of a woman with light eyes and hair, like me. She was born the same year as me, lived in my hometown, and died from the same illness I had. But due to a variety of factors, I survived the eating disorder that afflicted us both. She didn’t.

This narrative — that one recovers while another perishes from the same disease — is common these days. About 27 million have tested positive for coronavirus in the United States, and over 460,000 of these people have died. The mortality rate hovers around 1.7%.

Hopefully the coronavirus pandemic will be tamed within the next year or two. The vaccine brings a collective sigh of relief, in contrast with the ongoing frustration felt by eating disorder advocates and researchers about the plight of their sick patients and family members. Eating disorders have a lifetime prevalence rate of 9%; 30 million Americans in any given year will have an eating disorder during their lifetime. One out of five people with anorexia dies from the disease — a mortality rate of 20%.

Eating Disorders Awareness Week began Feb. 22. This news will likely get lost in the chaotic shuffle of headlines, though this is starkly opposed to how we openly mourn coronavirus deaths. We know COVID-19 patients don’t choose the disease; in contrast, many believe that eating disorders are about self-image and weight control despite a plethora of research showing they stem from genetics, family conflict, and additional psychosocial factors.

Our health system is based on the principle that medical illnesses aren’t a conscious choice, yet eating disorders continue to be stigmatized because of the misconception that patients have control over symptoms. Just as neglecting to wear a mask or attending large gatherings increase chances of getting COVID-19, risk factors make it more likely — but don’t guarantee — that someone will fall ill with an eating disorder. Scientists say there’s no way to predict how each body will respond to a COVID-19 infection, and no way to know for certain who will get an eating disorder, who will recover, and who will die.

Thousands of eating disorder specialists, family members mourning the loss of a loved one to anorexia, and those of us who have been diagnosed with an eating disorder know it isn’t a choice. No one would voluntarily choose the misery, pain and often permanent damage eating disorders cause.

When I entered treatment for an eating disorder, I was terrified and unsure. But I learned that the missteps of my past didn’t have to define my future. The coronavirus pandemic is a tragedy that can teach us to what financial, emotional, and psychological lengths we are able and willing to go in order to help people heal from eating disorders, too.

Despite popular belief, people with eating disorders aren’t weak, immoral, or vain. Many of us are strong, creative, compassionate individuals whose pain has been dismissed because of a limited understanding of the underlying causes and nature of eating disorders. Like being infected with coronavirus, succumbing to an eating disorder is involuntary. Relying on a trusted support system and well-informed practitioners during the healing process, however, can be a worthwhile choice. I, and millions of others who have recovered, am living proof.

This story was originally published March 4, 2021 at 9:21 AM with the headline "What COVID-19 reminds us about eating disorders."