While the economy remains closed in many states and cities across the US, many Americans are going without services that once felt like necessities: dental checkup, eye appointments, chiropractic adjustments, and even their annual physicals. This closure may lead those suffering from eating disorders (or those who love them and are worried about their health and well-being) to believe that residential treatment programs are either suspended or unsafe in light of the COVID-19 epidemic.
Quite the opposite, now is always the best time to seek treatment for an eating disorder. Individuals who wait too long to get help run the risk of suffering the lasting consequences of an eating disorder, but services are both safe and available, even during this pandemic. Residential treatment facilities are taking safety precautions according to guidance from the Centers for Disease Control and Prevention (CDC) to protect their clients and prevent the risk of infection.
Knowing the signs of an eating disorder, the risks associated with untreated eating disorders, the benefits of residential treatment, and the safety measures in place to prevent the spread of COVID-19 in these facilities can help you make informed decisions about your treatment or guide your loved one to seek the treatment they need to get healthy.
Signs and Symptoms of an Eating Disorder
It can be difficult to know if someone you love is suffering from an eating disorder as they often participate in unhealthy behaviors privately to hide the problem (and sometimes to prevent unwanted intervention from concerned friends or family members).
The most common eating disorders include bulimia nervosa, characteristic by binge eating episodes followed by purging (self-induced vomiting or diarrhea); anorexia nervosa, marked by extreme food intake restriction and/or exercise and accompanied by a distorted perception of oneself; and binge eating disorder, involving periodic but regular episodes of significant overeating, often in response to difficult emotions.
Many individuals struggle with more than one eating disorder, like coexisting anorexia nervosa and bulimia nervosa. The most common signs of an eating disorder include:
- wearing oversized, loose clothes or many layers to cover weight loss
- dramatic weight loss (unhealthy appearance, skeletal appearance, unhealthy BMI)
- obsessing over calories, carbs, fat, or dieting
- extreme exercise routines
- absence of menstruation or irregular menstruation
- not eating in front of other people or joining the family at mealtime; avoid mealtime get-togethers
- denying that there is a problem with their diet, exercise routine, or weight
- evidence of binge eating – large amounts of food are missing, excessive wrappers appear in a short time
- signs of purging, like making trips to the bathroom during or after meals, the sound or smell of emesis, or frequently purchasing laxatives
- frequent use of mouthwash, mints, or gum
- scarred knuckles, also called Russell’s sign, which results from inducing vomiting frequently over a long period
While excessive weight loss and unhealthy low weight often accompany anorexia nervosa and bulimia nervosa, you may see that somebody who suffers from binge eating disorder continues to gain weight or fails to lose weight despite constantly or obsessively dieting and exercising. Weight gain despite dieting is a sign of binge eating disorder.
Because those who suffer from these conditions may not want help, loved ones must look for and recognize the signs and symptoms of a problem. Eating disorders can lead to serious health problems, including death if left untreated, but effective treatment is available even during the COVID-19 pandemic. In fact, the circumstances surrounding this pandemic, like lack of social interaction, job loss, and financial strain for millions of Americans, can increase the risk of development or exacerbation of mental health issues including self-harm, suicidal ideations, anxiety, depression, and low self-esteem, making treatment not just important but urgent and pressing.
Risks associated with untreated eating disorders
The long-term consequences of untreated eating disorders are many and serious as outlined by the National Eating Disorders Association.
Eating disorders have a direct and detrimental impact on the cardiovascular system. Extensive dieting leaves the body to break down its own tissues for fuel, starting with muscles like the heart. As the heart runs out of fuel, blood pressure drops, the pulse slows, and the risk of heart failure rises. The electrolyte imbalances caused by purging also directly impact the heart, leading to irregular heartbeat, heart failure, and in the most serious cases, death.
Gastrointestinal system consequences are extensive and include, gastroparesis (slowed digestion), constipation, stomach rupture, esophageal rupture, swollen salivary glands, pancreatitis, and intestinal infection, obstruction, or perforation. Some of these complications can lead to life-threatening emergencies.
Because up to 20% of the calories consumed are routed directly to the brain, the neurological system also suffers when caloric intake is greatly reduced. The neurological consequences include obsessive behavior, difficulty focusing, numbness, and tingling in the extremities, sleep troubles, dizziness, fainting, seizures, muscle cramps, and sleep apnea.
Fat and cholesterol intake support hormone production, so reducing intake of fat and cholesterol can reduce the production of important hormones like testosterone, estrogen, and thyroid hormones, leading to a myriad of problems: the absence of menstruation, bone loss (and subsequent fractures), insulin resistance, hypothermia, and high cholesterol.
Other problems caused by eating disorders include hair loss, excessive body hair, kidney failure, anemia, and death. Seeking treatment promptly is necessary for the greatest possible outcome.
The benefits of residential treatment
Residential treatment can be life-changing for those suffering from anorexia nervosa, bulimia nervosa, and binge eating disorder, offering a myriad of benefits over other treatment options:
- these treatment programs are designed to address other health problems associated with the eating disorder, such as kidney failure, esophageal ulcers, and more, ensuring treatment encompasses the needs of the whole person and not just the disease
- residential treatment programs can provide safe setting and supervision to reduce the risk of self-harm or suicide, both common among those suffering from eating disorders
- inpatient treatment removes barriers that prevent clients from getting the treatment they need, such as distance from home, the cost of gas, obligations at work or home, or the distractions of everyday life
- a setting away from home can remove individuals from environments like school, work, or home, that contribute to their unhealthy thoughts and behaviors and allow them to focus on themselves without negativity or pressure
- continuous supervision makes it difficult if not impossible to participate in unhealthy behaviors, making inpatient treatment ideal for those who may not be strong candidates for outpatient or day treatment
- the interdisciplinary team includes specialized team members who are qualified to address some of the mental health issues that commonly occur alongside eating disorders like low self-esteem, anxiety, and depression
- residential treatment gives clients the opportunity to build relationships and support networks with professionals as well as people like themselves, which can improve their chances of long-term success
It can be scary to consider a residential treatment facility and most clients have a lot of questions and concerns about how they’ll manage their responsibilities while seeking the care they need. The specialists at any treatment center can assist prospective clients in developing a plan that prioritizes their treatment while ensuring peace of mind and sustainability.
How we prevent the spread of COVID-19
Many people who could benefit from residential treatment for eating disorder recovery feel nervous about the COVID-19 pandemic and may consider delaying treatment as a result of those fears. The truth is, residential eating disorder treatment can still help, even during the COVID-19 pandemic, and getting treatment is still safer than foregoing treatment for most clients especially during this stressful time.
Oliver Pyatt Center’s residential programs in home-like environments provide the opportunity to better protect clients from exposure to COVID-19. Protocols include the latest CDC guidelines along with state mandates. The process is well-defined and designed with patient safety in mind:
- The admissions team asks prospective clients questions to help gauge risk of exposure to COVID-19, including whether or not the individual has traveled to a high-risk area, been exposed to anyone with confirmed or suspected COVID-19, or is experiencing any symptoms that are indicative of potential COVID-19 infection. Only clients who pass this screening may proceed with admission.
- At the time the individual arrives at the house, the family says their goodbyes outdoors to reduce the number of visitors in the residential treatment facility, and the patient is questioned again about exposure and symptoms. A temperature is obtained and if all is normal the individual admits to the facility.
- Inside the house, the staff has been fully trained on proper hygiene with frequent hand washing, use of hand sanitizer and cough/sneezing techniques to avoid spreading infection. Isolation and mask protocols spell out the specifics of use and if an individual gets a fever or other symptoms worrisome for infection, whether a typical viral upper respiratory infection, the flu, or possible COVID-19 infection, they are isolated and proper testing is obtained.
Just like other healthcare facilities that continue to operate such as long-term care facilities, retirement communities, and inpatient drug and alcohol treatment centers, residential eating disorder treatment facilities can safeguard their clients through intentional policies and practices that reduce the risk of transmission.
It is critical to note that for most clients, the risks of an untreated eating disorder will outweigh the risk of COVID-19 transmission in a residential treatment center.
To conclude, COVID-19 can lead to exacerbation of mental health conditions and eating disorders as social isolation, job loss, the added stress of homeschooling, fear of transmission, and financial worry weigh heavily on those impacted. Knowing the signs to watch for, the long-term risks of an untreated eating disorder, the benefits of inpatient residential treatment, and the measures in place to keep clients safe can help you get the help you need or facilitate treatment for someone you love. While many businesses, industries, and economies are shut down, treatment for eating disorders and coexisting conditions remains essential and safe and now – whenever that is – is always the best time to take the first step toward healing and restoration. Eating disorder recovery is possible.