By Dr Chandrima Chatterjee and Dr Parul Malik
The ongoing coronavirus (COVID-19) pandemic has had wide ranging consequences for everyone in the world. Not only has the health infrastructure come under close scrutiny and COVID has claimed the lives of many people, but the effect has stretched into the lives of people, who were not even infected by this virus.
To contain the spread of the virus, the first community mitigation measure, adopted at the community level throughout the globe was the imposition of a “lockdown”. This compelled the people to stay indoors and not venture out, unless necessary. This exercise continued for a span of quite a few months at a stretch and in ongoing in some parts, even till date. The effect of this step was very rampant and affected the economies of various nations significantly and also had a huge impact on the mental health of the populations. “Work-from-home” got added to the urban vocabulary as soon as the lockdown had started. Working for long hours, overcoming network issues, and managing household chores, all of this together, became a commonplace for the life of every individual, striving to achieve his/her livelihood. This “new normal” came with its daunting effects one of which can be noticed much on the waistlines of the urban dwelling working class population.
All of us are aware of the term “binge-eating” which refers to the engagement in disinhibited eating practices, regardless of any constraints. Binge eating occurs as an instinct to escape self-awareness. This could even be resulting due to coping up with difficult situations such as high expectations from family, friends, employers, or others and falling short of fulfilling those (Heatherton & Baumeister, 1991).
With the constraints introduced by the lockdown i.e. the confinement, there have been rising concerns about health and fitness. Among the many ailments, there are high chances of developing an eating disorder in vulnerable individuals, when subjected to the stress of a lockdown. Increased time spent on social media, coupled with loneliness and isolation could be some of the possible reasons leading to various eating disorders. Apart from binge-eating disorder (BED), the other disorders that may result are Anorexia Nervosa (AN) and Bulimia Nervosa (BN). These disorders may even have pre-existed in many individuals and could get aggravated during this lockdown period of COVID-19.
Along with headlines of COVID creating fear one side, the social media has also been giving out the message of “Being Positive” during this period. So, there is negativity on one hand and an attempt by people on the other hand to try to think “positive” and push aside their negative thoughts. But is it really that easy? The various existing “images” being created about hat is a “good way to be”, striving towards an ideal body shape and perfect skin and hair has pushed the people towards higher expectations and a lower self- image for themselves (Touyz, Lacey & Hay, 2020). The limitations of access to proper workout environment and equipment, coupled with the increasing work stress, anxiety etc., achieving or maintaining this “ideal body” is becoming increasingly difficult.
With the people with eating disorders (ED) forming a significant part of the vulnerable population, people are at an amplified risk of developing weight loss in anorexia nervosa (AN), electrolyte imbalance in bulimia nervosa (BN), or cardiovascular diseases in binge eating disorder.(Baenaz et al, 2020). Studies show that when negative stimulus is introduced, the bulimics tend to over-eat without any restrains or binge-eat, to overcome stress (Laberg, Wilson, Eldredge & Nordby, 1991).
When the effects of binge-eating on the heart are looked at and analyzed, a major role is seen to be played by stress. It is also associated with decrease in heart rate variability (HRV). The balance of low-frequency HRV and high-frequency HRV reflect the balance of sympathetic and parasympathetic activities which in turn affects the cardiac rhythm. Different studies have shown that, the introduction of different stressors can produce very different results in individuals with BED and even in those who do not have BED but have similar Body-Mass Indices (BMIs). This concludes that people with BED show a longer recovery time from any cardiovascular disease. (Naish, Laliberte, MacKillop & Balodis, 2019).
Thus, it can be conclusively stated that the lockdown has stressed everyone and has in turn affected the eating and sleeping patterns of many. The changes in the circadian rhythm have forced the vulnerable population i.e. those suffering from eating disorders to turn to other unhealthy habits to overcome the imminent anxieties and tensions. The social media and the advancement of technology have also negatively affected this situation. Increases in body weight, a predisposition to obesity and electrolyte imbalance have resulted, thus affecting the health of the individuals. A few of the things can be kept in mind, to pass through the tough times. Spending less time on the social media and hereby, “taking a break” from that can help in relaxing the mind. Inculcating some habits like sleeping early and meditating may have a positive effect on the mind and body and can also help in avoiding the midnight hunger pangs. Acceptance of the fact, that we are going through a tough time and there can be ups and downs rather than spreading toxic positivity messages, will help in relaxing the mind. After all, relaxing the mind, indeed, would help in handling the emotions well.
Dr. Chandrima Chatterjee is a dental surgeon and currently a postgraduate student, pursuing Master of Public Health (Global Health) at Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India.
Dr. Parul Malik is a medical doctor with a Master of Public Health (Global Health) degree from Prasanna School of Public Health, Manipal Academy of Higher Education (MAHE), Manipal, India.
Baenas, I., Caravaca‐Sanz, E., Granero, R., Sánchez, I., Riesco, N., Testa, G., … & Fernández‐Aranda, F. (2020). COVID‐19 and eating disorders during confinement: Analysis of factors associated with resilience and aggravation of symptoms. European Eating Disorders Review.
Friederich, H. C., Schild, S., Schellberg, D., Quenter, A., Bode, C., Herzog, W., & Zipfel, S. (2006). Cardiac parasympathetic regulation in obese women with binge eating disorder. International Journal of Obesity, 30(3), 534-542.
Heatherton, T. F., & Baumeister, R. F. (1991). Binge eating as escape from self-awareness. Psychological bulletin, 110(1), 86.
Laberg, J. C., Wilson, G. T., Eldredge, K., & Nordby, H. (1991). Effects of mood on heart rate reactivity in bulimia nervosa. International Journal of Eating Disorders, 10(2), 169-178.
Touyz, S., Lacey, H., & Hay, P. (2020). Eating disorders in the time of COVID-19.