Here’s what parents need to know.

By Lisa Damour

As a psychologist who cares for adolescents I am well aware of the prevalence of eating disorders among teenagers. Even still, I am stunned by how much worse the situation has become in the pandemic.

According to the psychologist Erin Accurso, the clinical director of the eating disorders program at University of California, San Francisco, “our inpatient unit has exploded in the past year,” taking in more than twice as many adolescent patients as it did before the pandemic. Dr. Accurso explained that outpatient services are similarly overwhelmed: “Providers aren’t taking new clients, or have wait-lists up to six months.”

The demand for eating disorder treatment “is way outstretching the capacity to address it,” said the epidemiologist S. Bryn Austin, a professor at the T.H. Chan School of Public Health and research scientist in the Division of Adolescent and Young Adult Medicine at Boston Children’s Hospital. “I’m hearing this from colleagues all across the country.” Even hotlines are swamped. The National Eating Disorders Association helpline has had a 40 percent jump in overall call volume since March 2020. Among callers who shared their age over the last year, 35 percent were 13 to 17 years old, up from 30 percent in the year before the pandemic.

What has changed in the pandemic?

There are several possible explanations for this tsunami of eating concerns in teenagers. When adolescents lost the familiar rhythm of the school day and were distanced from the support of their friends, “many of the things that structured a teenager’s life evaporated in one fell swoop,” said Dr. Walter Kaye, a psychiatrist and the founder and executive director of the eating disorders program at University of California, San Diego. “People who end up with eating disorders tend to be anxious and stress sensitive — they don’t do well with uncertainty.”

Further, eating disorders have long been linked with high achievement. Driven adolescents who might have normally poured their energy into their academic, athletic or extracurricular pursuits suddenly had too much time on their hands. “Some kids turned their attention toward physical health or appearance as a way to cope with anxiety or feel productive,” Dr. Accurso said. “Their goals around ‘healthy’ eating or getting ‘in shape’ got out of hand” and quickly caused significant weight loss.

For some, an increase in emotional eating in the pandemic has been part of the problem. Attending school from a home where food is constantly available may lead some young people to eat more than usual as a way to manage pandemic-related boredom or stress. “Being at school presents a barrier to using food as a coping mechanism; at home, we don’t have that barrier,” noted Kelly Bhatnagar, psychologist and co-founder of the Center for Emotional Wellness in Beachwood, Ohio, a practice specializing in the treatment of eating disorders.

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