Prioritizing Eating Disorders Recovery and Well-Being During the COVID-19 Pandemic
Dear patients and families,
We are thinking of you and your loved ones and recognize the shared challenges we are all facing, as well as those unique to you and your family in the context of the COVID-19 outbreak. Your health and well-being are of great importance to us, and especially so in light of the current public health crisis. Our team is committed to supporting your/your child’s continued recovery in treatment, which also means helping you access your strength and resiliency in the face of stress. We have developed a list of resources and tools to support you during this time of change and uncertainty, with the goal of improving your physical and emotional well-being and bolstering your/your child’s continued path towards eating disorders recovery.
The below “Tip Sheets” provide a list of general suggestions for eating disorders recovery, for families in Family-Based Treatment (FBT), and for general coping, as well as a final list of resources for young people and their family members that we hope will be helpful to support your mental health and well-being, and help you more effectively navigate the path towards recovery (a PDF of this document is available here).
Please do not hesitate to reach out to your team during this time for extra support. We are all in this together and remain committed to supporting your recovery.
Warm wishes,
UCSF Eating Disorders Program Team
Tips for eating disorders recovery
Tip 1: Don’t forgo regular meals and snacks
This is a critical time to take good care of your body. We know that eating disorders impact all physical systems of the body and that being malnourished makes the body more vulnerable to illness. Create a structure and schedule to help you stay on track with regular meals and snacks. Stick to your meal plan, if you have one. If you are having trouble accessing foods that support your recovery, work with providers and loved ones to identify alternatives. Some may struggle with feeling overwhelmed by having more constant access to food. Should you struggle with binge eating, for example, you may recruit help from loved ones to stick to a regular schedule of eating as much as possible and integrate varied nutrition throughout the day. Fully nourishing yourself with a variety of foods, getting enough sleep, and finding ways to relax are all proven to support overall health and immunity.
Tip 2: Stay actively engaged in care
While the global scale of this crisis changes the context of your medical and mental health care, it is critical to stay engaged in your treatment. Your providers are committed to your recovery and want to make sure you are accessing the care you need. Our team is primarily providing outpatient visits via telehealth (and scheduling in-person medical follow-ups as clinically indicated). For medical issues, you can call our main number at (415) 353-2002 for non-urgent scheduling issues or urgent questions about your care. For mental health issues, you can reach out to your individual provider directly. You can also reach your providers via MyChart for non-urgent advice.
Tip 3: Find safe ways to move your body
There are many different ways to move our bodies. Physical movement can decrease stress in the body, facilitate feelings of joyfulness and help us stay grounded. Simple stretches, a short walk in nature are examples of movement that may bring positive benefits without activating disordered behaviors. However, finding activity that supports recovery can be challenging, and should be done with the guidance of your treatment team and family. Please consult your treatment team about what type of activity is safe and advisable for you at this time.
Tips for families in FBT
Tip 1: Remember, you are doing the best you can
We aren’t supposed to know exactly how to respond to the current situation. Every family’s circumstances may be slightly different. Try to be kind with yourself as you navigate new terrain and create new structures and rituals as a family. Now is not the time to expect perfection (and we’d argue there’s never a good time for this!). For those of you in partnerships, recognize that you will each have your own unique challenges in coping and communicating during this time, and give each other the benefit of the doubt.
Tip 2: Create a meals/snacks schedule that works for your family
You may find it helpful to post a schedule in the home. Divvying up meals between caregivers when possible may be important to give one another a break. Share the schedule in advance with your child so they know what to expect and whether there will be any changes. For caregivers split across households, communicate clearly with one another about how to support your child during this time.
Tip 3: For families in Phase II, find new ways to support your child’s independence
It may be difficult to find as many opportunities for your child to practice independence, especially if they were practicing eating independently at school or with friends. They may be able to schedule virtual meals and “outings” with their friends that involve eating tasks. Get creative and brainstorm strategies to facilitate next steps in recovery with your treatment team.
Tip 4: Monitor physical activity closely
For young people in recovery whom have struggled with using exercise to compensate for eating or attain a specific weight or shape ideal, this may be a very challenging time. It is also a time of great opportunity to help your child practice forms of movement that both support their recovery and are feasible during this unique situation (i.e., no more access to gyms, sports, dance classes). Physical activities in isolation may be especially problematic, and we encourage families to find ways to be active together (e.g., walks, kicking a soccer ball, stretching/yoga classes, many of which can be streamed online).
Tip 5: Connect with other families
Some families find it is helpful to connect with others who are going through similar struggles, and now especially, may be a helpful time to learn from one another about how to continue to support your child’s recovery. FEAST is a great resource for seeking additional support and connecting with other families.
Tips for general coping
Tip 1: Create space for all emotions
Some people may not notice much change in their emotional state, while others may experience a wide range of emotions. Each family member’s response may be different and may change across the day. Take time to check-in with one another daily. Understanding each other’s emotional response and how to support one another can greatly improve communication and a sense of connection and safety. Below are some helpful resources can guide conversations about COVID-19 and our reactions.
Tip 2: Set boundaries around COVID-19 media consumption
It may be difficult to disconnect from the inundation of news and alerts about COVID-19, and this can contribute to feelings of panic and fear. We recommend limiting media consumption around the virus and choosing one or two trusted sources for updated information (e.g., CDC and WHO).
Tip 3: Create a new routine
It is normal to feel disoriented with changes in routine and structure, and it may take time to find a new routine that works for you. We recommend creating a general schedule that allows for work or school time, unwinding activities, and some time outdoors. It may be helpful to reframe this time as an opportunity to slow down, connect with values and other interests, and care for one another.
Tip 4: Stay connected
While we are all doing our best to follow guidelines on social distancing to decrease the spread of COVID-19, it is equally important to find ways to stay connected to our community and loved ones. There are many ways to keep connected via social media, video calls, and online courses. We have shared some resources below. In addition, it is helpful to remember that we are all in this together. Each and every human being is struggling to weather this crisis; some struggles are individual and some struggles are universal. Connecting around our shared humanity and reminding ourselves that we are not alone can be a very helpful buffer against loneliness.
Resources
Mental health resources
UCSF Department of Psychiatry COVID-19 Outbreak Mental Health Resources
The UCSF Department of Psychiatry has compiled an excellent list of resources that may be helpful as a starting point for additional ideas and supports.
A mindfulness app that has guided meditations, relaxation exercise, sleep stories, and soothing sounds. They are offering a suite of free tools:
This website provides a list of evidence-informed apps that support mental health, including stress and anxiety management, sleep, substance use, and PTSD.
This is an eating disorder recovery app that has many different features. Talk with your clinician about whether you might integrate this into your treatment plan.
How to respond effectively to the Corona Crisis by Dr Russ Harris, author of The Happiness Trap
Other local resources
COVID-19 Bay Area Community Resources + Up-to-Date Health Information
This is a living document from the Freedom Community Clinic on mass resources in the Bay Area during the COVID-19 pandemic, also available in Spanish.
How to talk to your kids about COVID-19
How to Help Teens Shelter in Place
Talking to Kids About the COVID-19: Kids Worry More When They're Kept in the Dark
How to Talk to Your Kids About the COVID-19 Outbreak