Valerie Bledsoe said she’d already been in a downward spiral with her eating disorder since before the COVID-19 pandemic. The 40-year-old Vancouver woman had been suffering from poor body image for much of her life, and after birthing a child, she experienced postpartum depression, which fueled her eating disorder.
The pandemic just added to the compounding stress she’d been experiencing for years.
“I don’t want to sound negative or pessimistic, but I really am just sort of like, ‘Is this just the way it’s going to be?’” Bledsoe said. “The pandemic pretty much destroyed any kind of progress I had made over the last 20 years.”
Since 2020, mental illness and eating disorder rates have increased — Bledsoe is one of the estimated 30 million Americans who will have an eating disorder in their lifetimes, according to the National Eating Disorder Association.
Things are getting worse. According to a study by the National Library of Medicine, pandemic lockdowns contributed to worsening eating disorder symptoms. Schedule changes, an inability to connect with support systems and a lack of access to health care led to a “triggering environment” with increased anxiety and depression.
As many return to the office, school and other in-person activities, those suffering are starting to seek help — but the help isn’t there.
Not enough care
When all of the gyms shut down for safety during the pandemic, Bledsoe said she went into panic mode since she was compulsively exercising every day.
Bledsoe continued to work out at home, and throughout the lockdown, she became more obsessive about her workouts, restricting her diet and losing weight. People began to comment on her appearance, she said, and she could see it happening in front of her.
“I was just losing more and more weight,” she said. “Once I fell into that spiral, it was just almost impossible to get out.”
She felt virtual therapy wasn’t effective, so she stopped any treatment. Though she considered returning to an inpatient residential program, with the pandemic so constricting, she put it off.
Since COVID-19 restrictions have been lifted, Bledsoe has had difficulty finding some level of aftercare. Every therapist she called was booked. Most of the available providers wouldn’t take her insurance. More than anything, Bledsoe said she felt defeated.
According to a map from Rural Health Information Hub, most counties in Washington and Oregon are experiencing a shortage of mental health professionals, including Clark County.
Anne Cuthbert, a licensed mental health counselor in Vancouver, said she has a wait list for the first time — and it’s growing. Despite burnout, Cuthbert’s providers and colleagues still say yes to working with new patients.
“There are not enough therapists to go around,” Cuthbert said. “I certainly validate their frustration. It is a huge problem.”
Battling insurance companies
A recent study conducted by Keck School of Medicine at the University of Southern California revealed that anorexia and other forms of eating disorders could have serious, dangerous and even fatal physical complications.
Seventeen-year-old Jade Phillips has been struggling with eating disorders for several years. After being diagnosed with anorexia nervosa, characterized by a distorted body image and an unwarranted fear of being overweight, she was hospitalized for 14 days to stabilize.
There, she was diagnosed with postural orthostatic tachycardia, which can be a side effect of anorexia that causes light-headedness, difficulty thinking and concentrating, fatigue, blurry vision, palpitations, tremor and nausea, according to Johns Hopkins Medicine. She now also struggles with cognitive impairment, body dysmorphia and chronic lethargy.
The struggle for care is something that Phillips and her mother, Ladonna Kirkpatrick, know well.
Phillips did a partial hospitalization program at Providence Health and Services in Portland in 2020 then went into a residential program with Clementine in West Linn, Ore. Phillips was there for just under one month because the family could not afford the expensive treatment. Her insurance stopped paying the bills.
Phillips attempted suicide shortly after, and she was sent to Trillium Family Services in Portland for three months in 2020. She has also had two more hospital stays during this time. She then went to the Center for Discovery Eating Disorder Treatment in Portland because her eating disorder was compounding with other mental illnesses, including chronic depression and bipolar disorder.
Like Bledsoe, because of the COVID-19 pandemic, Phillips still hasn’t found a therapist who specializes in eating disorders.
“I think the biggest thing is the lack of resources for patients right now, even after the pandemic,” Kirkpatrick said. “Our biggest fear is that she’s going to die.”
Cuthbert said working with insurance companies can be challenging. It isn’t uncommon for companies to deny coverage to those who need treatment for eating disorders, according to Cuthbert. She said that providers either won’t accept certain insurance payments or can give up a lot of time, energy and financial security to accept them.
“It’s tragic and harmful to all, except the insurance company,” Cuthbert said.
Kirkpatrick was charged $4,086.19 for Phillips’ 27-day stay at the Center for Discovery Eating Disorder Treatment.
“She needed to be there. But the insurance company basically said, ‘Well, you know, she’s not on her deathbed. We don’t want to pay for this,’ ” Kirkpatrick said. “She came home, and she just deteriorated.”
Lockdown fatigue
Lockdowns from the COVID-19 pandemic have caused people of all ages to face their eating disorders head-on. Cuthbert said that shutdowns caused some people to feel out of control once routines were disrupted, so people depended on controlling diet and exercise to feel secure.
“The pandemic has been stressful, isolating, fearful, and people have even shamed us for eating for emotional reasons,” she said. “These, as well as any trauma responses, will lead one toward an eating disorder or focusing on their body image as a means of coping.”
Kristie Brisby, 40, of Vancouver said it was freeing at first to eat during the pandemic. Before, she struggled to eat. She was on medication that stifled her appetite, so she had little motivation to feed herself.
But during lockdown, Brisby ordered food more often and enjoyed it with her family. For once, she felt some sort of freedom from food. But it soon became a coping mechanism more than anything else.
“There was no reason to feel guilty. I pretty much relaxed all my fears about food during COVID,” she said. “But every day was a crappy day. So the way to make myself happy was to order food.”
Brisby said that while she was happy eating whatever she wanted whenever she wanted, it became her only form of entertainment while everything was closed. And the minute she started gaining weight because of having that freedom with food, she started getting self-conscious about her body.
“I think all sizes are beautiful,” she said, “but it definitely tore down my self-esteem a little bit, just me being hard on myself. It was all me.”
She isn’t seeking professional help or therapy because she said she didn’t want to acknowledge her disordered eating patterns. Brisby said it can be scary to open up to professionals. Instead, she relies on her friendships for her support system.
Did you know?
Though eating disorders are among the deadliest mental illnesses, second only to opioid overdose, only 1 in 10 with eating disorders actually seek treatment.
— South Carolina Department of Mental Health
She’s still working on finding a healthy relationship between her body and food, Brisby said, but it’s difficult for her to break the habits created over the pandemic lockdowns. Still, she’s motivated to recover.
“I was always dehydrated. I was always tired. I had no energy for anything. It was because I wasn’t fueling my body,” Brisby said. “I just really want to be healthy and happy and feel good.”
