“I was left in limbo”: how the Covid pandemic fuelled an eating disorder crisis

The death of Nikki Grahame has highlighted the plight of those struggling with eating disorders through the pandemic - many of whom, cut off from NHS services, have been forced to go it alone.

Adrienne Rennie, a 25-year-old from North Lanarkshire, has long been a keen athlete.

Having experienced orthorexia - a fixation on healthy eating - since she was a young teenager, Adrienne has pursued athletics not just for the physical benefits, but the mental ones too:

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“[When training] my eating disorder thoughts are just pushed to the back of my mind”, she explains.

Eating disorder charity Beat have recorded a 302 per cent increase in demand for their helpline services during the pandemic.

“I’m focused on the sport I’m doing and on being a good athlete rather than how it’s helping me appease my disorder”.

Yet in early 2020, when the first lockdown saw the public locked out of gyms, sports clubs and leisure centres, Adrienne’s training was suddenly halted. With her physical activity reduced, she, like thousands of others across the country, gained some weight.

“It didn’t bother me at first”, Adrienne recalls. “But then I started to get all these ads and programmes thrown at me like ‘how to lose x amount of stones in a week...I started to feel really guilty for the fact that I’d put on weight.

“You’re seeing other people smashing their fitness goals [online] and you start to internalise that”, she adds.

Adrienne was far from alone in finding the barrage of strava kudos, Joe Wicks workouts and influencer fitness programmes difficult to cope with during lockdown.

Beat, the UK’s eating disorder charity, has recorded a 302 per cent increase in demand for their helpline since the pandemic began; a figure Beat's Director of External Affairs, Tom Quinn, says is “not surprising” given the “extreme changes to their daily routines, support networks and care plans” wrought by coronavirus.

Last week, the human impact of this crisis was brought into sharp focus by the tragic death of Nikki Grahame, who died of complications relating to anorexia, aged just 38.

Nikki, says Tom, was “unfortunately not alone in the impact of the pandemic on her eating disorder.” The tragedy, he adds, “has brought home the stark reality of eating disorders”.

Like Nikki, Zoe, a 28-year-old student living in Edinburgh, has experienced anorexia nervosa for several years. It’s the lack of routine, she says, which has made the pandemic a particularly difficult time to cope:

“I love going to work, going out and being busy”, explains Zoe, who is currently training as a primary school teacher.

“I love my job, and I get a lot of support from my colleagues...that all just stopped. People were there virtually but it just wasn’t the same”.

Work wasn’t the only thing that stopped dead when the first lockdown was called: many eating disorder services simply stopped running as coronavirus forced mental health services to adapt to a new normal.

Previously denied help because she “wasn’t considered underweight enough”, Adrienne had been on the brink of accessing NHS counselling when the first lockdown came and forced all mental health services to adapt to the new normal.

“I felt really quite hopeful [in early 2020] about getting help”, says Adrienne.

“Then all of a sudden that whole process was taken away...everything was so uncertain, I felt like I’d been left in limbo”.

Zoe, meanwhile, was given an urgent referral to eating disorder services by her GP, but was confronted by a waiting list six months long. At the time of writing, she’s still waiting for help.

In February, doctors warned of a “tsunami” of pandemic-related eating disorders, with a 128 per cent increase in the number of people waiting for routine eating disorder treatment in 2021.

Services, even when accessed, are still often gate-kept by a low BMI requirement which Zoe calls “ridiculous”.

“Some of the times where I’ve been struggling the most with whatever’s going on inside my head have been some of the times when my weight is higher”, she explains.

Poor experiences with treatment and long waiting times “made me consider going private”, says Zoe. When she saw the cost, however, she realised “there’s no way as a student that I could afford it”.

The use of BMI thresholds, say NHS England, is “not supported” as a way of determining who gets treatment for an eating disorder, and calls have been growing for the requirement to be scrapped.

Demand, however, is perhaps the biggest issue NHS services will now be facing as society begins to open following months of successive lockdowns. In the wake of Nikki’s death, several petitions were set up imploring the government for greater funding for eating disorder services.

Without quicker action, the backlog will be huge - and the consequences even bigger.

The pandemic, says Adrienne, was novel at first - but struggling with an eating disorder in the absence of professional help has been tough.

“I’ve been trying to employ coping strategies, but they only go so far”, she says

“There’s only so much a person can do to help themselves...no coping strategy can prepare you for a pandemic”.

If you have been affected by an eating disorder and need help, please contact Beat on one of the following helplines, or speak to someone for free on their web chat.

Helpline: 0808 801 0677

Studentline: 0808 801 0811

Youthline: 0808 801 0711

Helplines are open 365 days a year from 9am–8pm during the week, and 4pm–8pm on weekends and bank holidays.

If you are in need of urgent help for yourself or someone else outside of Helpline opening hours, please contact 999 or the Samaritans on 116 123 if you or someone else is in immediate danger.