COVID-19 + ED: FAQs

Yes! A number of clinicians and organizations are running webinars or online education sessions.

• Eating Disorders Nova Scotia is presenting Exploring Movement on August 15 and Eating Disorders in Midlife on August 22.
• Body Brave is presenting a monthly series of free recovery sessions and workshops on Thursdays, open to anyone ages 17+ in Canada.  View the schedule and topics that will be covered here.
  
  

There are several online groups and programming that you may find useful during this time. Information about eligibility is available on their websites.

• Body Brave:  information about current program offerings here. Please note that while group support sessions are open to anyone in Canada, treatment groups are limited to Ontario residents.
• BridgePoint Center for Eating Disorder Recovery:  find out more about the recovery support helpline open on Tuesdays and Thursdays, and about how to receive supportive and encouraging text messages here.
• Danielle's Place:  group programs available for parents/caregivers and youth 
  1.  parent/caregiver support group meets twice a month.
  2.  virtual spring offering for youth is SibShop (age 8-17 with a sibling affected with an eating disorder).
• Eating Disorders Support Network of Alberta:  online support groups using Zoom. Registration fees may be reduced if they are a barrier to participating - contact to discuss.
  1.  Drop-in support group for caregivers is ongoing. The registration fee for each session is $10.
  2.  Support group for adults (18+) living with an eating disorder/disordered eating which begins Wednesday August 31. The registration fee is $70 for the 7-week program. 
  3.  Support group for women over 40 living with an eating disorder/disordered eating which begins Wednesday September 14. The registration fee is $80 for the 7-week program.
  
  
• Eating Disorders Nova Scotia:  online peer support groups, including a new 2-Spirit, Trans+, and Non-Binary group, individual mentoring, and monthly friends/family support groups
• Hopewell:  runs online support groups for individuals ages 17+ living in Eastern Ontario. Registration for Spring 2022 groups is open; view the offerings here.
• Looking Glass BC:  online peer support chat groups are available every day of the week except for Saturday, with multiple meetings on Tuesday and Thursday, and a new binge eating-specific peer support chat group meets on the first and third Wednesday of the month.
• Silver Linings Foundation:  online support groups accessible anywhere from Canada. Registration fees may be reduced if they are a barrier to participating - contact to discuss.
  1.   Adult support group (18+) which begins Tuesday August 30. The registration fee is $150 for the 8-week program. . Details here.  
  2.  Adolescent support group (ages 14-17) which begins Wednesday September 15. Parent/caregiver consent is required. The registration fee is $80 for the 4-week program. Details here.  
  3.  Adult binge eating disorder support group (18+) which begins Monday September 12. The registration fee is $150 for the 8-week program. Details here. 
  4.  Adult body image support group (18+) which begins Wednesday September 28. The registration fee is $120 for the 6-week program. Details here.
  
  
• Sheena's Place:  Groups open to Ontario residents only. Registration for Spring 2022 programs is open; view the program calendar here. Register for all programs here. Spaces are limited.
• The Instagram account eatcakepod hosts Snack Time and Chill for individuals seeking eating support Thursdays at 3:00 p.m. PST.
• The Instagram account covid19eatingsupport was a collective effort to offer HAES-based community mealtime support to individuals living with eating disorders. While live support is no longer being offered, many recorded sessions are available for viewing.
  
  

You may find some of these tools, activities, apps and workbooks to be useful in helping to manage anxiety:

• Coping with COVID-19 AND an Eating Disorder by Debbi Tjeng, social worker at TGH ED program.
• Tolerance for Uncertainty: A COVID-19 Workbook  by Dr. Sachiko Nagasawa can help you learn to accept your feelings, tolerate distress, and move forward with grace despite not knowing what lies ahead. This free workbook is available in English and in French, and Dr. Nagasawa asks that you pass it on by doing one random act of kindness.
• Health Anxiety Workbook from the Centre of Clinical Interventions includes modules on understanding health anxiety, how it develops, what keeps it going, reducing your focus on symptoms and worries, re-evaluating unhelpful health related thinking, reducing checking and reassurance seeking, challenging avoidance safety behaviors, adjusting health rules and assumptions, and healthy living and self-management planning.
• Your Creative Journaling Field Guide, created by Errin Witherspoon
• Online (Free) Yoga Classes
• How to Meditate
• The S.T.O.P. Practice for Stress
• A 20 Minute Connection Practice (Meditation)
• Free Mindfulness and Meditation App: Insight Timer
• Free Audio Recording Of RAIN, A Mediation by Tara Brach for Calming Anxiety 
• 54321 Grounding Exercise
• Breathing Techniques
• Asking Different Questions to Combat the Negative Voice in Your Head 
• HeadSpace
• Bounce Back Online from the CMH
  
  

• Journaling - it may be helpful to write down your thoughts and feelings. Sometimes it is enough just to get them out of your head and onto paper. It could make it easier to organize those thoughts and feelings and keep track of any changes.
• Drawing - art can be a positive way to distract thinking or express moods and feelings. You can also try other forms of art like origami.
• Mechanical Eating - it could be helpful to try shifting your mind's focus to get through your meal. So, instead of focusing on the meal itself, you concentrate on the actual process of eating, which is called mechanical eating. For example, it would mean focusing on lifting the utensil, putting it into your mouth, chewing, swallowing, and then repeating until you have finished the meal.
• Mindfulness - practicing mindfulness can be very helpful. Tune into your senses and be in the moment -- smell the scents in the room, listen to the birds outside, look at a beautiful picture on the wall, focus on your breathing, etc. Many different apps are available to guide you.
• Talking - if you feel comfortable doing so, it may be helpful to talk and/or ask for support from your family or friends, when you find yourself struggling more.
• Walking - you may find going for a little walk outside to be good for your mental health. Some people find getting some fresh air and taking in the beauty of nature to be a good distraction.
• Disconnect - at a certain point, it may be unhelpful to continue following the news closely. Mindlessly scrolling through social media can reinforce negative feelings. Make sure to take breaks, and try to limit your time online if you feel that it is a problem for you. Look at news from reputable sources.
• Recovery Apps - recovery apps can be useful tools -- they can be used to keep track of your thoughts/emotions/behaviours and they offer suggestions for coping strategies and skills to practice. Two examples of apps for people with eating disorders are:

• Recovery Record
• Rise Up + Recover 

If you’re feeling alone or isolated-- reading about other’s experiences and advice may help you feel more connected in your recovery journey. 

From the NEDIC website and blog: 

• Here to chat
• What can the helpline do for me?
• 5 ways to stay motivated in recovery by Sonia Seguin of Body Brave
• Empty bellies do not beget genius by Gala Darling
• Celebrating body resilience on and off the mat by Marlee Liss
• Body Positivity: 8 things I’ve learned in university by Erin Huston
• Staying strong during recovery by Kelsi Cronkright
  
  

From NEDIC partners:

• How to practice self care during a time of uncertainty (Looking Glass BC)
• How to care for yourself in a time of unease (Looking Glass BC)
• Positive coping mechanisms to get through COVID-19 (Butterfly Foundation)
• Coping with COVID-19 in Eating Disorder Recovery (Waterloo-Wellington Eating Disorder Coalition)
• Recovery Blog: Living alone with an Eating Disorder during a Pandemic (Wellington-Waterloo Eating Disorders Coalition)
  
  
  

• Being informed is important, but it is equally important you take breaks from the news and social media. Try limiting how much time you spend on social media and news or even talking about COVID-19.  This comprehensive guide to mental health during COVID-19 includes a long list of coping tips and links to resources.
• CAMH also has a few different resources on how to deal with stress and anxiety, and supporting others and talking to children about COVID-19.
• NEDIC has a YouTube series in partnership with eating disorder clinicians. The series offers a variety of coping tools from different clinical perspectives. 
  
  

The wonderful individuals at each of these services would be happy to help support you:

• Distress Centres of Greater Toronto Area (for those in the Toronto area) 416-408-HELP (4357)
• Crisis Services Canada Text 45645
• Crisis Text Line Text 686868
• Distress Centres 
• Good 2 Talk or 1-866-925-5454 (for post-secondary students)
• Kids Help Phone 
  
  

Our friends at FEAST are a global support and information network for parents/caregivers of children with eating disorders. You can access their COVID-19 resources here. 

NIED also does a lot of work with families in Canada. 

Many programs closed when the pandemic started. While some were able to transition quickly from delivering care in-person to providing services by telephone or virtually, their operational capacity was reduced. Programs across the country are working through backlogs of referrals. As the pandemic continues, and COVID-19 cases are increasing again in some regions, programs are having to juggle their backlogs and new referrals. Waitlists are unfortunately lengthy. For information about the status of a specific program, please contact that program directly. 

There is currently very little information available as to whether individuals with eating disorders are at a heightened risk for developing COVID-19.  We hope that there will be more detailed information available at some point, but recommend practising social distancing if at all possible as well as following the recommendations of your local health authority. 

Our friends at BEAT in the UK have also compiled a set of FAQs.

We are still in the relatively early stages of understanding COVID-19, so there is little information available about the complications of COVID-19 as it relates specifically to eating disorders. This blog post from the Gaudiani Clinic discusses potential complications if someone with an ED does contract COVID-19. Dr. Gaudiani discusses potential complications that could arise based on the person's eating disorder (AN, BN, BED). It is important to note that, while this is based on her clinical expertise, we have very limited specific information as yet so this should be considered an educated guess.

Journal articles that may be of interest:

• Access to evidence-based care for eating disorders during the COVID-19 crisis by Weissman et al. (2020)
• Eating disorders during the COVID-19 pandemic and quarantine: an overview of risks and recommendations for treatment and early intervention by Cooper et al. (2020)
• Incidence and outcomes of eating disorders during the COVID-19 pandemic by Taquet et al. (2021)
• COVID-19 pandemic and eating disorders: What can we learn about -psychopathology and treatment? A systematic review by Montoleone et al. (2021)
• Eating disorders spectrum during the COVID pandemic: A systematic review by Miniati et al. (2021)
• A systematic scoping review of research on COVID-19 impacts on eating disorders: A critical appraisal of the evidence and recommendations for the field by Linardon et al. (2021)
• People's lived experience with an eating disorder during the COVID-19 pandemic: A joint virtual issue of research published in leading eating disorder journals by Weissman & Hay (2022)

At this stage, we are not aware of any research specifically into the experiences of people who have an eating disorder and receive the vaccine. We hope that more information will be available soon. 

This article discusses some safety considerations for practitioners whose clients have an eating disorder. 

Our colleagues at BEAT in the UK have released this statement in support of vaccine prioritization for individuals who have an eating disorder. 

Tips that may be helpful:

• How to look after yourself at home if you have coronavirus (COVID-19), with a list of signs that you should seek immediate medical attention, from the National Health Service (NHS) - UK
• Nutrition Tips for Recovering from COVID-19 (also available in French) from the Primary Care Dietitians Association

Recommendations from public health agencies:

• Care at home for those who have or may have been exposed to COVID-19 from the Government of Canada
• Self-isolation: Guide for caregivers, household members and close contacts (also available in French) from Public Health Ontario

This varies somewhat depending on your specific location. 

If you live in a Canadian province, you can find a food bank near you using these tools: 

Alberta: Food Banks Alberta

British Columbia: Food Banks British Columbia

Manitoba: Winnipeg Food Harvest  

New Brunswick: Food Depot Alimentaire 

Newfoundland & Labrador: Community Food Sharing Association

Nova Scotia: Feed Nova Scotia

Ontario: Feed Ontario

Prince Edward Island: More information about food banks in this PDF

Quebec: Banques Alimentaires

Saskatchewan: Food Banks of Saskatchewan

You may find it most helpful to visit your city's website for updated information regarding COVID-19, and what services/supports are being altered. For example, information for Toronto. 

• A list of grocery stores in Toronto offering online grocery delivery
• A list of grocery delivery services for Toronto
• If you are outside of Toronto, you may have some of the same services. You can also search “grocery delivery” with your location to find services.

We recognise that this may be a serious anxiety, especially for folks who live with an eating disorder. Evidence available at present indicates that COVID-19 is not a foodborne illness. 

The Canadian Produce Marketing Association has developed a fact sheet (PDF) that includes links to credible resources. 

North Carolina State University has developed fact sheets that address questions about grocery shopping and take-out food which you can find here -  one and two (PNG files)

• Government of Canada and the COVID-19 Information Line at 1-833-784-4397
• World Health Organization
• Flatten The Curve: for plain language information on reducing the impact of coronavirus and the COVID-19 illness at home and in your community (this resource uses U.S. examples)

Here are some quick links to the provincial/territorial COVID-19 websites. You may also find it helpful to look up information for your city or town. You can usually do this by searching "[your location] public health" 
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• Alberta
• British Columbia
• Manitoba
• New Brunswick
• Newfoundland & Labrador
• Nova Scotia
• Northwest Territories
• Nunavut
• Ontario & Toronto
• Prince Edward Island
• Quebec
• Saskatchewan
• Yukon Territory

This document discusses possible ways to receive support: Canada’s COVID-19 Economic Response Plan - financial support for Canadians and businesses. An update on the new Canada Recovery Benefit is available here. 

You can find relevant information on these websites:

• Disability Tax Credit: the disability tax credit (DTC) is a non-refundable tax credit that helps people with disabilities or their caregivers reduce the amount of income tax they may have to pay. For more information, click here.
• Registered Disability Savings Plan: the Registered Disability Savings Plan (RDSP) is a long-term savings plan to help Canadians with disabilities and their families save for the future. For more information, click here.

The Public Health Agency of Canada is advising travellers, regardless of their vaccination status, to avoid non-essential travel internationally. Check the Government of Canada website for information and updates:  https://travel.gc.ca

For specific advice and rules pertaining to travel to, from, and within Canada, see: https://travel.gc.ca/travel-covid

To get the latest updates on the situation at your destination: https://travel.gc.ca/travelling/registration

Canadian abroad directly impacted by COVID-19 will have the option of applying for an emergency loan of up to $5,000 to help secure their timely return to Canada and to temporarily cover their life-sustaining needs while they work toward their return, contact: CAN.finances.CV19@international.gc.ca

For all other consular emergencies, Canadians can contact the nearest Government of Canada office or Global Affairs Canada’s 24/7 Emergency Watch and Response Centre in Ottawa at +1 613-996-8885 (collect calls are accepted where available) or email sos@international.gc.ca