Coronavirus Chronicles — Are We Really on Our Own?

When life was proceeding in a way that most Americans had come to accept as “normal,” some people had eating disorders, and the possible helpful responses were understood to include “policy revisions, preventative interventions, and psychiatric treatments.”

In this strange new era, some people have food available, either because they stockpiled it beforehand, or because they live in an area where shortages are not yet apparent, and they can afford to buy what is on the shelves. So while not in immediate danger of starvation, they are still very much in danger of succumbing to an eating disorder. When food is available but the future is unclear, binge eating is a maladaptation to watch out for, and so is routine, everyday overeating in regular increments that add up.

At this time, with so much else going on, authorities are not eager to put resources into policy revisions and preventative interventions designed to stop people from overeating. So out of the three suggested helpful measures, that leaves psychiatric treatment — which is unlikely even in the best of times, because psychiatrists mostly do not concern themselves with eating disorders.

e-Health as the Last Resort

Psychologists and other types of therapists do, however. It is possible to find an online counselor who can work with motivated people for a fee. And for free, there are groups where people who share the same problem can help each other with the struggle. But these lifelines are tenuous at best, depending on many factors including possession of a device, an Internet connection, discretionary income that can be used to pay a therapist, and a certain amount of privacy at both ends of the communication. Consequently, a lot of us are pretty much on our own.

A very recent article by Jud Brewer, M.D., Ph.D., confirms that stress and anxiety impact the appetite in two major ways: not eating, or eating too much. Similarly, there are two kinds of not eating: intentional, and inadvertent. The inadvertent kind results from being too busy in a chaotic environment — not having time to eat, or just forgetting because something more important is always front and center.

Loss of appetite is, on a cellular level, intentional; a thing the body does on purpose, as it works toward self-preservation. Dr. Brewer says,

Losing our appetite is actually an adaptive survival mechanism. Our ancient ancestors who were out on the savannah in the midst of danger had to be ready to fight or run at a moment’s notice. When our fight-or-flight mode is engaged, it signals to our bodies that this is no time to sit down and have a nice meal, and diverts blood from our digestive tract into our muscles.

The other main type of disorder caused by stress is overeating. The environment provides an anxiety trigger, like hearing a news report. We respond with a behavior, like eating. We get a reward, a very temporary spurt of feeling better. Usually, before too long, we are feeling even worse. In other words, the behavior is not genuinely rewarding. That is the revelation Dr. Brewer helps patients to arrive at. He writes,

When we see really clearly that a behavior isn’t rewarding, we become disenchanted with doing it in the future. We can’t think our way into changing a habit because that relies on the thinking part of our brain, which ironically goes offline when we’re hungry or stressed. But we can rely on our old, survival brain because it functions on a much simpler level.

Not everything works for everybody, but just for today, when life is so topsy-turvy and weird, maybe there is an idea in here that will help somebody.

Your responses and feedback are welcome!

Source: “Household food insecurity is associated with binge-eating disorder and obesity,”, 12/19/18
Source: “How to Manage Stress Eating — or Not Eating at All — in Uncertain Times,”, 04/27/20
Image by Jake Vig/Twitter

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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