Coronavirus Chronicles — When Shelves Are Empty

Yes, that title is a trick — because the shelves don’t need to be literally empty for people to emotionally go off the deep end. In what we used to think of as normal life, anyone with an eating disorder faced plenty of difficulty already. Every day would involve walking a tightrope of avoidance in environments strewn with triggers on every side.

For people whose world is much smaller because of sheltering in place, that world has become both more and less controllable. Just as one example, the risk of contagion can justify asking certain people not to visit. But it can also trap someone in shared isolation with the person or people who pose the biggest threat to their mental equilibrium.

Drawing lines

In the current situation, even if there is still food in the retail establishments, and even if a person can afford to buy it, and is able to get to the store or have food delivered, the specter of scarcity looms in the background. The people who pick the food and work in the packaging factories and drive the trucks and stock the shelves are sick. Every break in the supply chain sets off a cascading series of consequences down the line.

The need to ration food may be quite real, or not… but even if there is no genuine risk of starvation, the disordered mind can seize upon the idea and use it to rationalize calorie restriction that is not objectively necessary, and is in reality harmful.

What about stockpiling and hoarding? Is there a difference? One term implies a reasonable and prudent measure, while the other suggests a reaction that is unhealthful and antisocial. But in such uncertain times, who even has enough reliable information to draw that kind of line? Journalist Gabby Landsverk spoke with Sarah Herstich, a licensed clinical social worker and body image therapist, and learned that…

Anxiety could drive people to purchase more food than they typically might and, with many people confined to their homes, that can be a challenging environment for people with a tendency to binge-eat.

Melainie Rogers, executive director of Balance Eating Disorder Treatment Center, adds:

If you’re bringing more food into the home, you’re more at risk of overeating because it’s right there. For some people it’s their worst nightmare. Like an alcoholic being locked into a wine store.

Silver bullet thinking

Orthorexia, a relatively new term that does not yet appear in the official literature, signifies going overboard with the notion of healthy eating. Dawn Delgado in Psychology Today wrote,

Society’s fixation on perfection, social media, and health-ism help to reinforce this obsession in those with orthorexia… You may become obsessed and extremely focused on the quality of your food, specific ingredients, or healthy trends…

You may have orthorexia if you become fixated on the fear of sickness, disease, and unhealthiness, and the need to control your health through any means necessary.

So now, with the world swamped by a disease whose details are not yet fully understood, the circumstances are tailor-made to foster orthorexia. We are ripe for “silver bullet” thinking. In our hearts we all want to believe that if we ingest a sufficient amount of a certain nutrient, and avoid certain other substances, we will be protected. People with orthorexia can persuade themselves right smack dab into a dangerous state of malnutrition.

Note from Sarah Herstich:

The National Eating Disorder Association (NEDA) offers many resources for people to connect with virtual support, as well as a map of treatment centers across the US. Many dietitians are now offering meal support, chats, and support groups online via live streaming or other virtual platforms.

Your responses and feedback are welcome!

Source: “Coronavirus anxiety and quarantining could increase eating disorder risk. Here’s what to look out for,”, 03/23/20
Source: “Orthorexia: 10 Signs You Should Seek Help Now,”, 02/26/19
Image by Martin Thomas/(CC BY 2.0)

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Profiles: Kids Struggling with Weight

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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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