Coronavirus Chronicles — Uncertainty and Responsibility

It may seem like there is a lot of discussion here lately about eating disorders in adults, and a seeming neglect of child obesity. But it is all part of the same complex problem, for many reasons.

When everybody is stuck at home together, there is a lot more opportunity for mutual observation. Parents find themselves asked to rationalize and justify activities that in “normal” times would slide under the radar. Children flirting with dangerous nonsense like ana might be watched closely enough to make red flags very obvious. If teens are already committed to destructive eating disorders, their behavior has been much easier to scrutinize, of late.

When relative isolation is combined with food insecurity, things can go haywire. One dimension is, the emotional trauma and psychological effects are not always proportional to the actual deprivation. This dimension of sequestration can affect adults directly, making them less effective as parents, which in turn hurts the kids.

If a parent already was dealing with food issues, being cooped up and massively anxious can present what psychologist Lauren Muhlheim terms “new stressors and disruptions to treatment plans.” Everyone has been losing things that meant a lot to them. She advises,

Allow yourself space to grieve and experience the whole range of emotions that ensue.

Good luck with that, overwhelmed parents who have no peace or privacy. Those are privileges that, face it, some may never enjoy again. But if you are a grownup responsible for children, you have a special mission, which is to not let your crazy rub off on the kids.

How? Muhlheim advises staying connected. She writes,

Use the internet to connect with family, friends, and people in your professional life. Don’t just text but do facetime and video chats. Have a video meal with a friend. Many people are having online cocktail parties, Netflix watch parties, and the like.

But again, those latter three suggestions may not be a good fit, for parents in these particular circumstances. Likewise, telemedicine and virtual treatment can be wonderful, life-saving instruments — if patients have electronic equipment and the savvy to use it, and a way to pay for enrollment.

Academics are sometimes seen as ivory-tower fantasists, and this is one reason. They often do not understand the unlikelihood of ordinary people owning or having access to goods and services that the professional class takes for granted.

Parents or not, adults may have to ask themselves hard questions about their relationship to exercise. If a person had already not been doing enough physical activity, that really needs to be taken into consideration. Some kind of plan needs to be made. If, on the other hand, over-exercise was part of an eating disorder, a period of isolation might allow transition to a less rigorous exercise regimen.

In the virus avoidance department, things seem to be easing up — but there are no promises. Many parts of the United States appear to be ripe for a “second wave.” Rather than saying goodbye to restrictions, we may be headed into times of even more confining lifestyles before this is all over.

Your responses and feedback are welcome!

Source: “Eating Disorders During the Coronavirus (COVID-19) Pandemic,”, 03/30/20
Image by Sebastien Gagnon/(CC BY 2.0)

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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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