Caring For Yourself When You’re Ill in Eating Disorder Recovery

As we continue to live our lives during the global COVID-19 pandemic, it seems especially important to talk about the impact that illnesses and getting sick can have on eating disorder recovery, and how to best protect and maintain recovery when you become ill.

Eating disorders, particularly anorexia nervosa, weaken the immune system leaving the body vulnerable to infection from viruses, like the virus SARS-CoV-2. People with eating disorders, especially anorexia, are considered to be at increased risk of infection from viruses and bacteria due to malnutrition. Adequate nutrition plays an important role in the function of the immune system, and without it the body is not as well-equipped to fight off infection. Those with eating disorders also often exhibit a high level of mental and emotional stress, which also leads to a lowered immune response and can make the person more vulnerable to contracting an illness.

Eating disorder recovery is incredibly challenging, and coming down with an illness adds another layer of difficulty. It’s important to be prepared for these types of curveballs so that you have the support you need. If you feel an illness coming on, talk to your treatment team about what you’re experiencing and start to come up with a plan specific to you and your recovery*. Here are some general tips for caring for yourself when you’re sick in eating disorder recovery:

Eat nourishing food throughout the day at regular intervals.

Illnesses like colds, the flu, or COVID-19, can impact appetite and affect our senses of smell and taste. You may also feel more fatigued or exhausted. All these factors can make eating more difficult. If you are following a meal plan designed by your dietitian, it’s as important as ever to stick as closely to the meal plan as possible. When your body is fighting an illness, the calories, protein, and nutrients from food are vital to fuel your immune function. Set an alarm on your phone for meal and snack times, or have the person who’s caring for you provide food on a regular schedule. Stick with foods that sound appealing and “boost” them up as needed. For example, does a smoothie or milkshake sound good? You could add a Boost Plus or ice cream to make it more calorically dense. Or add extra noodles or a side of bread with butter to chicken noodle soup. If you’re having difficulty eating larger meals at one time, you can make the meals slightly smaller and snacks slightly larger, making for 5-6 eating opportunities instead of the traditional 3 meals, 2-3 snacks. Your dietitian can provide more guidance on an individualized plan for you. The most important thing is to not allow the illness to drive restriction. Eating regularly will help you to feel better sooner and will help your appetite to return to normal more quickly.

Allow yourself to rest.

This can be a really tough one if you are someone struggling with overexercise or exercise compulsion, but rest is a vital part of recovering from illness. Exercise puts additional stress on the body. By resting during the day and getting plenty of sleep, your body is able to devote more resources and energy to fighting off the illness. Even when you’re resting, your body is working hard! Sleep also helps strengthen your immune system. When you deny your body much needed rest, you are at risk of prolonging the illness or potentially making it worse. Our bodies work harder and use more energy when we’re ill, so it’s important that we give our bodies the chance to heal. It can be a bit boring to stay in bed or lay on the couch all day, so have a few easy activities to do such as a puzzle, a coloring book, a good movie, or a book to read. And when you feel tired, nap! You have permission to rest and recharge.

Stay hydrated.

Our fluid needs can increase during illness for a number of reasons, including fever or in some cases, vomiting or diarrhea. If your appetite declines during illness, it’s likely that your fluid intake declines too. If you’re experiencing extreme vomiting or diarrhea, contact your medical doctor as it could lead to severe dehydration and/or electrolyte imbalances. If symptoms are mild, sip on fluids throughout the day and with meals. Water, Gatorade, juice, milk, and tea all count towards fluid intake. Foods that have a high water content or are liquid at room temperate also count towards your fluid intake. Think fruits and veggies like watermelon, oranges, cucumbers, and tomatoes, and foods like popsicles, soups, ice cream, milkshakes, and jello. Just make sure to leave room for calorie-dense foods and don’t fill up on liquids alone. Your body needs the energy!

Make self-care a priority.

Being sick is a vulnerability factor. Vulnerability factors are things that make you more susceptible to eating disorder thoughts and more prone to falling back on eating disorder behaviors to cope. Being thrown out of your usual routine, being less active, decreased appetite, and not eating many of the foods you’re used to eating can cause significant distress in ED recovery. This can cause ED thoughts and negative body image thoughts to really flare up. Work on a cope-ahead plan with your treatment team for how you’ll respond when these thoughts and urges flare up. Some strategies might include distract-delay, affirmations, practicing radical acceptance, journaling, or talking to a trusted support person.

Many individuals in ED recovery have a hard time slowing down, giving themselves permission to practice self-care, and being gentle with themselves. Being sick is the opportune time to practice doting on yourself (but remember, you do NOT need to be ill to practice self-care). Depending on how ill you’re feeling, do something to help your physical body feel a little better. Take a warm bath or a shower (sometimes even just feeling clean when you’re sick can help you feel a little better), paint your nails, drink some hot tea or hot chocolate, wrap yourself up in a soft blanket and watch a funny movie. Take out your journal and write down your thoughts and feelings on paper.

Trust that your body is doing what it needs to do in order to heal. It will just take some time. What are some of your favorite ways to take care of yourself when you’re feeling sick? Head over to our Instagram, @sdnutritiongroup, and tell us in the comments or send us a DM!

*If you’re experiencing symptoms of COVID-19, please follow the recommendations from the CDC/your local organization regarding being tested and keeping yourself and others safe.