(WXYZ) — The COVID-19 crisis is having a profound impact on America's mental health, but it can also make other mental and emotional issues even worse.
That's especially the case for young people who are struggling with eating disorders. According to the National Association of Anorexia Nervosa and Associated Disorders, 9% of the U.S. population, about 29 million Americans, will have an eating disorder in their lifetime.
They can start early. 46% of 9- to 11-year-olds are "sometimes" or "very often" on diets. Other adolescent girls use crash dieting, fasting, self-induced vomiting, diet pills or other laxatives.
A new study by researchers at the University of Michigan says the pandemic is making matters worse.
Since early childhood, 25-year-old Kate Summers has had a troubled relationship with body image and eating.
I went on my first diet when I was about eight or nine years old." she said. "By the time I got to middle school, it was a full-fledged eating disorder. I was anorexic."
Summers is five years into her recovery, and said it's been tough during the pandemic. She said the added stress and isolation kids and young adults feel during the pandemic could be a tipping point.
"It took a lot of work, for me to not relapse, especially early in the pandemic when my life got put on hold," she said.
Dr. Terrill Bravender, the executive director of the Comprehensive Eating Disorders Program, said at C.S. Mott Children's Hospital, there was a dramatic increase in referrals for patients with eating disorders.
He said that there are more cases in adolescents to young adults in their early 20s, and cases are more severe – requiring hospitalization from severe malnutrition.
Bravender said patients tell him the pandemic has made them feel socially isolated and have their every day routines disrupted, feeling a loss of control.
"Nutrition intake and their kind of individual exercising behaviors were something that they could control," he said.
Some athletes worry about weight gain with team sports on hold. People are also looking into the digital mirror of Zoom classes and social media.
Social media can be a bridge for kids fighting isolation, connecting them with peers. They're also exposed to unrealistic and unhealthy images, according to Judith Banker, the founder of the Center for Eating Disorders in Ann Arbor.
"It has fostered a lot of body focus, a lot of what already was an unrealistic beauty ideal, but has increased it even more because there are filters," she said.
Banker said eating disorders are often tied to other issues. The pandemic is causing depression or anxiety, which can lead to the disorders.
Bravender said with proper treatment, recovery can happen, and long-term success improves the earlier healing begins.
Both C.S. Mott and the Center for Eating Disorders use family-based treatment which involves parents and other family members as a key in helping kids and young adults.
Once eating is stabilized, the improvement can be dramatic. The first step is getting help, which can mean some difficult conversations.
"It wasn't easy by any means, but it was necessary and key to my recovery," Summers said.
Summers wrote a letter to read aloud to her parents so she could figure out what she wanted to say and how she wanted to say it.
Some signs to watch for include a dramatic change in eating behavior, refusing to eat with family, a child focusing on calories and how much they're eating, along with excessive exercise.
Eating disorders affect all income levels, but during the pandemic, low-income patients receiving treatment fell dramatically -- from 20 percent to 2-3 percent during the pandemic.
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