A new study has found that the pandemic saw a significant increase in eating disorders across Aotearoa. Alex Casey talks to those who experienced it first hand. 

This article mentions mental health and eating disorders, please take care.

It was Te Uru’s dad who first raised the alarm with her GP. The teenager was in year 11 in 2020, had become fixated on “good” and “bad” foods, and convinced herself she couldn’t keep food down, which frequently resulted in vomiting after eating. She wasn’t able to concentrate at work or school, and had lost a significant amount of weight. “I was trying my best to live a normal life,” she says. “But not very successfully.” 

When she went to that first doctor visit with her dad, Te Uru felt like she hadn’t been properly heard. “They got me alone and asked me about what I had been experiencing, and they said it was all just anxiety around food, rather than an eating disorder,” she says. “I ran on that belief that there was nothing wrong with me for a long time into my eating disorder, so that I didn’t have to take the steps necessary to get better.” 

Her condition worsened. She lost more weight, began experiencing fainting episodes and, within a few months, Te Uru would become one of approximately 1,500 New Zealanders admitted to hospital with an eating disorder during the pandemic. As found in a study from the University of Auckland, eating disorder hospital presentations increased significantly from March 2020-March 2021, particularly for wāhine Māori and those aged 10-19 years.

The main eating disorders include anorexia nervosa, bulimia nervosa, binge-eating disorder, and other specified feeding or eating disorders (OSFED). According to the Eating Disorders Genetics Initiative, anorexia nervosa is estimated to affect 30,000 New Zealanders over the course of their lifetime. Approximately 62,000 New Zealanders, or 1.3%, are estimated to have had bulimia nervosa at some stage, and almost 2% develop binge-eating disorders.

David Menkes, associate professor at the University of Auckland, was involved in the study and says the trend is in keeping with a general universal increase in eating disorders over time, particularly for younger people. “Presentations were noted to be gradually going up everywhere, but then in the pandemic, they really lifted off,” he says. “I think social media is probably playing a role in that, particularly because during lockdowns, people had a lot more time on their hands.” 

While social media provided connection in times of social isolation, Menkes also mentions that algorithms can get people hooked on more extreme information, creating “a perfect storm” when those people also have too much time on their hands. “People who are prone to eating disorders might get attracted to dieting tips and success stories, so they click on that, and then they get something a bit more intense, and then they click on that, and on it goes.” 

Te Uru found that social media had a largely negative impact on her during the pandemic. “I was in communication with my friends, but they were quite heavily fitness-orientated and dieting and always talking about losing weight,” she says. “That was quite triggering for me, especially with all those eating habits I was already starting to develop.” She also found “harmful” things on her feed that would “put me back in a space where I really shouldn’t have been”.

Menkes also posits that the wider social disruption caused by lockdowns could have contributed to the increase. “A lot of us had the experience of being isolated from people that we wanted to be with, and possibly being stuck with people that we didn’t,” he says. “Eating disorders can be about getting a sense of control, whether it’s over your diet, your weight, your body shape. And so, if you can’t control something else, like your social environment, some people might naturally focus on something else that they can control.” 

This rings true for Te Uru, who was already feeling the stress of school exams and self image when the country went into lockdown. “Usually I love being around my family, but the eating disorder took away my ability to talk to people very early on,” she says. “When we were all in lockdown, being around my family was quite hard when I felt like I was hiding this from them, so I would just isolate myself and not talk to anybody. I wouldn’t want to be around them, even though I was stuck with them.” 

The findings of the University of Auckland study indicate that the health system may need to be better equipped to deal with eating disorders in the event of another public health emergency, says Menkes. “Somewhere down the road this big league social disruption is going to happen again, and it seems only logical for the health system to anticipate that at some level,” he says. “Anorexia nervosa has the highest mortality rate of any psychiatric disorder, and we need to take it seriously.” 

Menkes also notes the “impossible to miss” data that showed wāhine Māori experienced the biggest increase in eating disorders during the pandemic. “While some of our clinical services are doing great work, many still aren’t what you’d call culturally safe,” he says. “I think having that degree of cultural sensitivity and responsiveness is important across the board, but it’s particularly important with regard to eating disorders, where people often feel awkward or embarrassed about providing a full history of what’s going on.” 

Te Uru was shocked to discover how many other people just like her were going through the same thing during the pandemic, and wants to challenge pre-existing ideas about who can develop an eating disorder. “When I first went to the doctors, I feel like I was dismissed because I was Māori and I wasn’t in the stereotypical body that they would see as someone with an eating disorder. I had dropped a significant amount of weight, but because I didn’t look as small as someone who would have anorexia, I was told that it was just anxiety.” 

Now 19 years old, Te Uru says she is in a much better place after a “very long, very hard” journey for her and her whānau. She is still seeing the therapist she was assigned when she was first admitted to hospital in 2021, but now only checks in once every few weeks. She’s even considering studying psychiatry to use her own experience to help others like her. “That is something that I would want to see change,” she says. “I would like for us all to be treated the same way.”