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Eating Disorders On The Rise After A Year Of Uncertainty And Isolation


People who treat eating disorders say they were flooded with new cases and relapses during the pandemic. Treatment centers are overwhelmed with calls for help. And more young people are being hospitalized. Triggers for eating disorders can include isolation, uncertainty and changes in routines, all of which happened on a massive scale over the last year. Nooshin Kiankhooy is an eating disorder specialist and founder of Empowering You, a therapy practice in Maryland.


NOOSHIN KIANKHOOY: Thank you, Ari. Thank you so much for having me.

SHAPIRO: How much of an increase in demand have you seen over the last year?

KIANKHOOY: Oh, my goodness. It's really been disheartening over the past year. Everybody is full. There's nowhere to refer to. And it's been really difficult. And another thing that we're seeing is even when someone finally gets into treatment, they're three- to four-month waitlist to get into an inpatient or residential treatment center.

SHAPIRO: And as people start to get vaccinated and businesses and schools start to reopen, are the numbers still climbing? Or do you feel like the crisis might be starting to subside now?

KIANKHOOY: I think they may still climb because now that everybody, in a way, is coming out of the woodworks, there's going to be more eyes on people. And during the pandemic, most of the referrals we were getting were for teens because mom and dad or whomever they're guardian was had eyes on them. Now as we get out of the pandemic, there's going to be more eyes - friends, extended family, colleagues. And things are going to change, I think. I think that we're just probably at the peak now.

SHAPIRO: Can you talk about warning signs that you advise people to look out for in friends, loved ones or even themselves?

KIANKHOOY: Absolutely. You know, one thing I did want to say is that we have to remember there's a difference between eating disorders and disordered eating. There are people that - you know, they enjoy working out, but they also work out, you know, to burn calories or to look a certain way. Or people that are on certain diets lose weight. That doesn't mean they have an eating disorder. And so I would say, you know, just some of the things we really want to look out for is, has there been a change in their mood, their irritability, a change in their interests? They may not want to socialize around food. Or if they're at a gathering where there is food, they may not have the food. What we really look for when it comes to the difference between an eating disorder and disordered eating is really an impairment in their day-to-day and their functioning.

SHAPIRO: How do you advise people to start that conversation in a sensitive way that doesn't sound like they are just asking invasive questions about how much a person is or is not eating?

KIANKHOOY: Yeah, you know, Ari, I think it really depends on the relationship you have with that person. So if this is a friend, I would - and let's say we've, you know, gone out to dinner. And I've noticed that there has been a really big shift in them. I may just kind of go through the meal and then maybe a few days later give them a call and say, hey, how's it going? You know, I noticed that you seemed really down. And I don't think we really got to talk too much about, like, how this past year has really impacted everyone. And I think it's important for - to try to stay away from talking about food or talking about their body or what they look like because we also have to remember that eating disorders come in all different shapes and sizes. I think there's such a huge misconception of what someone with an eating disorder may, quote, unquote, "look like."

SHAPIRO: And if someone is concerned that they themselves may have an eating disorder, you're saying places are overwhelmed. There's no capacity. There are long waiting lists. What should someone in that situation do right now?

KIANKHOOY: Oh, my gosh. The first step might be, really, to reach out to a therapist that has that specialty. Another great thing is a lot of treatment centers out there online and on the phone can do screenings pretty easily just to help you get a better idea of where you are. But at, again, at least the phone screenings, it can take a week or two to even get into those. And so it's like, what are people supposed to do?

SHAPIRO: That's Nooshin Kiankhooy, eating disorders specialist and founder of the therapy practice Empowering You in Maryland.

Thank you very much.

KIANKHOOY: Thank you, Ari. Transcript provided by NPR, Copyright NPR.

Ari Shapiro has been one of the hosts of All Things Considered, NPR's award-winning afternoon newsmagazine, since 2015. During his first two years on the program, listenership to All Things Considered grew at an unprecedented rate, with more people tuning in during a typical quarter-hour than any other program on the radio.
Christopher Intagliata
Christopher Intagliata is an editor at All Things Considered, where he writes news and edits interviews with politicians, musicians, restaurant owners, scientists and many of the other voices heard on the air.
Alejandra Marquez Janse
Alejandra Marquez Janse is a producer for NPR's evening news program All Things Considered. She was part of a team that traveled to Uvalde, Texas, months after the mass shooting at Robb Elementary to cover its impact on the community. She also helped script and produce NPR's first bilingual special coverage of the State of the Union – broadcast in Spanish and English.