DISCUSSION
Regarding the results, we could see a pattern indicative of a correlation between anxiety and higher levels of stress and behavior in which food has a compensatory role towards this psychic imbalance possibly caused by quarantine. Here are the results:
The first question in the questionnaire is broad and serves as an overview of how much food is a frequent thought for respondents. In it, 64% “stated sometimes” and 15% “always” think about food during the day. We can thus associate it with two other questions that show us that 73% of respondents use food to relieve stress at specific times and 7.6% always; and that 41% of respondents eat beyond satiety more than twice a week and 36% once a week, which are indications of compulsive eating behavior, possibly triggered by increased anxiety in the quarantine period.
About how they feel after eating, 75% always or sometimes feel guilty, but 67% do not eat in secret nor are they ashamed of it, only 10% do so. As for the frequency with which they eat, the results indicated that only 37% of the interviewees showed a significant increase (a score of 5 to 10 on a scale of 0 to 10).
However, when it comes to food quality, more than 20% scored between 8 and 10 on a scale of 0 to 10, when it comes to increasing consumption of processed foods (sweets, fast foods, and the like). Showing worsening in the nutritional quality of the interviewees. Henceforth, we proceeded to questions of a psychological nature based on the Hamilton anxiety scale.
A total of 80.2% of respondents reported an increase in fear/concern since the beginning of the quarantine, among them, 75% scored grades between 5 and 10 on a scale of 0 to 10, with almost 20% having a maximum score for how much social isolation has hampered your mental health. In addition, only 31.4% had no feeling of shortness of breath, palpitation, or restlessness during social isolation. Another result that is in line with the previous one is that 85% of the interviewees scored 5 or more on a scale of 0 to 10 in which the lack of coexistence with their family, friends, and loved ones has negatively affected their psychological state, being that 25% of respondents scored 10 in this regard. In addition, 73.8% reported mood swings, negative thoughts, and discouragement and 58% reported difficulty sleeping.
Finally, there was a scattered result on the question of eating to feel better. 21% had a minimum score for this aspect (grade 1), 11% had a maximum score (grade 10), and 50% scored from 5 to 10, which may reveal that people with compulsive eating behavior are not fully aware of this behavior, since 80.2% consider themselves more anxious due to the pandemic and the feeding patterns of the previous questions reveal a worsening in the quality of the respondents’ food and an increase in the amount of food per day; and anxiety patterns were confirmed by questions based on the Hamilton anxiety scale.
In this scenario of the results of the present study, one should not only help to care for those who suffer from contracting COVID-19, but one must also address the psychological, financial, and social impact - on those who do not. The peculiarities of COVID-19 and the reaction of the public and governments to it are particularly relevant for people living with an eating disorder and those who care for them.
Traumatic events affect people’s mental health. The fear of contagion and the death of family members created enormous uncertainty. Isolation brings anxiety, sadness, anger, and loneliness. Social detachment and ”quarantine” are against human nature. The negative emotional effects of “quarantine” are likely to be accentuated for many individuals with anorexia nervosa who are already emotionally and physically isolated [14].
In this sense, people with an eating disorder have a complex problematic relationship with food, which will be intensified at this time of food insecurity and panic buying [14]. Undoubtedly, there will be an abundance of research in the coming months and years documenting the impact that COVID-19 will have on the eating disorders community, both from the perspective of the clinician and the patient. In addition, there are similarities between previous outbreaks and the COVID-19 pandemic, as these outbreaks have resulted in an increasing sense of foreboding and fear, as well as heightened feelings of anxiety and panic and symptoms associated with post-traumatic stress disorder. [15].
In addition, many people with bulimia nervosa and binge eating disorder now stay at home 24 hours a day, seven days a week. There is no escape from distancing yourself from food at home and the opportunities to go out and buy food are limited. Overeating with family food when refueling is problematic can lead to more family conflicts, increased emotional arousal, depression, and anxiety, as well as the likelihood of increased self-harm or even suicide [15].