There is a saying in recovery that “we’re only as sick as our secrets.” It suggests that what we hide from others will fester and continue to grow beneath our surfaces, limiting our potential for growth and progress. Despite the partial destigmatization of psychiatric health concerns in our society, the guilt and shame of mental health issues still keep some from being more open about what troubles them. The isolation and social withdrawal of quarantine for COVID-19 has certainly further contributed to this idea of suffering alone. Students are returning to in-person school instruction and adults to their physical offices. As this happens, some of the changes we have experienced during COVID-19 and have been able to keep hidden thus far may be coming to the light of others’ attention. Some changes may include undesired changes in weight that arose from the upheaval of our daily routines, sleep, hygiene, stress levels, diets, and physical exercise during the pandemic. Pre-existing disparities in obesity along socioeconomic and racial lines have grown. During the pandemic, marginalized groups felt the impact of COVID-19 harder than other groups.
While for some, resuming more interpersonal interaction is the motivation they need to hop back into healthier lifestyle patterns. Those who have seen more dramatic changes on the scale may face feelings of shame and fear of judgment from their peers. In particular, women and children may face harsher criticism or bullying. Weight stigma is a factor for depression, anxiety, and ongoing disordered eating. Medical and mental health professionals recognize weight gain as a possible coping reaction to exceptional circumstances, not a moral failing or personal lack of willpower. Beyond a greater tendency towards snacking throughout the day or a comforting and caloric dessert at the end of the evening, binging behavior is another way of dealing with uncomfortable or difficult to identify emotions. It is crucial to remember COVID weight gain was likely a gradual accumulation over a year and a half of quarantine. So healthy weight loss will also be a gradual process. This process will often be in collaboration with one’s internist, nutritionist, psychiatrist, and therapist. They will cover reasonable goals, comorbid conditions, helpful strategies for weight management, a greater sense of self-compassion, and developing a form of accountability. Eating disorders, including overeating and binge eating, are treatable conditions that can benefit from support and resources. Efforts to rapidly return to one’s pre-COVID weight through the use of “crash diets,” or other forms of disordered eating can establish yet another unhealthy pattern. Our focus should not be on achieving a particular weight or body mass index. Providers are there to be a safe space to share one’s feelings without judgment and help those seeking help for their obesity or weight gain feel less alone in their journey.