decorational arrow Expert Advice | 4 min. read

Quarantine and social isolation: Coping in the age of COVID-19

You may be one of the several million people who have been forced to stay at home in isolation or quarantine due to the outbreak of the coronavirus (COVID-19). Social distancing and interruption to our everyday routines is a challenge for everyone, but if you live with obesity, you may experience the challenging times of living under a world-level threat especially difficult regarding weight management.

In order to make life just a little bit easier and help you cope with the situation, we asked Dr. Michael Vallis (MV hereafter), a health psychologist and Associate Professor of Family Medicine at Dalhousie University, Canada to explain some of the emotional reactions that people are having to the coronavirus pandemic and what the healthy ways to cope with the situation are.

Michael Vallis giving a speech.

"If you are feeling nervous or fearful, that makes you normal."

-Dr. Michael Vallis, health psychologist, Associate Professor of Family Medicine, Dalhousie University, Canada

This is general disease awareness information and should not be understood as medical advice. If you experience symptoms of COVID-19 or have questions, doubts or concerns, you should contact your doctor and always follow the advice of local authorities.

Q: A lot of people find it hard to cope with having to stay home all day. Many are nervous or afraid. Why exactly do we react the way we do?

MV: It is generally the case that fear grows in the dark. What do I mean by this? The natural reaction to the perception of threat, uncertainty and “what if…” thinking is a host of feelings: anxiety, worry, fear and panic. COVID-19 brings with it extreme threat and uncertainty. So, if you are feeling nervous or fearful, that makes you normal. But it also puts you in the position of needing to manage your feelings. Low to moderate levels of anxiety can kick you into gear, but very high levels can overwhelm or paralyse you.

The most natural response to fear is escape – to get away from the fear. This worked well for us in primitive times when we could escape a predator. How do we get away from a stress that we cannot escape, like COVID-19? Isolation can help you avoid the virus itself but not the fear of the virus. We go into survival mode and we do what works. It turns out that for most of us, food is calming and positive or distracting and numbing. Ask yourself: Are you likely to turn to food when stressed? If so, would you be interested in coping strategies that can help you manage stress and manage the stress-eating connection?

Man sitting on his couch eating chips from a bowl.

"It turns out that for most of us, food is calming and positive or distracting and numbing."

-Dr. Michael Vallis, a health psychologist, Associate Professor of Family Medicine, Dalhousie University, Canada

Because food is experienced as pleasure, stress eating (and eating when bored) is really a way of coping. Although not healthy, it makes sense from a coping perspective. I encourage you to see food as serving a function in this situation. My invitation to you is to ask yourself: How can I replace the function of food as a stress manager?

Q: Now that we understand how the COVID-19 situation may affect people, the central question seems to be: How can people with obesity cope with the extra stress?

MV: Understanding is an important first step in coping, yes, but it is only a first step. So now let’s talk about the next steps of coping. Coping involves several steps:

Step 1: Emotional expression and social support

Fear is normal when there is a threat. Humans are emotional beings and we will feel both positive and negative emotions, based on our experience. Threat results in fear, the perception of loss results in sadness (or depression) and the experience of intrusion results in anger.

Coping with these normal feelings is generally associated with emotional expression and social support. That is, when we are feeling worried and anxious, we do not have to suppress these feelings. Finding ways of expressing our feelings (such as talking, writing, singing or dancing) can help us discharge our feelings. Emotions are like waves; they come on and if we allow them, they pass. Trying to ignore or suppress our normal feelings can make things worse.

"Ask yourself: How can I replace the function of food as a stress manager?"

-Dr. Michael Vallis, a health psychologist, Associate Professor of Family Medicine, Dalhousie University, Canada

Step 2: Engage in coping strategies

Here is where the concept of replacing food as a stress manager comes into play. If you find yourself eating in reaction to fear, anxiety or boredom, would you consider practicing coping strategies other than eating? The good news here is that there are many alternative strategies that could be helpful. The bad news is that any coping strategy needs to be learned and will not work right away. We recommend that people practice any coping strategy many times, say 20 or 25 times, before deciding if that strategy is helpful. I can summarise general coping strategies into five categories :

  1. Physical calming activities. The stress response prepares the body for action; stress hormones increase, our muscles tense and our breathing speeds up – all in an effort to get us ready for action. Learning to calm can go a long way toward managing stress. Calming strategies including deep breathing, muscle relaxation and mental calming. Organised activities such as yoga, tai chi, meditation, prayer, listening to music, painting, patting a cat or dog or tending to plants work for many people. I encourage you to be creative and try things till you find what works for you. These of course need to be practiced in accordance with your local government guidance for quarantine.
  2. Physical discharge activities. It has also been shown that activity can be a good way of managing stress. Walking, running, jumping, cycling or dancing can be helpful to many if you are able to do it indoors. You might need to get creative to find a way to discharge physical energy in a small space. The nice thing about coping strategies is that every little bit helps. There are many online and virtual exercises taking place during this time.
  3. Emotional expression. As mentioned above, humans are emotional beings and finding ways to experience, express and accept our emotions is very healthy.
  4. Social support. Connecting to others is an excellent way to manage stress. Within COVID-19, we are seeing how random acts of kindness towards others can inspire us all. Even if you are physically isolated, you can stay socially connected either online or by calling friends and family.
  5. Acceptance. I am sure you have heard that “today is all we have”. Yesterday is over and all we can do is learn from it. Tomorrow hasn’t happened yet; we are in this moment NOW. Being mindful of our current state in an accepting and curious way can be helpful. Mindfulness is enhanced when we think about the core values that we are committed to. Those of us isolating ourselves are doing this not just for ourselves; but for our community and the whole world. Those values can guide us.
Calm looking ocean with two small waves.

"Emotions are like waves; they come on and if we allow them, they pass."

-Dr. Michael Vallis, a health psychologist, Associate Professor of Family Medicine, Dalhousie University, Canada

Step 3: Have a meal plan

COVID-19 has changed our physical world. For many of us things have changed significantly and very quickly. We have more unstructured time and we are closer to our kitchens than usual. We may benefit by figuring out how to keep a distance from our food, especially the foods that we might turn to for reasons other than hunger.

If you have a daily meal plan (say, 3 meals and 1 or 2 snacks) it will be healthy to stay on the plan. Here are some ways to control your eating:

  • Eat at set times and try to avoid eating at other times.
  • Eat in one location only.
  • Sit down and do not engage in any other activity when you eat.
  • After you serve yourself a portion, put the remaining food away so it is not sitting on the stove or cupboard.
  • Package food into small bags so you don't access large amounts of food (especially tempting food) at any one time.
  • Consider keeping really tempting food out of the house.

If you have any further questions regarding COVID-19, please visit the World Health Organization and your local health authorities websites.

References
  • Marks, I. M. (1987). Fears, phobias, and rituals: Panic, anxiety, and their disorders. Oxford University Press.
  • Berthoud, H.-R., Münzberg, H., & Morrison, C. D. (2017). Blaming the Brain for Obesity: Integration of Hedonic and Homeostatic Mechanisms. Gastroenterology, 152(7), 1728–1738.
  • Beck, A. T. (2019). A 60-Year Evolution of Cognitive Theory and Therapy. Perspectives on Psychological Science: A Journal of the Association for Psychological Science, 14(1), 16–20.
  • Hutto, D. D., Robertson, I., & Kirchhoff, M. D. (2018). A New, Better BET: Rescuing and Revising Basic Emotion Theory. Frontiers in Psychology, 9.
  • Lillis, J., & Kendra, K. E. (2014). Acceptance and Commitment Therapy for weight control: Model, evidence, and future directions. Journal of Contextual Behavioral Science, 3(1), 1–7.
  • Almén, N., Lisspers, J., Öst, L.-G., & Sundin, Ö. (2019). Behavioral stress recovery management intervention for people with high levels of perceived stress: A randomized controlled trial. International Journal of Stress Management.
  • Varni, J. W., & Banis, H. T. M. A. (1985). Behavior Therapy Techniques Applied to Eating, Exercise, and Diet Modification in Childhood Obesity.  [Review]. Journal of Developmental, 6(6), 367–372.]

Related articles

Obesity and COVID-19: Stay safe and hang in there
decorational arrow Pandemic | 3 min. read

Obesity and COVID-19: Stay safe and hang in there

Over the past several weeks, the world has been hit by the global outbreak of the coronavirus disease (COVID-19). Millions of people have been asked to stay at home, often without being able to see family and friends.