How to cope with Christmas if you have an eating disorder?
Christmas can be a difficult time for people with eating disorders, such as anorexia nervosa, bulimia nervosa, or binge eating disorder . It's a time of year when food and social gatherings take center stage in many households. Negative emotions like anxiety, loneliness, and guilt can surface for many people with eating disorders during the holiday season.
The difficulties are mainly focused on the change in routines regarding meals and social interactions.
In people suffering from an eating disorder, anxiety can be significantly increased due to the increased time spent, with family or in a social environment, talking about and planning the Christmas menu, buying the products and storing them.
People with eating disorders often anticipate anxiety related to the type of food they will eat (larger meals), the quantity (increased portions), and the time spent around the table after eating (lingering at the table). Added to this is the social aspect of Christmas, which involves sharing a meal with people who are sometimes not seen regularly at other times of the year.
Coping with Christmas during eating disorder treatment
A person with an eating disorder has an unhealthy relationship with food. This relationship can be based on restricting food intake, as in the case of anorexia nervosa, or on binge eating or loss of control, as in bulimia nervosa or binge eating disorder. In both cases, Christmas brings increased anxiety due to personal and social pressure to eat appropriately (without restricting food intake) and avoid binge eating (consuming an excessive amount of food with a feeling of loss of control) during a time when food is so prevalent. Another issue to consider is the potential for compensatory behaviors during this period, which often manifest as self-induced vomiting, use of diuretics and/or laxatives, food restriction or fasting, or excessive exercise.
Because Christmas can be one of the most difficult times of the year for people with eating disorders and their families, we offer some recommendations to reduce anxiety:
Before meals
- Isolate the person with the eating disorder from all food-related preparations (participating in menu selection, grocery shopping, and cooking). This will help prevent them from anticipating and unnecessarily prolonging anxiety related to food.
- To prevent binge eating episodes, it's important to agree on where food will be stored so it's not easily accessible. It can also be helpful to have a support plan with family or friends in case the person with the eating disorder detects a risk of binge eating.
- Developing a support plan with family can help someone with an eating disorder feel better prepared to avoid binge eating. It's important to remember that food restriction increases the risk of binge eating.
- Establish a framework of trust and security with the person suffering from an eating disorder during this time. You can agree beforehand that they won't have seconds and that the portions will be normal, even if everyone else tends to eat more than usual.
- Because eating with people outside the immediate family can be difficult, it can be helpful to explain to the person concerned who we will be sharing each of the holidays with .
- It can also be a good idea to offer information about eating disorders to the guests, always with the prior consent of the person affected, to help them understand the feelings and possible behaviors of the affected person during this time.
During meals
- To reduce the anxiety that seeing a table full of food can cause, it is recommended that someone else, such as a parent, serve the meal to the person with an eating disorder. This way, we ensure that the portions are appropriate.
- Distractions during meals can be very helpful. For example, choosing conversation topics other than food or having background music.
- It can be helpful to agree on a minimum amount of time to spend at the table after a meal in order to reduce the anxiety of spending a long period of time sitting at a table full of food.
- If the people attending the Christmas lunch or dinner have information about the disorder, it can be agreed to avoid inappropriate questions or comments such as those related to the amount of food, insisting on repeating things, or making judgments about physical appearance.
- You can agree to establish a signal with a trusted person to let them know if you need help during a meal, so you can step away and receive emotional support . Or to shift the focus of the conversation if it centers on difficult topics related to food, weight, or body image.
After meals
- It is important to focus on all those aspects related to Christmas that we enjoy and that are not related to food or exercise, such as movies, games or decorating the house.
- It can be helpful to use distraction techniques to reduce anxiety, such as relaxation, yoga, meditation, or listening to music.
- It may be advisable to agree with the affected person not to go to the bathroom alone if there is a risk of compensatory behaviors.
- If things haven't gone as we expected, it's important to try to lessen the worry and guilt that people with an eating disorder may feel about the negative emotional impact the disorder has on family and friends, especially at Christmas.
It is important that family and close friends understand the characteristics of eating disorders to foster empathy and understand the difficulties the holiday season presents for someone with an eating disorder. Any questions about how to proceed in a specific case should be addressed to the healthcare professional for personalized advice. Family support and communication with the affected person are vital to facilitating the process of change and recovery.
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