Because Eating Disorders Don't Take a Holiday

Surviving a food-centric season isn't easy for those who struggle with anorexia, bulimia or compulsive eating

Professional experience reminds us that the holidays can be a highly stressful time of year for those with eating disorders. So many gatherings of family or friends are focused on "breaking bread" (or eating pie)—and then, people arrive with "gifts" of even more food. It can feel totally overwhelming. This emphasis on food can impair recovery or even trigger a relapse among the many patients we see, but awareness, compassion and sensitivity are key to helping those with food challenges navigate their struggle. After all, eating disorders don't take a holiday.

For some individuals wrestling with an eating disorder, Thanksgiving and Christmas and other food-oriented holidays are known entities—and familiarity with a holiday meal can be an asset. Fear of being out of control subsides as those who suffer know who will host the meal, who will be attending, which foods will be served and who will prepare them. And for the most part, they also know in advance what will be their greatest challenges.

"Because holidays create their own unique reasons for anxiety, knowing what to expect brings some comfort. It's important for those in recovery to do what is needed to lift their pressures—and not be coaxed into eating more than they can handle," says Dr. Kim Dennis, Medical Director at Timberline Knolls Residential Treatment Center.

For others, the holidays mean encountering entirely new eating situations, where they not only are uncertain about who is preparing the food, but also unclear about what exactly is on the menu. Maybe an individual is spending her first Christmas with different relatives or celebrating the holiday at a restaurant. Gathering information and planning ahead are the keys to success in this situation.

"As part of our work with residents and their families, we recommend identifying the time, location, hosts and guests who will be at the holiday meal. If it is appropriate, the individual can call the host or restaurant and determine what's on the menu," says Dr. Dennis. "And, of course, it's important for an individual to stay in touch with her support environment."

Whatever the fear, it is most important to plan to the type of eating disorder. The strategies developed during counseling sessions vary, depending on the pattern of the eating disorder. For a client with bulimia, who has a history of bingeing on holiday meals and does not want to fall into old habits, counseling could focus on factors that contribute to her binge-eating. She may repeat a positive affirmation to herself throughout the day and enlist a support person to help keep her on track at the meal.

"It's also important to communicate to family members on how to have open and honest communications with their loved one—to be able to address what they are seeing and state how they are feeling—in a loving and supportive manner. That's not always easy to do," says Dr. Dennis. If a family member, who has a loved one in recovery from bulimia or binge eating, wakes up to discover two leftover pumpkin pies are gone, it is important to address it. "Not saying anything is one of the worst things to do. The 'don't talk rule' is a big part of the disease and family members should know they can help their loved ones recover with open, honest and loving dialog."

Some people with eating disorders dread holiday meals so much that they will make excuses to get out of joining festivities or going home at all. The season's spotlight on food means that people with diagnosed disorders feel their eating habits will be watched closely, and people who are trying to hide disorders will be especially worried about being caught. However, with advance planning and family support, strategies can be developed to make holiday meals bearable and even enjoyable. Dr. Dennis says, "All of this needs to be done with kindness and love, which, after all, should be what we celebrate at this time of year."