Navigating through Holidays When You or Your Loved One Has an Eating Disorder

Contributor: Christy Baker Rogers, MSW, LCSW, CEDS, Clinical Director, Carolina House-Raleigh

The holidays can be a stressful time for anyone, regardless of whether an eating disorder is involved in your life. Commonly, there are plans to be made, family members and loved ones to visit with, parties and social gatherings to attend, gifts to buy, meals to make, and often inundation with food.

With the addition of an eating disorder, the anxiety, fear, stress, etc. can make what most people go through during this bustling time of year seem unmanageable without the use of ineffective and harmful eating disorder symptom use.

This additional struggle is also present, not just for the person with the eating disorder, but also for the family and other loved ones of those who are struggling with these illnesses.

The Additional Pressure During the Holidays

For people who struggle with eating disorders, the holidays bring with them additional social pressures, responsibilities, and potentially-triggering situations with food. Holiday social gatherings are often times we see people who are significant in our lives, some we see frequently, and some we see only on special occasions.

These events can lead to body image-related fears about what these individuals may think about the appearance of the person with the eating disorder.

“Will they think I’ve lost/gained weight?”;
“Will they think I look pretty/thin/healthy/fat, etc?”

The list could go on with questions and self-doubts a person could experience.

The Perception of Negative Judgement from Others

Self-consciousness about appearance, weight, shape, and size may be at a greatly heightened place for those struggling with eating disorders, and being in situations like these can then lead to behaviors that might be aimed at preventing negative judgment from others or that might, in the perception of the person with the disorder, increase positive evaluation from others.

For example, often during the holidays, people with eating disorders increase their restrictive/diet-focused eating disorder symptoms in order to lose weight and increase the chances that they might receive positive, appearance-related comments from others.

These symptoms may include:

• Restriction of caloric intake
• Excessive exercise
• The use of diet pills, diuretics, laxatives, and enemas

These behaviors are not just aimed at impacting the types of comments and evaluations the person might receive from others, but these behaviors can also serve as coping strategies for dealing with difficult emotions for the person struggling with the eating disorder.

Additionally, a person may engage in binge and/or purge behaviors to cope with the pressure, as these symptoms, like restrictive symptoms, are also coping strategies.

How to Best Support Your Loved One

If you’re the loved one of a person with an eating disorder, these gatherings can be stressful for you as well. You’re often faced with body image-related questions about weight/shape/size more than you typically are, and there is generally no “right” answer to these questions.

When Questions Arrive

You may struggle with knowing how to best support your loved one or help them cope with the fears and anxieties that come up.

Commonly, while facilitating family therapy with this population, the requests made by the person with the eating disorder of their loved ones are things like “Please redirect me when I ask you questions about how you see my body/weight/shape/size and do not answer the question”.

How to Answer

Questions like this, as mentioned before, have no “right” answer, and thus it’s more effective to not answer at all and to remind the person that they are loved no matter what.

Other common requests include being available for processing if needed, accompanying the person to the gathering and being available to take breaks away from the larger group if needed, as well as helping the person “cope ahead” by planning how they might respond to comments about their body from others.

Exposure to Food

Additionally, the exposure to large amounts of foods, especially “holiday foods” that are often sweeter or more nutritionally dense than other food consumed regularly, can be very “triggering” for a person with an eating disorder.

This means that this experience could lead to higher urges to use eating disorder symptoms or contribute to higher intensity of emotions that the person struggles to cope with outside of the eating disorder.

Meals and gatherings often center on a buffet or “family style” meal where portions are unspecified, the number of servings is not necessarily limited, and food has frequently been prepared by hands other than those of the person with the disorder.

This can lead to ambiguity about ingredients and subsequent fear or anxiety, as well as uncertainty about how much of a certain food comprises an appropriate portion. Additionally, a person is able to have numerous servings, which may play into someone’s urges to binge.

Being the Life Line of Your Loved One

For the loved ones of someone experiencing this scenario, this is a situation where you may be a strong “life line” or source of support. One thing the person with the disorder commonly asks for from their support people is non-judgmental support and maybe “fact-checking” assistance.

This “fact-checking” may sound like a question such as, “Does this look like an appropriate portion of this food?”, or “Does it look like I need to add anything to my plate to make up a balanced meal?”

These questions are often necessary because there are many times the person with the eating disorder does not know or cannot accurately gauge if a portion or plate is “normative” in terms of portion size or food groups included to make a meal.

Non-judgmental Support

Non-judgmental support from the loved one may sound like:

• “It’s alright to have foods you enjoy”
• “You’re allowed to have a little more of a food you enjoy. Some days you have a little more, some days you have a little less.”, or even
• “You are a worthy person, no matter what you eat tonight.”

If you’re unsure of what you’re loved one needs going into these scenarios, ask! It’s perfectly appropriate to let someone know you want to be there for them to support them, you’re unsure how, and you’d like some suggestions for what would work for them.

Lending a Compassionate Ear

If there are slips and symptom use during these times, it’s important for the person with the disorder to feel safe and comfortable coming to their loved ones with this honesty and to seek support.

Often, emotions such as shame accompany this act and disclosure of symptom use, and this shame is unjustified, as the behaviors are merely symptoms of an illness, not something to be judged or shamed.

We know that shame only intensifies and perpetuates the cycle of symptom use, so if you are the loved one of the person with the disorder and you’re being trusted with this information, it’s critical that you allow a non-judgmental space for that conversation and ask the person what they need from you next.

Maybe it’s accountability. Maybe they need simply a compassionate ear. Or maybe they need support engaging in proactive skills use to prevent further symptom use. If you’re unsure what is needed, again just ask.

Holidays and holiday meals are potentially very tricky times for the person with the eating disorder and their loved ones, but there are ways to effectively navigate through this time, especially when the relationship between the person with the disorder and their support people is one that allows honesty, non-judgment, and openness.

Community Discussion – Share your thoughts here!

How have you or your loved one experienced successfully navigating the holidays when struggling with an eating disorder? What are your quick tips?

Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 20th, 2014
Published on EatingDisorderHope.com