For many people, the holiday season is the most wonderful time of the year, a time to surround yourself with loved ones, honor traditions and gather around the dining table for a celebratory meal.
However, for individuals who struggle with or are recovering from an eating disorder, the holidays may not always be merry and bright. If you have a loved one with an eating disorder, the best gift you can give them this holiday season is your love and support.
A Time of Anxiety and Stress. “If someone struggles with an eating disorder, the holidays can exacerbate the anxiety they already have about food and their bodies and can perpetuate feelings of guilt around what and how much they are putting on their plate,” remarks Rebecca Boswell, PhD, director of Penn Medicine Princeton Center for Eating Disorders and administrative director of Psychiatric Services at Princeton Medical Center.
“Holiday meals often require loosening some control over what you eat, and for people with eating disorders, eating food prepared by others or served at atypical times can be stressful,” suggests Yasmin Abdelwahab MS, MPhil, a doctoral student in clinical psychology at Rutgers University, completing her clinical psychology practicum training at Penn Medicine Princeton Center for Eating Disorders. Facing the abundance of holiday food and the tendency for many of us to overeat can also increase anxiety for individuals suffering from eating disorders.
Tips for Friends and Family. While the holidays are challenging for people with eating disorders, the season can also be difficult for friends and family who know their loved ones are struggling and want to help. Here are four tips to support a loved one with an eating disorder during the holidays.
1. Remember the reason for the season. Food and drinks are often a large part of holiday celebrations, but they do not have to be the primary reason for coming together. Instead, focus on spending quality time together. Revisit happy memories and start new traditions, such as watching a movie, looking at holiday lights, playing board games, or decorating. Spend time together talking and discussing non-food related, non-body-related accomplishments. Share points of gratitude not related to food.
2. Create a cope-ahead plan with your loved one. Prior to the gathering, discuss with your loved one their struggles and triggers. Triggers can be comments or discussions about how many calories a food contains, weight, clothing size, exercise routines, diets, and food behaviors (e.g., picky eating). Identify healthy means of coping with triggers, such as going for a walk, getting fresh air, or employing distress tolerance skills like TIPP. TIPP stands for:
• Temperature. Splashing cold water on your face, drinking a cold beverage, or putting on icepack on the back of your neck can help bring the temperature of your body — and mind — down quickly. Anxiety and stress can increase our body temperatures, further adding to our distress and making eating disorders louder.
• Intense exercise. A short burst of intense exercise, such as a quick set of jumping jacks or a sprint to the corner of the street, is a fast way to bring stress levels down. However, some people who struggle with eating disorders would need to eat more to make up for this energy expenditure; sticking to the other parts of TIPP might be healthier and less stressful for them!
• Paced breathing. Focusing on your breath can calm your mind and bring you back to center. One way to do so is by taking a deep breath through your nose and exhaling through your mouth as you say the word “calm.”
• Paired muscle relaxation. Tightening and then relaxing your muscles can relieve tension and bring down your heart and breathing rates.
The cope-ahead plan can also include a list of people your loved one can turn to for support; an outline of the day, including a list of who will be in attendance, the menu, and planned activities; and a safe word if your loved one starts feeling overwhelmed.
3. Be an ally. Educate yourself about eating disorders and be part of your loved one’s recovery. Validate their concerns and feelings. Encourage them in whatever stage of recovery they may be in. Ask them about how you can best support them, remind them that you love and care about them, and offer hugs or kind words. Check in with them at the end of the day. Offer to be a support person and be open to feedback if they mention concerns about a remark you made that may have been hurtful or triggering. Also, ask them about what they feel comfortable sharing with others and if they would like you to relay that information to others on their behalf.
4. Make sure YOU are supported too. Just as your loved one needs support, so do you. Identify your own support people and coping mechanisms. Give yourself grace that you will not be perfect. Practice and model self-care — take a bath, read a book, go for a walk, do something that makes you feel good. Also, remind yourself that this is not forever. Recovery takes time, but you and your loved one will get through it. And remember, you cannot change your loved ones’ behavior; you can only offer support for their recovery.
If you or a loved one are struggling with an eating disorder, help is available.
Penn Medicine Princeton Medical Center Princeton Center for Eating Disorders provides inpatient treatment for adults, adolescents, and children as young as 8 who suffer from eating disorders, including anorexia, bulimia and binge eating. In addition, Penn Medicine Princeton House Behavioral Health offers outpatient care through its Emotional Eating Track, geared toward individuals who are having difficulty managing the symptoms of a mood disorder and use food to regulate emotions. For more information about the Princeton Center for Eating Disorders and Princeton House Behavioral Health, call 888-437-1610, option 3, or visit princetonhcs.org/eatingdisorders.
