Coping with Eating Disorders at Christmas

Preparation

Supporting a family member with an eating disorder at Christmas presents multiple and very complex challenges. It is important to prepare for this and to acknowledge how different members of the family feel about Christmas, including their fears, hopes and concerns. For the individual who is coping with anorexia at Christmas, there is likely to be raised anxiety about the super-abundance of food at this time of year and an increased pressure, compared to other times of years, to eat with other people and to eat food they might otherwise avoid.

Parents are likely to be feeling the pressure to create a happy, or even perfect day (social media can be particularly unhelpful in this respect). Parents may find themselves reflecting on how different Christmas is now the family are coping with an eating disorder, compared to previous years, when children were younger. These concerns and conflicted feelings can become an ‘elephant in the room’: parents carry on with Christmas preparations, hoping all will go well, unwilling to share anything which could be seen as ‘negative’. However, it is much better to talk through and acknowledge worries of eating disorders and Christmas at an early stage.

What preparation is helpful if you are coping with eating disorders at Christmas?

  • Family members should try to talk about how they are feeling about Christmas openly and honestly in advance
  • Try to avoid comparing this Christmas with previous years
  • It may be helpful to avoid or adjust social media interaction, particularly if this is something that makes you feel a pressure to have a ‘perfect’ Christmas
  • Emphasise your own traditions around Christmas, for example, going to get a Christmas tree and decorating it, shopping together, going for a walk or to a Christmas market. These traditions can be comforting and enjoyable and they also help to take the emphasis away from a big Christmas dinner/the consumption of food

Relatives

A significant aspect of Christmas is the emphasis of getting together with relatives and friends. When someone is struggling with an eating disorder at Christmas, this presents a particular challenge. If they have not seen relatives for several months or longer, they may feel anxious simply about seeing them and particularly about comments they may make (however well meaning).

An individual with an eating disorder is likely to feel particularly anxious about eating with people who they do not share meals with on a regular basis. Who to invite, for Christmas Day or at other times, can become a significant source of conflict. The individual who is coping with anorexia at Christmas may not want relatives to visit because of the difficulties this could present. Other family members may feel anorexia or bulimia already compromises family life in many ways and for also Christmas to be changed is not acceptable. If you are caring for someone with anorexia or bulimia at Christmas, you may find yourself in the middle of this conflict.

Practical advice for Christmas and relatives when you are coping with eating disorders at Christmas:

  • Perhaps invite only close relatives or friends to your Christmas meal, which is likely to be a major pressure point. Consider who your child feels most comfortable with and it is worth bearing in mind, if your child has not seen a particular relative for a significant period of time, they are likely to feel anxious (will they comment on changes to their appearance?)
  • Consider getting together with wider family and relatives in a way in which food (particularly sitting down for a meal) is not the primary focus, for example, going for a short family walk together, or a more informal ‘drop-in’
  • Talk to your relatives in advance about what may help and what may not be helpful. Explain that any comments about appearance, even “you look well” could be misinterpreted by a person with an eating disorder (to suggest weight gain/fatness) and it is best to avoid any comments about appearance. It is also best to avoid any comments about anyone else’s appearance and certainly to avoid discussion about New Year diets. Comments about how much food is being eaten are also unhelpful (“I’m stuffed”/ “aren’t you doing well”)
  • If relatives feel worried that they might ‘say the wrong thing’, reassure them that people with eating disorders usually welcome talk during mealtimes as distraction. General talk about all subjects not related to food/body imagine/eating disorders are helpful. Straightforward statements like “I’ve been really looking forward to seeing you” are a positive way of starting conversation. Relatives may need to be aware that the young person may be less chatty than they have been on previous occasions.

The Christmas Meal

Anyone coping with anorexia or bulimia at Christmas is likely to be feeling anxious about the Christmas meal. Family members are likely to also have worries and concerns about how the meal will be; for the individual with an eating disorder at Christmas and for the family as a whole. It is very helpful to discuss and agree portions and strategies in advance. At Newbridge House, we have a Christmas meal early in December. This helps young people prepare and we also share portion sizes (weights and photographs) with the families we work with.

Planning and organising your Christmas meal when a family member is coping with an eating disorder

  • It may be useful to have an agreement such as: parent will plate up the meat and potatoes for the young person and perhaps do the same for others. This way, the young person has an agreed portion of protein and carbohydrate, has a choice of vegetables and is not ‘singled out’ as having their meal in a different way to others
  • It may be helpful for the young person to sit next to a designated supporter who they trust and knows them well. Some people find it useful to copy their supporter’s portions, which is helpful if people are serving themselves
  • It is often helpful to have an activity planned for after the Christmas meal as a distraction, such as a board game or watching a film

Eating disorders at Christmas: help and advice

In summary, if you have a family member who has anorexia at Christmas or bulimia, these steps may help:

  • Plan and prepare: think through everything, what will help and, importantly, what will be your Plan B if things go off course
  • Talk though your concerns and conflicts. Don’t try to carry on with your Christmas preparations in the same way as before, hoping for the best
  • Adjust your expectations. A smaller number of visitors, a few less activities may be helpful
  • Avoid social media or anything that perhaps projects the ‘perfect’ Christmas

Advice from a parent of a young person with an eating disorder

“I think it is really important to prepare and make a plan for Christmas with your loved one, then to be prepared for your plan to go off course. Try to be flexible and be aware of your own expectations; it is probably better to lower them a little. If your teenager needs some time out in their own room it may be better to allow that than to have a big fight. My daughter is in recovery from anorexia and certainly has issues with food still, but she loves Christmas. She loves the traditions and as she moves into her early twenties, she really values the time together with family and that certainly outweighs the food anxieties, even though they are still there.”
– Parent of young person who was treated for anorexia at Newbridge House

If you are struggling to cope with Christmas and want to talk to someone, we recommend you call the Beat helpline, which is open on Christmas Eve and Christmas Day. This is run by trained specialists and Beat is the national charity dedicated to supporting people with eating disorders and all those affected by them.

Adult Helpline: 0808 801 0677
Studentline: 0808 801 0811
Youthline: 0808 801 0711 

During Christmas, these Helplines will be open 4pm to 8pm from Christmas Eve to New Year’s Day

This article was compiled by Samantha Grigg, dietitian, Newbridge House, Rachel Matthews, clinical manager, Newbridge House, Professor Hubert Lacey, Medical Director, Newbridge House and a parent of a young person who was treated for anorexia at Newbridge House. December 13th, 2016.