Making the Holidays Safe for Those with Eating Disorders

The holiday season can be stressful for everyone for various reasons. Figuring out what to buy for your loved ones, spending money, seeing family members whom you have unresolved issues with, and even traveling. For those with eating disorders, the holidays are much more difficult than what the average person experiences.

Food is the most obvious culprit of what can make the holiday season especially difficult for people recovering from eating disorders and body image issues. However, other factors play roles that are not as obvious. Eating in front of family members, being exposed to trigger foods, receiving triggering gifts, and comments made by family members about one's appearance are all reasons why people with eating disorders have a more difficult time during the holidays than the average person.

For us to help reduce the stress and anxiety caused by this time of the year for those suffering from eating disorders by being considerate of what we say and what we give, we first need to understand some of the reasons why this time of the year is especially challenging for them.

Eating Around Others

When dealing with excessive stress or anxiety, people who suffer from eating disorders often lean into their disordered eating behaviors as a way to cope. It is not uncommon for people with eating disorders to have difficulty eating in front of other people. Most people that have an eating disorder have more than one mental illness that co-exists, such as anxiety, which heightens the fear of eating with others.

Most, if not all, people with an eating disorder experience an “eating disorder voice”. People suffering from anorexia or bulimia, for example, can become obsessed with counting the calories of every single food item they consume, which is fueled by this voice. Jenni Schaefer, in her book Life Without Ed, refers to her eating disorder voice as “Ed". She describes:

“You might recognize Ed as the little voice inside that says, ‘You just need to lose a few more pounds,’ or, ‘Do you know how many calories are in that?’. Ed is the one who stares back at you in the mirror and says that you should be dissatisfied with your appearance. Ed talks to all of us.”

Imagine every time that you eat a meal, or even just a snack, that you’re pestered by this voice. Now imagine trying to do so while surrounded by family members during holiday events. The more anxious you become, the louder the voice gets, and the more mental energy it takes to try to silence it.

As someone is experiencing this voice while trying to eat, it can be made worse by worrying if others present are judging them. Once anxiety reaches a certain point, it can cause physical symptoms such as elevated heart rate, stomach pain, nausea, sweating, and feeling as if you have a lump in your throat (Williams, 2018). Who would be able to eat easily if they were feeling that way?

Restricting

People with anorexia see a distorted version of themselves, which causes them to eat very little, avoid certain types of foods, or restrict food altogether (National Institute of Mental Health). People with bulimia similarly see a distorted version of themselves, causing them to fall into a cycle of binging and purging. After binging, people with bulimia practice compensatory behaviors (restricting being one of them) in an attempt to counteract the effects of eating, i.e. gaining weight.

Restricting is one way that people with eating disorders try to take control of their disorder. Strict rules about eating can pose a challenge during the holidays when food, especially treats, are everywhere. Having a sense of control can feel absolutely essential to those with eating disorders. Being presented with threat after threat to that control during the holidays can be detrimental, especially if that person is actively in recovery.

Trigger Foods and Environmental Triggers

“A trigger, sometimes referred to as a stressor, is an action or situation that can lead to an adverse emotional reaction. In the context of mental illness, referring to triggers usually means something that has brought on or worsened symptoms” (Ponte, 2022).

Triggers make it more likely for someone with an eating disorder to practice their disordered eating behaviors as a way to manage the emotions that arise. The causes of triggers can vary from seeing or interacting with specific people, hearing inappropriate comments about food or one’s body, or even feeling certain moods and emotions.

Binge eating disorder, or BED, is when someone eats large amounts of food in a short time and feels a loss of control when doing so. It is similar to bulimia in that they both involve binging. However, people suffering from BED do not practice compensatory behaviors, while those with bulimia do.

For people with BED, seeing certain types of foods can be very triggering. Because people with BED experience a loss of control when binging, seeing binge trigger foods while attending a holiday event can be distressing. Being exposed to large portions of foods can be triggering as well- making someone with BED want to eat even if they are not hungry.

Now that we have a better understanding of why people with eating disorders experience more stress during the holiday season than the average person let’s get into what we can do about it.

What You Say Matters

Family members are going to talk about food during the holidays: quantities of food eaten before and after a holiday dinner, weight loss or gain through dieting, and “bad” foods that are being avoided to follow a diet. If you’re spending the holidays with someone with an eating disorder, and even if you’re not, some topics shouldn’t be discussed for the sake of everyone’s mental well-being. Even if someone isn’t actively fighting against an eating disorder, they could have body image issues that would be negatively impacted by comments made about food and body size.

Here are some topics that should be avoided when around others during holiday gatherings to make the conversation safe for those suffering from eating disorders and body image issues.

Diets

Although it’s not unusual for family members to discuss the latest diet they are trying, it’s dangerous to talk about it in front of someone with an eating disorder. Dieting encourages restriction, keeping track of calories, and labeling foods as “good” or “bad”- all of which are harmful behaviors seen in eating disorders. Especially with the New Year right around the corner, people will bring up their New Year’s resolutions which often involve dieting. Don't do it!

Body Size

Some family members are known for making comments about other people’s body size. Sometimes they mean well, commenting on how good you look or that you’ve lost weight. Even though the intention is good, any comment on body size can be harmful. Saying that someone looks good for losing weight reinforces the idea that our worth is tied to what we look like. It can also encourage someone who may be using disordered eating behaviors to lose weight, to keep doing so, which compromises their recovery.

Binging

It’s widely accepted that everyone eats more than they normally do during the holidays. If people want to binge during holiday events that is their choice, but it shouldn’t be discussed or commented on if someone with an eating disorder is present. Binge eating is a common eating disorder behavior, and it’s not okay to talk about it casually. Talking about it can trigger someone who is actively working toward recovery.

Compensating for Eating

In preparation for holiday gatherings, it's common to hear people make comments about not eating all day in preparation for dinner, or how they don't want to eat again for days after the gathering. Compensating for meals is another eating disorder behavior that should never be discussed in front of someone with an eating disorder. It may seem like a harmless comment, but with over 30 million people in the US suffering from eating disorders, it’s an insensitive comment to make.

It’s important to remember that family members discussing the topics mentioned may be doing so with no bad intentions. If you suffer from an eating disorder and any of these or other triggering topics come up, gently redirect the conversation, or just be upfront and honest with your family that the conversation makes you uncomfortable. If that is ineffective, you may need to excuse yourself or leave the event. It’s perfectly okay to do so, and you should always put your recovery first.

Gift-Giving

Another way we can make the holidays less stressful and safer for people suffering from eating disorders or body image issues is to be considerate when giving gifts. Even when someone means well, certain gifts can be very triggering for someone with an eating disorder. Here we will cover what gifts should be avoided, as well as some good alternatives from The National Eating Disorders Association’s (NEDA) website.

Gifts to Avoid:

Exercise Equipment or Classes

People diagnosed with certain types of eating disorders often exercise excessively as a way to compensate for eating. If someone is in recovery, they should be monitored by a healthcare professional when participating in exercises on their own or in a class. To avoid encouraging this compensatory behavior, don’t give gifts that relate to exercise.

Self-Help Books

This is a gift that has very good and caring intentions behind it. Eating disorders are complicated and vary a lot on an individual basis. If someone is in recovery, they may be following a customized treatment plan by a healthcare professional. This is why, although this is a thoughtful gift, it’s not the best option for someone with an eating disorder. Unfortunately, eating disorders are caused by many different reasons and it’s likely that a self-help book would not cover the complexities of all of them. We don’t want to encourage someone in recovery to verge outside of their treatment program.

Cooking Utensils, Gadgets, or Food

Food, most of the time, is one of the top triggers for someone with an eating disorder. Gifting someone with something that is a major trigger for them can be very distressing and lead to unwanted thoughts and emotions. This can cause a relapse in eating disorder behavior as a way to cope with those unwanted feelings.

Clothes

Although this is another well-intentioned gift, it’s another that can be triggering for someone with an eating disorder or body image issues. Fixating on numbers is a common trait many people with eating disorders have whether it be weight, calories, or the size of clothes. Receiving clothes that are too small or too big for someone with body image issues can be detrimental to their recovery.

Alcohol

Alcohol is a very common gift to give during the holidays, but it shouldn’t be. You never know who is in recovery, from substance abuse issues to eating disorders. Regardless of the type of recovery, an important step is to keep your body healthy and happy- one way to do that is to avoid alcohol. Not gifting alcohol shows that you are supporting and promoting the message that you support those who are in recovery, and they will very much appreciate that.

Good Gift Alternatives:

Self-Care Products

Self-care is one of the most crucial parts of recovery. Promoting that importance by giving someone something that encourages them to practice self-care is a wonderful gift. This could be anything from cosmetics to art supplies- what does the recipient see as self-care that they would appreciate? Even though self-care products can’t achieve happiness or recovery on their own, they still promote the right message and help that person to relax.

Accessories

Accessories are a great gift alternative to clothes. Necklaces, earrings, bracelets, hair clips, and fun socks, are all great things one can wear that don’t have numeric sizes.

Writing Supplies

Another key part of recovery is self-reflection. Gifting writing supplies like journals, writing utensils, notepads, or even computer software is another way to promote a good message and support someone in recovery. You can customize the gift by making it reflect things the recipient likes, making it even more thoughtful.

Gifts for Hobbies

What does the person you are buying a gift for like to do? They could be into painting, building Lego sets, plants, or video games- the options are endless! Even puzzles or strategy games would be a good gift for the right person. If you don’t know enough about their hobby to get them something directly related, get them a gift card to a store that sells things they can purchase on their own for their hobby.

Sentimental Gifts

Get crafty and make something as a gift! Frame a photo, make jewelry, use old clothes to make a blanket or pillow, or get photos printed online onto a calendar- there are tons of things you can make! Loving and supporting someone struggling with an eating disorder is so important and makes a huge difference. Show that love and support with a sentimental gift.

Check out Eating Disorders Families Australia’s website for a list of products and more ideas for inclusive gift ideas.

This list serves as a reminder of what many people with eating disorders may go through during the holiday season and is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment.

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Sources:

American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association; 2000.

National Institute of Mental Health. (n.d.). Eating disorders: About more than food. National Institute of Mental Health. Retrieved December 19, 2022, from https://www.nimh.nih.gov/health/publications/eating-disorders

O'Grady, K. (2018, December 19). Holiday gift giving for those in recovery: A little sensitivity goes a long way. National Eating Disorders Association. Retrieved December 19, 2022, from https://www.nationaleatingdisorders.org/blog/holiday-gift-giving-those-recovery-little-sensitivity-goes-long-way

Ponte, K. (2022, January 10). Understanding Mental Illness Triggers. National Alliance on Mental Illness. Retrieved December 19, 2022, from https://www.nami.org/Blogs/NAMI-Blog/January-2022/Understanding-Mental-Illness-Triggers

Schaefer, J., & Rutledge, T. (2014). Introduction. In Life without ed: How one woman declared independence from her eating disorder and how you can too (p. xxi). essay, McGraw-Hill.Williams, L. (2018, February 20). Dear Lesley: Why is it so difficult to eat in public? National Eating Disorders Association. Retrieved December 19, 2022, from https://www.nationaleatingdisorders.org/blog/dear-lesley-why-so-difficult-to-eat-public