Written by: Henny Tan, Senior Clinical Psychologist
Most of us look forward to the festive season. After all “‘tis the season to be jolly”. It is a time for family and friends to be gathered together, often with the accompaniment of special treats and food. However, this may not always be the case for individuals who struggle with eating disorders.
Across various cultures, food is a unifying cultural thread, and eating is a huge and important part of our social lives. Oftentimes we forget the pervasiveness of food in our everyday lives. Have you ever considered how integral the role of food is in building social connectedness and relationships? We catch up with friends over meals and have informal business meetings over coffee. We also celebrate important occasions and milestones over food. The phenomenon of foodstagramming (a term used to describe the act of taking pictures of one’s food and posting it on social media), or “the camera eats first”, also dominates our social media.
As a result of the emphasis that is being placed on food, individuals with an eating disorder may feel tremendous stress and anxiety partaking in food-focused family traditions and gatherings with friends during the holiday season.
What are eating disorders?
Eating disorders are a category of psychological conditions that manifest themselves in persistent and unhealthy relationships between body image, food, eating and exercise. They usually develop in adolescence and young adulthood and are often associated with a whole host of distressing thoughts and emotions. Eating disorders can affect people of all ages and of any race, gender or body type.
Some types of eating disorders include:
- Anorexia Nervosa
- An eating disorder characterised by weight loss (or lack of appropriate weight gain in children), unhealthy eating patterns, intense fear of gaining weight and significant body image concerns. This condition is extremely dangerous as it can lead to malnutrition, starvation, and death.
- Bulimia Nervosa
- Bulimia is characterised by a cycle of bingeing and purging, where the individual eats large amounts of food (larger than what most people would eat in a similar period of time) in a way that feels out of their control, and then engages in purging which involves self-induced vomiting, fasting, or excessive exercise, Individuals with Bulimia also tend to have significant body image concerns.
- Binge-eating Disorder
- Binge-eating disorder involves periods of consuming unusually large amounts of food in a discrete period of time, accompanied by a sense of loss of control over eating. Binge-eating episodes are commonly associated with difficult emotions such as guilt, disgust and shame.
Struggles Faced During the Holiday Season
Food
A daily struggle for someone with an eating disorder is worrying about what and how much they will eat, how to burn off the calories consumed. When faced with an abundance of food choices and especially food that they do not commonly eat or labelled as “bad”, such worries become exacerbated. For example, someone with binge-eating urges may find it difficult to control their eating during such situations, leading to increased feelings of guilt and shame, as well as negative beliefs about themselves that come with these feelings.
Disruption of Routines
Obligations to attend various parties and gatherings will also likely disrupt everyday routines such as meal timings and exercise. In addition, structured meal plans that may be essential for someone at a specific stage of eating disorder recovery may also be impacted when dining with others.
Expectations
The holiday season is also a time when we are faced with expectations from family and friends to be happy and relaxed, and to indulge in food. However, for individuals with anorexia nervosa, they may find it extremely difficult to finish their food when family is watching what they eat, or may feel pressured when others are encouraging them to eat larger amounts of food, which can lead to feelings of shame and guilt. Asking someone if they have eaten is often a way of showing we care, but for someone with an eating disorder this could potentially trigger a whole slew of body-image related thoughts. Additionally, stress may also come in the form of worrying about how to manage comments from others about how they look or what they are eating or not eating.
Isolation
Individuals with eating disorders tend to feel isolated as they may withdraw from social gatherings as a way of coping with the deeply rooted fear of being negatively evaluated by others. During the holiday season where gatherings involve many more people, this fear can become intensified. They often find it hard to express their anxieties and struggles to family and friends, while at the same time feel unable to escape such situations, resulting in them feeling overwhelmed and detached.
How One Can Manage The Struggle
Preventive Measures and Coping
Given the challenges that someone with an eating disorder might face during the festive season, it is important to be proactive and plan ahead to make it easier to transition into the holidays. Friends and family can also be a significant source of support.
Plan Ahead
- Adhere to a meal plan as much as possible to avoid binge or restrictive eating habits.
- Identify potential triggers. List them down and try to brainstorm appropriate solutions or coping for each one of them.
- List down coping statements that you think might be helpful. Remind yourself the reasons to leave the eating disorder out of this meal.
- Plan non-food related activities that are fun and relaxing to recharge or bond with loved ones. You might feel most vulnerable during the first hour after meals, so plan to do activities that may help to distract yourself from the difficult thoughts or urges to binge or purge.
- Arrange check-in sessions to review your game plan with your psychologist before the holiday season.
- Practise how to politely set boundaries and prepare a list of topics in case you need to change the topic for when someone makes comments about your appearance or eating that make you feel uncomfortable.
Communicate
- Speak with family members or other members of your support system before the holidays to help them understand your needs and potential triggers.
- Identify a support person or a “buddy” who can help with sticking to your plans as well as provide emotional support when needed. It might help to arrange a code word or signal to indicate that you are feeling overwhelmed and need additional support.
Self-compassion
- Be kind to yourself! Acknowledge that you are stepping outside your comfort zone. It is understandable that this might be difficult and challenging for you, but struggling does not mean you are failing.
- Set realistic goals and expectations of yourself. Take things one step at a time.
- Catch yourself when you criticise yourself again. Recognise that you are doing the best you can.
- Give yourself the gift of enjoying the meal. Remove the idea of treating food as a “reward”, and give yourself permission to enjoy the food and company.
How Family and Loved Ones Can Help
- Be there for a loved one who is struggling. Listen to their struggles without making any judgments.
- Ask them how they feel and try to validate their feelings, even if you may not fully understand what they are going through.
- Avoid being the “food police” unless the treatment team has given you a plan to monitor and portion food for your loved one.
- Avoid making comments and judgments about calories, eating and physical appearance.
- Refrain from making criticisms and instead offer support and words of encouragement.