Contributor: Jody Langford, M.D., Rogers Memorial Hospital
Each year, many families anticipate holidays filled with family, friends – and food.
Unfortunately for people recovering from an eating disorder, the holidays can create increased anxiety as they contemplate celebratory parties and dinners that often center on festive dishes.
At Rogers Memorial, we encourage patients to share their concerns with their treatment team, who can help them prepare a plan to successfully navigate these events. Adhering to a meal plan is important.
Patients need to continue to eat breakfast, lunch and snacks during the day rather than restricting themselves in anticipation of a large meal. Otherwise, they are setting themselves up to engage in eating-disorder behavior.
Cognitive Behavioral Therapy
Additional tools to stay on track include cognitive behavior therapy, in which patients examine their thoughts, feelings and behaviors and reshape negative perceptions.
For instance, upon entering a party, a patient might think: “Everyone’s judging me. They’re noticing how I look and what I’m eating, and I don’t belong here.”
At that moment, they need to immediately stop and reframe those thoughts in a more positive, realistic way. It’s important to remember that they have control over their thoughts and emotions, and that their support network, whether family or friends, want the best for them.
Here are some suggestions that can help children and adolescents recovering from eating disorders navigate the hectic holiday season:
- Don’t restrict your food intake before an event. Eat regular meals and snacks rather than “saving” calories that can lead to overindulging.
- Talk with your treatment team – therapist, dietitian, primary care and psychiatrist – to prepare for uncomfortable scenarios.
- Bring back up. Attend celebrations with a trusted friend or relative who can support you in your choices.
- Give yourself permission to leave if the situation becomes too overwhelming.
- Focus on people rather than food. Discuss milestone events and family news rather than food.
- Choose a seat away from the buffet or leave the table after you have eaten.
- Let yourself have fun rather than obsessing about food or body concerns.
Other Management Techniques
Other management techniques can include
- Breathing exercises
- Learning to set appropriate boundaries
- Giving themselves permission to leave if a situation becomes too uncomfortable
Having a Support Person
Another way to handle difficult scenarios is to attend events with a support person who can help reinforce their decisions when they are challenged.
For instance, in many families, food is equated with love, and well-meaning hosts may urge guests to eat more than necessary. I suggest patients diffuse the situation by being gracious, thanking the hosts and letting them know they enjoyed the dishes, but having another person to back them up can be extremely helpful.
Support is particularly critical at extended-family get-togethers where relatives may not be aware of a loved one’s eating disorder or not understand such disorders. A parent or close friend can educate them before the event and suggest they refrain from discussing anyone’s appearance or focusing conversations on food.
Placing the Emphasis on People
This can help avoid comments that may be well-intentioned but ultimately detrimental to recovery. It all goes back to the fact that the emphasis should be on people rather than food.
Overall, I suggest families encourage discussions that focus on happy memories or share positive news that everyone will be interested in, whether it’s a graduation or a new baby. Participating in charades, board games or cards also can bring people together and move attention away from food.
- Encourage open communication in order to understand which situations are going to be challenging.
- When your loved one is in the situation, check in periodically so they can reach out when feeling overwhelmed or experiencing urges. Know which cues indicate that the person is struggling.
- Support their choices, whether it’s stating they’ve had enough food or that they need to leave. This can help them be more comfortable at future gatherings.
About the Author:
Jody A. Langford, MD, is a child and adolescent psychiatrist at Rogers Memorial Hospital and is board certified in general psychiatry and child and adolescent psychiatry. She was awarded chief fellow in child and adolescent psychiatry during her postgraduate training.
Her residency program in psychiatry and behavioral medicine, as well as her fellowship in child and adolescent psychiatry, was completed at the Medical College of Wisconsin (MCW) Affiliated Hospitals in Milwaukee.
A member of the Medical Student Education Committee at MCW, Dr. Langford has been actively teaching residents, fellows, medical students and other health professionals on the subject of eating disorders, receiving the resident/fellow teaching award at her graduation.
Dr. Langford is a member of the Academy of Eating Disorders, American Psychiatric Association and the American Academy of Child and Adolescent Psychiatry.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on November 27th, 2014
Published on EatingDisorderHope.com