For many, the holiday season is a time for family and friends to gather around a festive meal, reminiscing of the year gone by. But for some, these festive gatherings bring with it stress that is unparalleled any other time of the year. We spoke to Melissa*, who has been in recovery from her eating disorder for six years, and Dr Sarah Howard, a psychiatrist who specialises in eating disorders, about what to do if you’re struggling with an eating disorder during the festive season.
Melissa says one of the things she mostly has to manage this time of the year is her own sense of self-worth. She finds it particularly triggering when relatives she hasn’t seen for a long time ask her questions about her weight and other uncomfortable topics, such as if she has a boyfriend or whether she’s been promoted at work. This leaves her feeling “less than”, which makes her want to act on her eating disorder. “I have to remind myself that I am good enough and I am worthy of love no matter what my body shape or weight. Any questions or well-meaning, but inappropriate, comments do not determine my self-worth.”
Dr Howard says festive events often bring various family members and friends together whose relationships may be conflictual or fraught, resulting in emotional distress. She adds that most of these gatherings also take place around food during the festive season – foods someone with disordered eating may consider “bad” or “forbidden”. “This perception is unhelpful,” she explains. “It may create anxiety, urges to binge and/or purge, or avoidance and restriction of quantity and food groups, or avoidance of other people attending these events.” A third trigger is the amount of alcohol consumed at these festive events, which may lower inhibitions and cause overeating and more conflict.
Alcohol is a concern for Melissa too, as well as the lack of structure. “Everyone goes a bit crazy at this time of year,” she explains. “It can end up being very stressful with mealtimes being irregular and food being available most of the time. There is also very little routine around this time of year, which can be unsettling and makes eating regularly difficult.”
What can you do if you have an eating disorder?
Dr Howard agrees that routines are important and says that you should try to maintain yours during the festive season. “Eat regular meals and don’t skip breakfast in anticipation of a large lunch, for example. The hunger and restriction usually result in bingeing or overeating later in the day. Plan ahead to avoid later difficulties.”
Melissa also speaks about planning. “Have a plan of what you will be doing to keep yourself safe. For example, if possible, have people that you can reach out to when things get tough,” she advises. “Try to stay out of situations that you know will be stressful and triggering – use COVID as an excuse if you need to.”
Dr Howard also advises that small quantities of everything are better than having certain “banned” foods. “This allows for moderation, and not a sense of abandoning or breaking rules if these foods are eaten.”
“The general advice is to eat slowly and deliberately,” she adds. “And be aware of cues like fullness or thirst. If you are tempted to binge, use distraction techniques such as getting up and going for a walk, making a phone call to a friend, or removing yourself from an emotionally distressing situation.”
She also says that the notion that all families get on well together has to be addressed. “Prepare yourself in advance if you are aware there are certain relationships or comments that can be triggering,” she urges.
The most important thing Melissa wants to remind everyone of is that they are not alone. “Be kind and gentle with yourself. You are not alone in this and you are doing the best you can for the situation you are in right now. The festive season will end eventually and things will get back to normal. Recovery is very definitely possible.”
Resources for if you’re struggling with an eating disorder
Melissa found the way out by attending 12-step meetings such as Eating Disorders Anonymous (EDA) and Anorexics and Bulimics Anonymous (ABA), and she is now a sponsor at ABA.
Dr Howard also suggests Lifeline or other online support groups as well as making an appointment with your GP or a registered dietitian who is experienced with eating disorders. You can also see a clinical psychologist to help you deal with emotional stressors and the resultant behaviours, or a psychiatrist who is experienced with eating and mood disorders. Dr Howard is available for consultations from 18 January 2021 and is based in Cape Town. You can reach her on 021 461 7111.
Melissa’s last words of advice are: “Remember you don’t have to wait for your eating disorder to be ‘bad’ enough or for you to be ‘sick’ enough to get help. You are worthy of love and recovery just as you are.”
*Name has been changed