Supporting a family member with an eating disorder at Christmas presents a lot of complex and challenging problems. It is important to prepare for this and to acknowledge how the different members of the family feel about Christmas, including their fears, hopes and worries.
For the person who is struggling with anorexia in this season, there is going to be raised anxiety about the super-abundance of food at this time of year, the expectations to have much more than usual and an increased pressure, compared to other times of years, to eat with other people and to eat food they might otherwise avoid.
Parents will probably feel the pressure to create a happy, or even perfect day (TV, movies and social media can be particularly unhelpful in this respect); they may find themselves reflecting on how different Christmas is now the family are coping with an eating disorder compared to previous years, or how different it was when the children were younger.
These concerns and conflicted feelings can become the ‘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's so much better to talk through and acknowledge worries of eating disorders and Christmas at an early stage.
What preparation is helpful if you're 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 family 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 AND OTHER VISITORS
A significant aspect of Christmas for a lot of people 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 will be feeling anxious about seeing them, about being watched too carefully when they eat and particularly about comments they may make (however well meaning).
An individual with an eating disorder is going 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.
ADVICE FOR FAMILIES 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/young person feels most comfortable with and it is worth bearing in mind, if your child/young person 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 most probably going 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. Consider having a trial run- a full practice Christmas dinner early in December. This can help young people prepare and and give you an opportunity to discuss and consider portions and meal sizes.
PLANNING AND ORGANISING YOUR CHRISTMAS MEAL
It may be useful to have an agreement such as: parent will plate up the food 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 their support person, so they're close to the person who they trust and feel most comfortable with. It can be helpful to model their support person's portions, if they're 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. "
*Many thanks to contributors for this post
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