Supporting Loved Ones with Eating Disorders During the Holidays

By Jessica Kenyon, LCSW

For many people, the holiday season is the most wonderful time of the year, a time to surround yourself with loved ones, honor traditions and gather around the dining table for a celebratory meal.

However, for individuals who struggle with or are recovering from an eating disorder, the holidays may not always be merry and bright.

If you have a loved one with an eating disorder, the best gift you can give them this holiday season is your love and support.

A Time of Anxiety and Stress

For people with anorexia, bulimia, binge eating disorders, and avoidant restrictive food intake disorder (ARFID), the holidays often magnify the very things they are trying to minimize — eating food and talking about food.

If someone struggles with anorexia, the holidays can exacerbate the anxiety they already have about food and can perpetuate feelings of guilt around what and how much they are putting on their plate.

Additionally, holiday meals often require loosening some control over what you eat, and for people with anorexia, not knowing every ingredient that went into the meal or a certain dish, can be stressful.

For those with ARFID, anxiety over whether or not they can eat what is on the menu will be difficult.

On the opposite end of the eating disorder spectrum, people with bulimia and binge eating disorders also experience anxiety and stress when faced with abundance of food that accompanies the holidays and the tendency for almost everyone to overeat.

Feelings of shame and guilt often cause people with bulimia and binge eating disorders to beat themselves up about how much they ate and what they ate and can trigger the urge to purge for people with bulimia.

And a time when homes are filled with family and friends, it is likely that multiple trips to the bathroom won’t go unnoticed.

Tips for Friends and Family

But while the holidays are challenging for people with eating disorders, the season can also be difficult for friends and family who know their loved one is struggling and want to help.  

To that end, here are five tips for how to support a loved one with an eating disorder during the holidays.

1. Remember the reason for the season. Food and drinks are often a large part of holiday celebrations, but they do not have to be the primary reason for coming together. Instead, focus on spending quality time together. Revisit happy memories and start new traditions, such as watching a movie, looking at holiday lights, playing board games, or decorating. Spend time together talking and discussing non-food related, non-body-related accomplishments. Share points of gratitude not related to food.
2. Create a cope ahead plan with your loved one. Prior to the gathering, discuss with your loved one their struggles and triggers. Triggers can be comments or discussions about how many calories a food contains, weight, clothing size, exercise routines, diets and how some people are picky eaters and ruin it for others. Identify healthy means of coping with triggers, such as going for a walk, getting some fresh air or employing distress tolerance skills like TIPP. TIPP stands for:
   • Temperature. Splashing cold water on your face can help bring the temperature of your body — and mind — down quickly.
   • Intense exercise. A short burst of intense exercise, such as a quick set of jumping jacks or a sprint to the corner of the street, is a fast way to bring stress levels down.
   • Paced breathing. Focusing on your breath can calm your mind and bring you back to center. 
   • Paired muscle relaxation. Tightening and then relaxing your muscles can relieve tension and bring down your heart and breathing rates.
3. The cope ahead plan can also include a list of people your loved one can turn to for support; an outline of the day, including a list of who will be in attendance, the menu and planned activities; and a safe word if your loved one starts feeling overwhelmed. In addition, invite your loved one to make a dish of their own to share, and most importantly, honor the plan you create.
4. Do not be the food police.  Someone with an eating disorder or in recovery already spends a significant amount of time noticing what goes in their bodies and what they are eating.  Don’t add to that stress. Avoid labeling foods as good or bad, healthy or unhealthy. This only reinforces negative food beliefs, leading to heightened feelings of guilt, anxiety and shame. Do not pressure your loved one to try a specific food or add more to their plate.  Those who struggle with eating disorders, already having a hard time being present for a meal, try not to make it worse. Avoid comments on how much or how little a person is eating, and do not give loud, dramatic praise for when your loved one does eat.
5. Be an ally. Educate yourself about eating disorders and be part of your loved one’s recovery. Validate their concerns and feelings and encourage them in whatever stage of their recovery they may be in. Ask how you can best support them, remind them you love and care about them, and offer hugs or kind words. Be gentle.  Offer to be a support person. Also, don’t overly share details with people your loved one doesn’t want to know about their eating disorder or recovery.
6. Make sure you are supported as well. Just as your loved one needs support, so do you. Identify your own support people and coping mechanisms and give yourself grace that you won’t be perfect. Practice self-care — take a bath, read a book, go for a walk, do something that makes you feel good. Also, remind yourself that this is not forever. Recovery takes time, but you and your loved one will get through it. And remember, you cannot change your loved ones’ behavior, you can only offer support for their recovery.

If you or a loved one are struggling with an eating disorder, help is available.

The Penn Medicine Princeton Medical Center Princeton Center for Eating Disorders provides inpatient treatment for adults, adolescents and children as young as 8 who suffer from eating disorders, including anorexia, bulimia and binge eating.

In addition, Penn Medicine Princeton House Behavioral Health offers outpatient care through its Emotional Eating Track, geared toward individuals who are having difficulty managing the symptoms of a mood disorder and use food to regulate emotions.

For more information about the Princeton Center for Eating Disorders and Princeton House Behavioral Health, call (888) 437-1610, option 3, or visit princetonhcs.org/eatingdisorders. 

Jessica Kenyon, LCSW, is a licensed clinical social worker and senior primary therapist at Penn Medicine Princeton House Behavioral Health.