Disordered eating is a serious problem for 30 million American men and women. Neither a phase nor a lifestyle choice, an eating disorder can lead to devastating health problems like osteoporosis, muscle loss, organ failure and premature death.
Recovery from an eating disorder does happen, but it’s hard work. Treatment delves deeply into the issues that underlie the eating disorder and helps individuals develop the skills and strategies they need to break the cycle of disordered eating and enjoy successful long-term recovery.
The holidays in particular can be very difficult for people with an eating disorder, due in part to higher stress levels and a greater prevalence of high-risk situations. Especially for those in early recovery, the holidays may present a major challenge. Paying mindful attention to your moods, attitudes, thoughts and behaviors during this time can help you successfully navigate social gatherings and family feasts and emerge unscathed and stronger than ever come January.
This article offers an overview of the three most common eating disorders—anorexia nervosa, bulimia nervosa and binge eating disorder—and offers tips and strategies for overcoming the temptations and triggers you might face this holiday season.
A Brief Overview of Anorexia Nervosa
Anorexia nervosa is characterized by inadequate food intake and typically results in excessive weight loss, causing malnutrition and dangerous medical problems. The longer it goes untreated, the worse the outcome. Up to 20 percent of anorexia nervosa cases end in death.1
The most important issue behind anorexia is a distorted body image. Men and women with anorexia will likely have an intense fear of gaining weight, and their behaviors will reflect that. They may refuse to eat and may engage in excessive exercise, leading to extreme weight loss and resulting malnutrition. People with anorexia often believe their behavior is a lifestyle choice rather than a dangerous medical condition.
Signs and Symptoms of Anorexia Nervosa
If you have anorexia, you may:
- Have an obsession with dieting
- Deny you’re hungry
- Develop rituals surrounding food, such as counting bites or eating food in a certain order
- Make excuses to avoid having to eat
- Withdraw from family and friends
- Neglect hobbies you once enjoyed
- Refuse to eat certain foods, such as anything with carbohydrates
- Exercise excessively to burn calories
Anorexia and the Holidays
During the holidays, it’s common for people in recovery from anorexia to experience some anxiety surrounding food and social interactions. A well-meaning aunt may try to encourage you to eat more, calling you “skin and bones,” or someone may exclaim that you’ve gained weight, throwing your mind into a tailspin. Arming yourself with skills and strategies for getting through these difficult situations is the key to maintaining successful recovery during the holidays.
A Brief Overview of Bulimia Nervosa
Bulimia nervosa is characterized by cycles of bingeing and purging. After eating a large amount of food in a short period of time, someone with bulimia will purge, either by inducing vomiting or taking laxatives. Unlike those with anorexia, people with bulimia are usually of normal weight.
Bulimia is associated with low self-esteem, a poor body image and depression. The U.S. Department of Health and Human Services’ Office on Women’s Health stresses that bulimia nervosa isn’t always about body weight or food.2 Bulimia is often a result of trauma or stress, with the act of bingeing and purging an attempt to feel more in control of things.
Signs and Symptoms of Bulimia Nervosa
Common signs and symptoms of bulimia include:
- Low self-esteem that’s related to body image
- Unhealthy attitudes and behaviors surrounding weight loss
- Frequent trips to the bathroom after meals
- Large amounts of food disappearing in a short time
- Compulsive exercising
- Swelling of the cheeks or jaws
- Calluses on the knuckles from inducing vomiting
- Dental problems from contact with stomach acids
Bulimia and the Holidays
The vast amounts of food set out during the holidays can be dizzying for someone recovering from bulimia. The temptation to binge with the intent of purging later can be overwhelming, but there are some effective ways to mitigate these feelings in a high-risk situation. Family interactions can also be a trigger for relapse, especially in the case of severely dysfunctional relationships or former family trauma.
A Brief Overview of Binge Eating Disorder
Binge eating disorder is characterized by eating a large amount of food in a short period of time, often causing discomfort, and feeling a loss of control. Following a binge is usually a keen sense of guilt and shame. People with binge eating disorder are often of normal weight, but binge eating is also associated with obesity. Unlike those with bulimia, people who have binge eating disorder don’t purge after bingeing.
Binge eating may be the result of low self-esteem, a poor body image or high levels of stress. Boredom and negative feelings about life in general are also common reasons why people binge eat.
Signs and Symptoms of Binge Eating Disorder
The signs and symptoms of binge eating disorder include:
- Bingeing at least once a week for at least three months
- Eating faster than normal during a binge
- Eating until you’re uncomfortably full
- Eating a large amount of food even if you’re not hungry
- Feeling disgusted, guilty and ashamed after a binge
- Hiding your binge eating out of embarrassment
Binge Eating Disorder and the Holidays
During a binge eating episode, you may feel a great release of tension and positive emotions.3 Common personality traits among people with binge eating disorder include rigidity, inflexibility and perfectionism, as well as an inability to express feelings.
Because of the stress associated with the holidays, people in recovery from binge eating disorder may experience a strong pull to binge eat simply to numb the negative emotions and produce feelings of calm and pleasure. Feeling a loss of control over events can also be a trigger for relapse.
Recovering from an Eating Disorder
The National Institute of Mental Health stresses that eating disorders are a real, treatable illness.4 A treatment program that specializes in eating disorders offers the best chances for long-term recovery. A holistic approach to treatment that addresses issues of body, mind and spirit ensures that all of the complex issues underlying the eating disorder are addressed. A comprehensive treatment plan will include medical care if health problems are present, as well as psychotherapy, nutritional counseling and medications as needed.
Psychotherapy, or talk therapy, takes place in group, individual and family sessions. Therapy helps you identify harmful attitudes, thoughts and behaviors surrounding food and body image and replace these with healthier ways of thinking and behaving.
Nutrition education helps people in recovery understand the importance of good nutrition for optimum body function, disease prevention and good overall health and well-being.
Medication may be a component of treatment as well. Eating disorders commonly co-occur with other mental health issues like depression and anxiety, and treating these conditions is essential for successful recovery.
During treatment, individuals develop essential coping skills and an arsenal of strategies and techniques for handling cravings, lowering stress and navigating high-risk situations to stave off relapse and enjoy success in recovery.
Why the Holidays Can Be Difficult in Recovery
Food is a central theme during the holidays. Parties and feasts dominate the social calendar, and navigating these food-centric festivities can feel like walking through a minefield. Emotions run high as well, especially if family dysfunction abounds or the holidays bring unhappy memories to the forefront. Stress runs higher during the holiday season, and that can make it more difficult to make good choices. Alcohol consumption is a common component of holiday gatherings, but drinking can weaken your resolve and lead to relapse.
Entering into the season prepared to face some difficult situations is crucial for continued recovery during the holidays, and the following tips can help.
Support is Crucial
- Helps you identify potential trouble spots
- Offers a safe place to express difficult thoughts and emotions
- Helps you maintain a higher level of personal accountability and responsibility
- Gives you a sense of camaraderie and belonging
- Helps you make plans to avoid or cope with high-risk situations
- Gives you the opportunity to make a difference in someone else’s recovery
- Helps prevent feelings of loneliness and isolation, which can lead to relapse
Reducing Stress is Key
Stress is a major trigger for disordered eating.5 Stress is linked to the development and maintenance of an eating disorder, and it’s a major factor for relapse. People with an eating disorder may be affected by stressful life events, a high level of perceived stress and inadequate coping skills for stress.
Lowering your stress during the holidays is essential for maintaining your recovery. These stress-busters are proven to reduce your body’s stress response and bring about a greater sense of calm and well-being.
Meditation is fast becoming a mainstream complementary strategy for treating a number of conditions, including chronic stress. Meditation reduces stress hormones on the spot, and it also helps the brain and body better respond to stress down the road.
To meditate, simply sit quietly and focus your attention on the present moment. Breathe slowly and deeply, and when you feel your mind wandering, focus on your breath until you’re back in the present. Meditate for ten to fifteen minutes a day for noticeable results.
Regular yoga practice promotes physical and mental strength, endurance and flexibility and can make a big difference in your stress levels during the holidays. Yoga combines postures and breathing for a relaxation-inducing workout that is proven to relieve stress. In fact, Harvard Medical School cites a study that found yoga reduces stress responses like increased heart rate and blood pressure, muscle tension and body temperature and helps your body learn better ways of responding to stress.6 Yoga also promotes healthy lifestyle choices and leaves you with a higher sense of well-being.
Deep breathing quickly elicits a relaxation response, lowering stress hormone levels and reducing the body’s reaction to stress. A successful breathing exercise to quickly reduce stress is called the “quieting response.” First, smile inwardly with your mouth and eyes and relax your shoulders. Imagine that the soles of your feet have holes in them, and when you slowly breathe in, visualize hot air coming in through the holes and moving slowly up your body and filling up your lungs. As the hot air moves up your body, relax the muscles it passes by. Hold the breath for a moment, then slowly release it, feeling it move back down your body and out the holes in your feet.
Treat yourself to a holiday massage to relieve stress. The Touch Research Institute at the University of Miami has found through numerous studies that massage therapy can effectively reduce symptoms associated with stress, anxiety, depression and anorexia nervosa.7
Tips for Navigating Social Events During the Holidays
Perhaps the most difficult aspect of recovery during the holidays is navigating the host of social events like work parties, family gatherings, holiday open houses and other events where the food is plentiful and your anxiety can be sky-high. Here are some research-based strategies for negotiating your holiday social calendar.
Anticipate High-Risk Situations and Have a Plan
Planning ahead is key for successfully getting through social events. Know ahead of time which events are likely to be most difficult and why. Then, arm yourself with a concrete plan for making it through successfully. Perhaps you’ll need to have a way to diffuse comments by well-meaning friends or relatives, or maybe you’ll need to plan an eating strategy so that you’re consuming healthy amounts of food.
Most importantly, have a supportive friend or family member you can call if you need help, or invite a supportive person to accompany you to the event. Have an exit strategy planned in case you feel you need to leave the event early.
Take Care of Yourself
- Get adequate sleep
- Eat healthy food
- Drink plenty of water
- Get a little exercise
- Relax every day
If you have a toxic friendship that contributes to your disordered eating, setting a limitation may mean distancing yourself from the friend or only interacting with them at social gatherings. If you have an uncle who pushes your buttons, setting boundaries may mean refusing to discuss religion or politics with him. If someone pushes you to eat something you don’t want, setting a boundary may mean firmly saying “no” and standing up for yourself, even if it may cause a bit of a rift. Planning ahead for how you will handle such situations can help you keep your cool and respect your own boundaries when they occur.
To determine where you need to set boundaries, ask yourself what kinds of interactions with certain people will be a detriment your recovery. Then, set boundaries to defuse the power of the person to act as a trigger for disordered eating. In some cases, setting a boundary may mean avoiding a person or situation altogether.
Stick with a Regular Meal Routine, But Be Flexible
Eating three healthy meals a day along with a few healthy planned snacks can help repress the desire to binge, but it’s important that you exercise flexibility and self-compassion if you end up lapsing.
Remember that these episodes will decrease as you continue to practice replacing unhealthy thoughts and behaviors with healthier ways of thinking and behaving. Approaching a lapse with a positive attitude and using it as an opportunity to evaluate what triggered it helps to make you stronger in your recovery.
Another important way to exercise flexibility is to plan on taking a break from self-imposed perfectionism and rigidity. Plan to allow yourself to eat some treats if you feel like it. If you find yourself counting calories or on the verge of a binge, actively engage in other activities that will distract you from these thoughts.
Try to keep your focus on the spirit of the season rather than on your eating disorder. Enjoy conversations with people you haven’t seen for a while, and appreciate the time away from work and the time spent with your loved ones. Make a point to acknowledge gratitude for the positive things in your life, and try to be more forgiving of yourself and others during the season.
Set a Non-Recovery Goal for the Holidays
Consider setting a holiday goal that doesn’t have to do with your recovery but promotes feelings of hope and goodwill, such as collecting toy donations or organizing a benefit for a food drive. Working toward something positive gives you less time to nurture negative thoughts surrounding food or your body image.
Make Time to Recharge
Overbooking yourself can wear you out and make it difficult to clear your mind. But staying clear-headed and mindful during the season is an important factor in preventing relapse. Make a point to spend quality time with yourself every day to refresh and rejuvenate. Meditate, take a bath, write in a journal, or simply reflect on your mood and thoughts for a time. Stay in touch with yourself, and don’t be afraid to turn down events that you simply don’t feel up for. Self-care is a major component of recovery, and taking time to recharge is an important part of self-care.
Recovery is Possible
Recovery isn’t always easy, but the hard work is well worth it. In recovery, you regain freedom from food and continue delving into the complex issues surrounding self-esteem and body image to promote a stronger sense of self-worth. While setbacks are to be anticipated, keep in mind that they present an opportunity for reflection and meaningful change.
Recovery is a journey as much as a destination, and as with all journeys, it will feature ups and downs. The holidays don’t necessarily have to be a downer as long as you arm yourself with effective coping skills and strategies and maintain a high level of mindfulness during the holiday season.
- Anorexia Nervosa. (n.d.). Retrieved from https://www.nationaleatingdisorders.org/anorexia-nervosa
- Bulimia Nervosa Fact Sheet. (2012, July 16). Retrieved from http://www.womenshealth.gov/publications/our-publications/fact-sheet/bulimia-nervosa.html
- Binge-Eating Disorder. (2016, February 9). Retrieved from http://www.mayoclinic.org/diseases-conditions/binge-eating-disorder/basics/risk-factors/con-20033155
- Eating Disorders: About More Than Food. (2014). Retrieved from https://www.nimh.nih.gov/health/publications/eating-disorders-new-trifold/index.shtml
- The Relationship Between Stress and Disordered Eating in Anorexia Nervosa. (2014, September 29). Retrieved from http://www.anzaed.org.au/stress-and-eating-disorders
- Yoga for Anxiety and Depression. (2009, April). Retrieved from http://www.health.harvard.edu/mind-and-mood/yoga-for-anxiety-and-depression
- Adult Massage. (n.d.). Retrieved from https://www6.miami.edu/touch-research/AdultMassage.html