Eating Disorder Articles

Strategies for Women with Eating Disorders During the Holidays

Eating disorders are chronic, stress related conditions and what time of the year is more stressful than the holidays? Thanksgiving, Christmas, Hanukkah, and New Years. This time of year is all about the food no matter what cultural or ethnic background a person comes from. For women who are still struggling with eating disorders and depression, the holidays bring up many different kinds of stressors.

There may be a great deal of pressure from well-meaning friends and family to eat and drink more than we feel comfortable with. Dysfunctional family interactions and social situations can be a source of tremendous stress. For many of us, the holidays may bring up extremely unpleasant memories of previous occasions. For many of us, holidays never seem to live up to our expectations. All of these factors can bring on an increase in eating disorder behaviors, whether it be restricting, bingeing, purging, or overeating. If we believe that eating disorders have a stress-related component and that we use eating disorder behaviors as a way of coping with stress in our lives, it is almost guaranteed that the holidays will be a time when we are most active in our behaviors, experiencing increases in depression, guilt, shame, fear, anxiety, and low self-esteem.

Therapists can help their client through these difficult times by helping clients role play potentially stressful scenarios. They may help their clients develop structured plans for navigating the holidays as well as learning assertiveness techniques to deal with family and social pressures. They may need to limit their exposure to particularly toxic people and destructive interactions. For those people who have lost a loved one or anticipate that they will be alone, they will need to think about how they will manage their time and the painful loneliness they may experience.

What I encourage everyone to do who has been a client of mine is to plan, plan, plan. (Incidentally these strategies work for every day, not just during the holidays!)

Here are some suggestions that really work!

1. When you first get up in the morning, after your morning ministrations, sit in a chair for 2-5 minutes, breathing deeply. Quiet yourself so you can become focused on the work at hand!

2. Make a schedule of all of your activities for the day.

3. Then take that list and circle situations which may be potentially stressful for you.

4. When it is a meal, write down exactly what you intend to eat (this is not written in stone, as you may change your mind, but it will serve as a guide).

5. If it is an event, write down what specifically is stressful, what you fear might happen, and what strategies you will use to deal (in advance) with the situation.

As an example, let us say that I am going to meet my mother for lunch. One of my mothers biggest faults is that she loves to play food police. No matter what I eat, to her it is never enough! Since I know I am going to meet her at a Mexican restaurant, I know that I will order the chicken taco salad with no sour cream. This is something that feels safe for me and that will meet my nutritional and caloric requirements. So I automatically will have the menu difficulty handled. Then I write out several assertive statements that I can make to my mother to deflect and maybe even diffuse her criticism.

(Mother comments)

1. Thank you for your concern, mother. This is exactly the right amount for me to eat right now.

(Mother comments again)

2. Mother, I feel angry when you keep telling me what and how much to eat. This is something I work on with my therapist and my dietitian.

(Mother comments again)

3. Mother, I want to tell you that if you keep on discussing my food, I will take care of myself by leaving the restaurant.

(Mother still cannot keep quiet!!)

4. I leave.

This is just one example of how beneficial a plan can be. Before I even meet my mother for lunch, I know what I am going to eat and what I will do if she acts in a less than respectful manner towards me.

I continue through my day and the amount of relief I feel after this process is enormous. This does not mean that I will do everything perfectly or even as planned, but I will not be surprised. I will be ready!!

The final suggestion is that do not forget all of the online help that is available. Many websites, discussion boards, and chat rooms are there with many friendly people just waiting to help you!

Jeanne Rust, PhD is the CEO and Founder of Mirasol, a treatment program for women and teens with anorexia, bulimia, obesity, and binge eating disorder. Her treatment philosophy is integrative combining the best of the medical model of treatment with the most effective alternative ones.