Experts at the University of Alabama at Birmingham are providing tips on how to navigate the holiday season for those coping with or recovering from disordered eating patterns.While the holiday season can bring joy and excitement, it may also present challenges for people who may have disordered eating patterns or who are recovering from an eating disorder. Stress can arise from the numerous holiday gatherings — typically built around meals — and can present triggers or intensify difficult emotions.
Experts at the University of Alabama at Birmingham Marnix E. Heersink School of Medicine are providing tips on how to navigate the holiday season for those coping with or recovering from disordered eating patterns.
Disordered Eating vs. Eating Disorder
While often the terms “disordered eating” and “eating disorder” are used interchangeably, there is a distinction. An eating disorder is a clinical diagnosis, while disordered eating is not.
Disordered eating involves behaviors that limit food choices, restrict calorie intake, cause discomfort or feelings of being out of control, and lead to negative emotions such as shame or guilt. Characteristics of disordered eating include eating for comfort rather than hunger, eating to deal with stress or difficult emotions, and restricting major food groups. It can also include extreme dieting, labeling foods as “good” or “bad,” and engaging in unhealthy weight control behaviors such as skipping meals, misusing diuretics, laxatives or enemas, using diet pills, and binging or purging on a limited basis.
“Dieting and overeating occasionally are normal behaviors in the context of a healthy relationship with food and a balanced eating pattern,” said Caroline Cohen, Ph.D., a clinical dietitian and assistant professor in the department. “These behaviors may become disordered when they become a fixation that negatively impact how you feel about yourself and your body.”
According to the National Institute of Mental Health, eating disorders are serious, biologically influenced medical illnesses marked by severe disturbances to an individual’s eating behaviors.
“Signs and symptoms can vary depending on the type of eating disorder,” said Kaylee Crockett, Ph.D., assistant professor, clinical health psychologist and clinical scientist in the UAB Department of Family and Community Medicine. “Signs may include general feelings of guilt or anxiety about foods eaten, the quantity of food eaten, frequently eating in secret, engaging in complex or rigid rituals surrounding food, participating in compensatory behaviors to address perceived dietary indiscretions, and fixation on food to the point that it affects normal activities and relationships.”
There are three categories of eating disorders: anorexia nervosa, bulimia nervosa and binge eating disorder.
“Anorexia nervosa includes the restriction of food intake leading to low body weight, intense fear of gaining weight and disturbance in how one perceives one’s weight,” Crockett said. “Bulimia nervosa includes binge eating followed by behaviors meant to prevent weight gain such as self-induced vomiting, use of laxatives, fasting or excessive exercise. Binge eating disorder includes recurrent episodes of binge eating behavior that may include eating very rapidly, eating until uncomfortably full, eating when not physically hungry, and feelings of guilt and shame following binge episodes.”
Why can the holidays be challenging for people with disordered eating?
Since many holiday traditions and celebrations are centered around food, this may cause stress for people who are coping with disorder eating behavior or recovering from an eating disorder.
Stress may be caused by encountering large quantities of food, worries about weight gain, having to eat in front of others or dealing with comments about one’s appearance. Additionally, messaging about “cleaning your plate,” New Year’s weight loss goals or labeling certain foods as “bad,” “sinful,” “guilty,” etc. can also be triggering.
Cohen, Crockett and Elliott Botelho, a graduate trainee in the Medical/Clinical Psychology Program at UAB, offer the following tips to help prepare for holiday gatherings.
Plan ahead
During the holidays, it is more important than ever for individuals in recovery to stay in touch with their care team and keep regularly scheduled appointments. They can work with a mental health professional to identify any triggers that may be encountered at these holiday gatherings and review and practice coping strategies in advance. A dietitian can help one navigate the holiday menu and come up with a plan to nourish one’s body appropriately.
Planning ahead may include regular use of coping tools over the holidays such as keeping a journal to help manage difficult thoughts and emotions in writing. Consider practicing mindful eating by focusing on the eating experience, body sensations, thoughts and emotions without judgment. Bring headphones or plan another soothing activity to help de-stress after a long day of holiday festivities.
“By planning ahead, you can take some time to think about who you would like to sit next to, which dishes you are interested in trying, and potential conversation topics that do not revolve around weight or dieting, so you can help reduce some of the stress you may feel on the day of the gathering,” Cohen said. “The goal of planning ahead is to create an environment that is supportive of recovery.”
UAB experts offer tips on how to enjoy the holidays without sacrificing physical or mental health. Read more here.
Eat regular meals
Cohen recommends individuals try to maintain their regular eating patterns as much as possible.
“Individuals who are recovering from an eating disorder or who may fall into disordered eating patterns may be tempted to restrict or skip meals earlier in the day in anticipation of a holiday meal,” Cohen said. “However, a key aspect of recovery is eating adequate and consistent meals every day.”
By not skipping meals, one can ensure they do not end up feeling extremely hungry and can help avoid engaging in further restriction or eating past fullness leading to feelings of shame or feeling out of control.
Be present
While food may play a large role in holiday gatherings, Cohen says it is important to recognize that coming together with friends and family is the main reason for the holiday season.
“Focus on the celebration,” Cohen said. “While food can sometimes seem like the focus, remember to enjoy the people and traditions associated with the holidays. Practicing gratitude in the moment can also boost your mood.”
To practice gratitude in the moment, find somewhere quiet and take a minute to sit down with eyes closed, take deep breaths, and think about the things and people you are thankful for. Take a few minutes to remember what is valuable to you and to think about activities that make you feel safe.
Practice self-care and self-compassion
During the holiday season, individuals should prioritize self-care to help manage some of the stress they may be feeling. There is not a one-size-fits-all technique for practicing self-care, so it is important for everyone to find a hobby, habit or activity that helps them connect with themselves and feel grounded in the moment. Some examples may include journaling, reading, meditating, snuggling with pets, or listening to music or a podcast.
It is also important to practice self-compassion and to avoid criticizing oneself after eating a food that they may have deemed “bad” or “forbidden.” While it is easy to fall into the thinking trap that one must be perfect in their recovery journey, it is important that they recognize their progress and forgive themselves if they experience any missteps in their recovery.
Self-care: What is it? Why is it so important for your health? Learn more here.
How to offer support
While at holiday gatherings, be mindful of friends or family members who may be coping with or recovering from disordered eating patterns.
“Avoid assumptions that people are in control of their eating behavior,” Crockett said. “Messages like ‘just eat something’ or ‘just stop eating so much’ can be harmful and shaming to people. Eating disorders can feel very isolating, and by opening up the door for supportive conversation and meeting family members where they are, you can help them feel supported this holiday season.”
One way to open this door is by having a private conversation. Ask, “How can I best support you this holiday season?” and then follow through.
Avoid making comments about a person’s body, appearance, eating rituals or fitness levels. Instead try to connect with people through discussing other topics such as music interests, movies, books, etc. By educating friends and family on the types of conversations that may be triggering for your loved one ahead of time, you can help protect your loved one in their recovery.
“The ways in which we — parents, friends and especially health care providers — talk about eating and weight can be very powerful in shifting others’ attitudes toward or away from a healthy mindset,” Cohen said. “Please be kind this holiday season, and remember that all bodies are good bodies.”
Resources
In the United States, 28.8 million Americans will suffer from an eating disorder at some point in their lives. The National Eating Disorders Association supports individuals and families affected by eating disorders, and serves as a catalyst for prevention, cures and access to quality care. For more information, visit nationaleatingdisorders.org.