Mindpath Health’s Kiana Shelton, LCSW, discusses how to navigate the holidays through disordered eating recovery. See highlights below or read the full article with sources here.
Gathering around friends and family during the holiday season can stir up warm and fuzzy feelings, which can make all the planning, cleaning, cooking, and spending feel worth it.
But sometimes, these festive occasions come with increased stress levels, which may overshadow those warm and fuzzy feelings.
For some people, holiday events — usually built around meals — can intensify feelings of anxiety and depression or present triggers.
In fact, research points to a link between eating disorders and depression, including seasonal affective disorder (SAD). SAD can follow a winter pattern and may coincide with the holiday season.
This makes stress management, self-care, and mindfulness all the more important to remain on your priority list this season, especially if you’re living with or recovering from an eating disorder (ED).
Why might the holidays be triggering?
Someone with extreme eating or exercise habits may be experiencing an ED. Symptoms can vary depending on the condition, including binging or purging food, restricting food, overexercising, and more.
Heather Russo, LMFT, CEDS-S, chief clinical officer with Alsana, an eating disorder recovery program, tells us that holidays are especially triggering for people in recovery from an ED because many traditions and celebrations are food and relationship focused.
She explains that facing large amounts of food on the table or recognizing that you’ll have to eat in front of others can cause worry and anxiety. “On top of this, the stress of wondering how to respond if someone comments on how you look or what you’re eating can feel heightened this time of year,” Russo says.
Julia, a member of the Alsana team who received treatment for an eating disorder and is currently in recovery, says the foods used to celebrate can be challenging for people experiencing eating disorders.
“There’s also an amplification of diet culture from everyone around us, echoing anxieties that certain foods are ‘bad,’ ‘sinful,’ ‘guilty,’ ‘unclean,’ ‘toxic,’ ‘cheat,’ ‘junk,’ ‘garbage,’ etc.”
Julia adds that complicated family dynamics, “clean your plate” generational expectations, and New Year’s anticipatory diet talk are also especially challenging for recovery.
According to Russo, food cues and relationship dynamics can send someone with an ED into a reactive state, making them feel vulnerable to unhealthy coping mechanisms and compulsive behaviors. Depending on the eating disorder, this may mean:
- Binging, or extreme overeating
- Not eating prior to or after an event
Managing Anticipatory Anxiety Leading Up to the Holidays
“Anticipatory stress is a real thing,” says Kiana Shelton, LCSW with Mindpath Health.
This is the type of anxiety someone may feel ahead of certain events or activities. However, according to Shelton, mindfulness is a great way to combat this anxiety.
“Recognizing you are feeling anxious and going over your plan can be a great way to stay grounded. It’s also a great opportunity to wrap tools around these specific stressors,” she says.
Activities that may help ease feelings of anticipatory anxiety, such as:
- Getting plenty of rest. Set a good sleep schedule and stick with it best you can.
- Participating in activities you enjoy — spending time outside, taking a walk, or reading a good book.
- Practicing mindfulness, meditation, or yoga.
- Creating a go-to playlist to listen to when you feel anxious or overwhelmed.
- Making sure to schedule time for self-care every day. This can look different for everyone. Maybe it means applying a face mask, making a call to a good friend, or heading to the spa for a massage.
For Julia, planning ahead has proved a powerful strategy.
“I used to go into events or gatherings hoping I would just suddenly and magically put my eating disorder on a shelf and hope for zero triggers — and then feel like a failure when I wasn’t able to refrain from disordered behaviors.”
Instead, she suggests thinking of a trigger or challenge that may come up, being specific with where, when, and how, and then pair that possibility with a small, recovery-minded action.
Build a Support System
Julia says surrounding yourself with support is also a vital step.
“If possible, connect with an eating disorder-specialized professional, such as a therapist or dietician, so they can help you navigate this time of year with your unique situation in mind.”
Although navigating insurance, waitlists, and more can be frustrating and even exhausting, Julia stresses that it’s worth the effort. “There are resources out there to help with access to care, and even just confiding in a trusted loved one to support with making those first calls,” she says.
Keeping Care Plans in Place
According to Russo, the most important thing that you can do for your health this season is to keep your standing appointments with your care team if you have one.
Although this time of year is often so busy, it can be tempting to put a pause on your recovery, but Russo tells us that’s risky. “I encourage my clients to continue to meet with their dietitian and attend therapy as usual. If you’re going home for the holidays, make a meeting with your care team via phone or video chat a priority.”
Shelton reminds us that maintaining healthy behaviors during the holidays can take a little bit of work.
“Remembering to eat regularly — which includes eating before attending a gathering — will prevent you from being too hungry at the event. Also, eating mindfully, such as remembering to put the fork down between bites, can keep you focused while you’re eating,” she says.
Navigating Comments About Food
Comments about the amount of food on your plate are very common during holiday gatherings.
According to Russo, discussions around food can go sideways and create more stress.
She suggests saying things like:
- “Thanks for your concern. I’m feeling equipped to manage my food today,”
- “I’m adhering to my meal plan today. I’m all set, thanks.”
Russo adds that it’s okay to remind loved ones that what you’re eating is not open for discussion but is being well managed by you and your care team.
Of course, many questions or comments may come from well-meaning people in your life. Shelton points out that within the Black, Indigenous, and People of Color (BIPOC) community, questions about what and how much food is on your plate are often signs of endearment.
She tells us while it’s important to consider the person making the uncomfortable or triggering comments, some of these go-to phrases below can be very effective:
- “I’m happy with what’s on my plate; it all looks so good.”
- “Thanks for thinking of me. I have enough right now.”
Staying present and focusing on connection during gatherings
While food may be one of the main attractions at these holiday gatherings, Shelton tells us it’s important to remember that coming together with family and friends is the main reason.
“Connect with those around you and make it a point to reach out to all in the room. This socialization can help keep you present and actively aware of the true reason for gathering,” she says.
According to Russo, being patient with yourself is also important, even if you feel out of control.
Here are some steps she suggests:
- Take a pause from the situation, even if that means moving to a different room — then sit down and close your eyes.
- Take deep breaths and think about the things (and people) you’re thankful for daily.
- Try to remember what’s valuable to you and how you want to engage with the moment, as well as any others that might come your way during the holiday season.
Shelton encourages clients to put their plans in the note section of their phones.
“Since we live in a digital age, and many have their phone on them, it can be an easy way to take a quick glance at your plan and remember your coping strategies,” she says.
Setting Boundaries and Honoring Your Needs
Shelton says meeting your own needs is one of the greatest forms of self-love, and sometimes no is the best answer. “Depending on how safe you feel, sharing more with the host about why you cannot attend may combat any potential feelings of shame or guilt for not attending,” she says.
It’s also important you don’t lean into people-pleasing behaviors.
“If you don’t think attending a holiday event or gathering makes sense for where you are at in your recovery, don’t go,” Russo says.
Just like it’s important getting in touch with your support system, dietitian, or therapist before the holidays, it’s also important to touch base after they end.
“If you find yourself dysregulated or struggling to return to your daily routine, aftercare may look like seeking professional support,” Shelton says. She also mentions that a call with the NEDA Helpline could prove helpful.
Russo agrees, saying aftercare might include following up with your care team and using your meal plan as the foundation of your recovery.
“This means not skipping breakfast because you plan on having a big holiday lunch. You’ve gained valuable lessons in treatment, so even if you’re feeling overwhelmed by all the hustle and bustle, try to stick to what you know but give yourself some flexibility.”
Russo stresses to her clients that recovery is not linear. “Try not to look at slip-ups as deviations from your path but rather vital opportunities to grow in your recovery.”
This can look like making the recovery action as small as it needs to be realistic. “It can be simply to experiment with a recovery strategy to see if it works in this situation — because even if it doesn’t ‘work,’ being willing to give it a try is still a success.”
She suggests staying away from “all or nothing” thinking. Instead of viewing an event as either a “success” or “failure,” see it as somewhere in the middle.
“What worked well? What didn’t? It’s okay to give yourself compassion to learn from both. Progress, not perfection.”
It’s also important to keep track of the small victories.
How to offer support to someone navigating recovery
Being mindful of your friends or family members with an eating disorder during the holidays can make a big difference. In fact, you can even ask them how you may be a part of their support system if they are comfortable with that.
“If you have a loved one that is in recovery, remember to be compassionate to their continued healing,” Russo says.
“Reinforce that you are there for them and will continue to support them in every way — whether that means frequent check-ins to talk about their recovery or emotional state or providing space if they want to share about the work they’re doing with their therapist and dietitian.”
Shelton adds that being an “emotional wingman” can also make a big difference. This can include:
- Making a code word to check in with your loved one
- Offering non-food centering activities, such as board/card games
- Engaging in simple activities, like taking a walk
“When loved ones know they have even one person in their corner to offer additional support on these days, it can be extremely helpful,” Shelton says.
Keep in mind, some people gathered around your table may be privately dealing with an eating disorder, and Julia suggests avoiding comments or questions on food or bodies (or giving nutrition or diet advice) as a general best practice.
“The most effective way to support is encouraging your loved one to connect with a professional specializing in eating disorders,” she says.
“The next most effective way to support is to join a family/friend support group or two, so that you can continue to learn how best to offer support.”
Holidays can be especially stressful for people living with eating disorders. Feeling pressure or unease around friends and family during meal-based events can also be triggering.