Eating Disorders & the Holidays: Information & Tips for Parents

According to the American Psychiatric Association, Eating disorders are characterized by a persistent disturbance of eating behavior, which impairs health and/or psychosocial function. Eating disorders have a lifetime prevalence of approximately 8 percent in women and 2 percent in men. Eating disorders include Anorexia Nervosa, Avoidant/Restrictive Food Intake Disorder, Binge Eating Disorder, Bulimia Nervosa, PICA and others.

Unhealthy preoccupations with food and weight are common among children and adolescents with eating disorders. When it comes to the holidays, many (or even most) healthy individuals will have a preoccupation with the meals that they are preparing and/or enjoying. With my own family, conversations about who’s preparing which entre or side dish, and where our favorite desserts are baked, start well before even Halloween. Pair this with the actual gatherings themselves, where family members sit around a table with mounds of food for hours. If someone is struggling at baseline with ruminating about food and/or their weight, and they feel obligated to partake in these activities, they certainly will be vulnerable to an acute exacerbation or their symptoms and emotional distress. However, that does not mean that these events cannot be enjoyed.

If a child or teen is struggling with an eating disorder, my recommendation will always be for the family to discuss a plan for the holidays with their mental health provider. Many providers will be open to a family session, which could be incredibly helpful. Just like all psychiatric treatment, navigating a patient’s specific struggles and developing a plan, needs to be individualized; there’s no one-size-fits all treatment plan, when it comes to mental health.

However, for some individuals with mild or moderate symptoms, a few tips could be considered:

1. Let your child know that you understand that the holidays may be a difficult time for them, and that you want to support them.
2. Offer participating in a family session with their mental health provider, to increase your understanding of their specific struggles and/or triggers, and to understand their plan for navigating holiday events.
3. Discuss ways that your child could distract themselves from triggers, should they become overwhelming. For example, letting your child know that they could excuse themself from the table to go for a walk, take the dog out back, clear some plates, play with some younger siblings/cousins, or even give a quick call to a support who’s not present, may be extremely helpful. Activities like these wouldn’t need to be advertised, and your child’s specific difficulties wouldn’t need to be discussed. Just knowing that they have the ability to take time to themselves, should it be needed, may be an incredible relief to a child worried about navigating large holiday gatherings. It also may be helpful for them to learn, that their struggles wouldn’t need to be discussed with everyone in attendance.
4. Remember that it’s ok if your child doesn’t try every dish that’s been prepared, and that a large family event is likely not the right time to push your child to make progress with their struggle. No one wants to feel that they’re under a microscope, especially when a crowd of extended family members are present.
5. Identify your child’s favorite aspects of the holiday gathering, and develop a plan to have them participate more in those activities. This may help them to not feel left out, if they have to excuse themself early from some of the more food-focused aspects of the evening. It will also help them to develop fond memories of the holidays, which is something that we all deserve to enjoy.

A word on setting Boundaries with family members: Family and friends may, or may not, be privy to the details of your child’s struggles. The decision to include others in the dialogue really should be discussed with both your child and their mental health provider. With that said, planning non-food focused activities and even discussion topics may be very helpful. Taking a few minutes to think about topics, stories or recent events that could be brought up ahead-of-time (should the conversation deteriorate or be too food focused), could pay dividends. Finally, if a child has commented that certain individuals who may be in attendance have specifically been inappropriate towards them, or have specifically triggered them by making certain comments, and your child is comfortable with you saying something, parents or supports could consider calmly asking them to avoid certain topics (or frankly, keeping them off the guest list).

Additional Resources

• ANAD.org – National Anorexia Nervosa and Associated Disorders. Free support for individuals and loved ones who struggle with eating disorders.
• Alliance for Eating Disorders Awareness Helpline: 1.866.662.1235 and web: www.allianceforeatingdisorders.com