An Eating Disorder Dietitian’s Guide to supporting your loved ones during the holidays!
By McKenzie Harris, RD, LD, CEDS
#1 Tis the season to EAT!
For a lot of us, the holidays are a time we look forward to every year. Time with family and tasty food – nothing better, right? Well, for those struggling with disordered eating – the holidays can be a dreaded time. Eating food itself is scary, for a variety of reasons, but eating NEW foods AND in front of other people – it’s a nightmare. So here are a few tips to supporting your loved ones through the holiday season:
Consistency – Follow a Meal Schedule! There is a lot of variability in our schedules during the holiday – so it can be helpful to have food timing as the ONE thing that your loved one can expect. Set alarms on your phone and try to plan meal and snack times every 2-3 hours.
Support – Set Check-Ins! Before going to a holiday gathering or party – talk to your loved one on a “code word” or set specific times to check-in with them on how they are feeling emotionally. If a meal is taking place at this event, sit next to them so that they can check-in with you discretely without having to notify the whole group on their difficult time.
Levity – Keep Conversations Light! In most families, talking about food, body size, and exercise is a common table or group conversation. Keep in mind that even if the conversation isn’t about your loved one’s body/food – they will be applying any perspectives to themselves. Keep conversation at the table or gathering – positive and light! This will help your loved ones create a positive association with food and family time!
Planning – Plan the menu ahead of time! Food or eating environments will already bring up a lot of anxiety – so sit down with your loved one at the beginning of the holiday week or day and plan out the times and types of foods they will eat. When planning with your loved one with disordered eating – only give two or three choices to avoid overwhelming them!
Grace – It’s okay if you don’t eat “perfect”! Holiday foods and timing is going to look different than your every day schedule – and that’s okay! Even if you ate more or less than you wanted to or were supposed to today – tomorrow is a new day and you can work on being more consistent and balanced going forward! Use each day as a learning experience!
#2 Take a Santa-Pause
Holidays can be VERY stressful. One thing that we prioritize here at Connections Wellness Group is preventative self-care, instead of reactive self care. Nourishing our body appropriately is one of THE main ways that we care for ourselves – and your loved one might have a difficulty doing that. So, it is important that we support them in making sure that we feed ourselves appropriately to ensure that we have the energy to enjoy the holidays! Here are some preventative self-care ideas to encourage ourselves and our loved ones to take care of themselves this holiday season:
Self Care – Spoon-giving activities! The Spoon Theory was created in 2003 by Christine Miserandino to explain how having Lupus impacted her ability to perform her daily activities. She used “spoons” to represent “unties of energy.” Use this language with your loved ones. Explain to people in your life how much energy you have to give to different activities or tasks throughout the day! If it takes several “spoons” to attend social events, cook dinner, or look at yourself in the mirror – be sure to engage in “spoon-giving” activities before proceeding or maybe wait for another day to challenge yourself with completing that activity!
Gratitude – Sit back and enjoy! What would it be like to take a pause from the holiday rush and find at least one thing you are grateful for? This could change your whole mood and outlook!
Joyful Movement – Moving your body can help give you endorphins! Now, movement should only be done if it is joyful. You or your loved ones will be tempted by diet culture to “work off” the holiday foods you eat. However, that only perpetuates the idea that you have to “earn” food. Which is not true!
Attunement – Listen to your Embodied Knowledge! Diet culture tells us to think about food with our head, instead of our bodies! This leads most people to eat based on calories, food labels, and based on what “seems” like enough. This is only going to keep you from listening to what your body is trying to tell you it needs. The reason we don’t listen to our bodies – is because we 1) don’t take the time to pause and listen and 2) don’t trust it. So, take a second to be curious and listen to what your body is telling you it wants and ask “why do I want this?” The answer to that will tell you a lot about your physical and emotional needs.
Boundaries – Internal vs External. When the holiday craziness comes – make sure you are setting boundaries with your time and body! There are two types of boundaries – internal vs external. Internal means that you set it for yourself in your head. For example, if grandma says something triggering you can rationalize that “that’s just the way she is” – not letting it affect your belief of yourself or food. External Boundaries are those that you set outside of yourself – typically by verbally setting them. For Example, if grandma says something triggering you could tell your grandma “Hey, can we not talk about my food/body?” Work on setting these for yourself or coaching your loved ones on using them.
#3 Fa-la-la-la-lamily roles
Time with family can be one of the most amazing parts of the holidays! But for some people, it can bring a lot of anxiety and tension. In therapy, we often hear about “dysfunctional” family roles that parents play – but we don’t hear about functional roles they can work to embody. The dysfunctional family roles include: the enabler, the hero, the lost one, the mascot, and the scapegoat. These titles leave family members questioning “I know what dysfunctional role I play, but now what?” Baqi Martin, Connections Wellness Regional Executive Director, saw this problem and decided to put language to the “functional” family roles. Here are a few of the functional family roles, and how they should navigate the holidays!
The Leader – This role leads positive family engagement, the safe spaces discussions, and conducts consistent and routine check ins (individually and as a group). So during the holidays the leader sets the structure for firm boundaries, defines boundaries for the family and educates what those mean to all members in a way they understand and comprehend. This could look like discussing with the client what their meal plan and eating structure needs to look like during the holidays, and sets the holiday day schedule for the entire family. Taking all needs and boundaries into account!
The Nurturer – Similar to the leader, this role guides in safe spaces, exemplifies compassion, and allows for emotionally safe spaces. The nurturer encourages compassion within the family system by ways of establishing a culture of emotional intelligence. So during the holidays, the Nurturer guides the mutual compassion for all family members and ensures that we consider each other in our freedom and autonomy of choice. This could look like educating other family members on the needs of the client, while also ensuring the needs of the client doesn’t affect the entire family.
The Champion – This role acts as the family advocate, they pull away from the superficial facade of Hero and communicates the challenges of the family. The champion acknowledges the families struggles and at times is the seeker of the external and internal supports. They speak to the hurt, guilt, and pain of the family system and opens the door for discussion and therefore change in the dynamic. During the holiday season, a Champion should have these difficult discussions with the treatment team PRIOR to the holiday itself. Discussing realistic expectations for your loved one.
The Advocate – This role becomes the grand speaker and is typically the Barometer to pain and dysfunction within the home. They feel and carry the significant weight of the internal traumas/shame of the family home. They become the emotional intelligence barometer to what is improving and how the healing is coming about within the family system. During the holiday season, it is important to listen to this person’s expressing of the any familial pain/shame – as this is an antidote to the shame and begins the healing process. If you identify as the Ambassador in the family, it could be helpful for your loved one to avoid difficult conversations during the meal or holiday. This is an important role to have, but should take place after the holiday eating festivities.
#4 Ghost of Christmas Pasta
As punny as this title is, our past experiences around certain holidays, people, food, etc. CAN continue to affect us days, months, or even years later. Those struggling with eating disorders often experience anticipatory stress – or stress felt ahead of certain events or activities. For example, if they had a stomach bug after eating Thanksgiving Turkey years ago, they still might remember that experience and want to avoid that food this year – and that’s okay!
The therapeutic modality that supports in treating or minimizing anticipatory anxiety is called Exposure and Response Prevention. It’s the idea that the more an individual experiences a situation or item that elevates an uncomfortable emotion – the more normal that experience becomes expected and the anxiety subsequently decreases. For those struggling with eating disorders, ERP happens commonly with types of food, eating behaviors, body image, and social eating. It is actually helpful (and necessary) to expose themselves to uncomfortable items/situations for their anxiety to decrease. The holidays are a BIG time for planned and spontaneous exposures. Here are a few types on how to ensure that your loved one is challenging themselves – while ensuring that they don’t push themselves past their ability to cope.
Plan ahead – If we know that buffets AND holiday foods are anxiety-provoking for your loved one, then it might be helpful to plan with your loved one if they feel able to challenge BOTH at the same time this year. It might be past their ability to cope to do both. So, this would be a conversation before arriving at the meal that you, as a support person, will plate the food for them. This would also be a good time to acquaint yourself with their meal plan and food preferences.
Set realistic goals – Have a conversation with your loved one to create a “fear hierarchy.” For example, eating a the holiday foods could be a 10/10 on the SUDs (subjective unites of distress), or anxiety, scale and could feel IMPOSSIBLE for your loved one. While, sitting with the family at the holiday meal and eating a “safe” food could still be a 5/10 SUDs score – which is more realistic for your loved one at this time. It’s important to understand your loved one’s fear hierarchy so that you can be more patient with small victories!
Educate yourself – It’s part of human nature for us to feel fear. It just so happens that your loved one’s mental illness causes them to be fearful of food and body. Put this same fear experience in words that you understand. Let’s say I am afraid of spiders… because I am. It would take ALOT for me to go from being afraid of spiders to getting a pet spider. Several steps would have to be taken for me to become comfortable with a pet spider. First step – visiting one in the pet shop. Second step – watching my friend pick it up in the pet shop. Next – touching it in the pet shop. Then – holding it for a few seconds. All the way until I could purchase one for a pet. This would take me weeks, if not months! Similarly, your loved ones are challenging something that feels just as scary. Find ways that you can nurture them in their quest to challenge their fears.
Make it enjoyable! – Now that we understand that your loved one is showing a ton of courage to challenge things that are very scary to them – let’s try to make the holiday eating experience as enjoyable as possible! Keep conversations at the table light! Avoid negative conversations such as the future, school, finances, work, ect. Ask positive-leading questions, such as “What are you looking forward to? What brings you joy right now? What’s the best thing that happened to you this year?” This will slowly help us heal any negative memories that your loved one has associated with holidays in the past.
#5 Love from Head to Mistletoe
Lastly, and DEFINITELY not least, let’s talk about holiday compliments! We all know that family members are the best AND worst at commenting on our body and food. Most of the time your loved ones are intending their comments and compliments to be positive and meaningful. However, most people struggling with eating disorders have a difficult time with comments on food and body. So, here are a few tips and tricks on how to make your loved one feel seen in a meaningful way!
DEFINITELY don’t comment on your loved ones body! – If you take ONE thing from this guide, this should be it. When we make comments such as “oh my gosh, have you lost weight?” or “You look so healthy” or “That outfit isn’t flattering on you” – this really affects your loved one’s mental health. Comments such as these place value on HOW they look, and not WHO they are. I want you to think to yourself – you don’t love the people in your life because of how they look, you love them because of how they make you feel or who they are. So, I encourage you supporting them in finding their identity in who they are, this holiday season!
Avoid commenting on ANYONE’s body or food! – Even if you don’t comment on your loved one’s body, you can still negatively impact your loved one’s mental health by commenting on you or other individuals body types. For example, if you comment on how you dislike your body or a celebrity’s body – your loved one could apply this to themselves. I have often had clients say “if you don’t like your body, and I am your ‘mini-me’ – then I should also hate mine.” Try to avoid comments on food and body and encourage the rest of your family to do the same!
Compliment your family on WHO they are! – I would encourage you to give compliments on the values that you admire in your loved ones. For example, “I love how selfless you are!” or “Your passion for the holidays is contagious” or “Your smile lights up the room! I love your zest for life!” This will encourage your loved one to act in accordance with their values, instead of feeling like their value is what their body is or how they eat.