Healthy Living

How To Cope With An Eating Disorder Over The Holidays

The season can heighten food anxieties, but there are ways to help yourself -- or a loved one -- get healthy.

When Meggie Sexton anticipated the holidays, she thought about one thing and one thing only: the food. And not in a good way.

"I didn't even think about family and friends and that camaraderie," says Sexton, a 32-year-old nonprofit account manager in Columbus, Ohio. "I was completely fearful of the meals because I felt like I would be totally out of control."

For weeks leading up to the celebrations, Sexton, a graduate student at the time, double downed on her efforts to eat as little and exercise as much as possible in order to "compensate" for the upcoming temptations. But when she went home, she rarely indulged, even turning down events as important as friends' baby showers because she didn't want to face food. Once the holidays were over, she returned to her apartment to binge and purge. "It was an awful cycle," remembers Sexton, who struggled with anorexia and bulimia for about seven years.

Feeling especially anxious around the holidays is common among people with eating disorders or attempting to recover from them, says Robyn Cruze, the national recovery advocate at Eating Recovery Center in Denver. "Even though an eating disorder is not about the food, the mental illness stands as it is around the food," she says. "When you're put in a room with food everywhere, it kind of can feel like walking through mine fields."

The season is also challenging because it's ripe with emotions, says Cynthia Bulik, director of research at the University of North Carolina–Chapel Hill's Center of Excellence for Eating Disorders. Just think of anyChristmas song or the childhood feelings – good or bad – that often reemerge when you return home, she says.

"Holidays are very much about emotions and about food, and those are two of the things that are most dysregulated in eating disorders," Bulik says. Even people who have been recovered for years and have the skills to manage the conditions' symptoms can hit road bumps during the holidays. "It can be a lot harder to engage those healthy behaviors" during particularly emotional times, Bulik says.

But it's possible. Sexton is a case in point. After getting help at an inpatient treatment center in 2010, she finds the season brings more joy than dread. This Christmas, for instance, she's looking forward to taking a break from the stress of daily life to spend time with her family, catch up with old friends and begin new traditions with her husband and 18-month-old son. "[I love] not feeling the stress that I used to – that robot of restricting, binging, purging and exercising like that was all that mattered," she says. "I'm free of those chains, and I'm able to just live my life."

Here's how Sexton and eating disorder ​experts suggest you handle the season if eating disorders affect you or someone you love:

If you have or have had an eating disorder …

Make a game plan.
Before Sexton’s first​ Christmas post-treatment​, ​she and her husband talked through what challenges she’d encounter and how she’d handle them. While meals were still overwhelming because she felt like all eyes were on her, their strategy helped. “[The disorder] is always going to have a little hold on me, but I know I'm stronger than the disorder now and know I can use my thoughts and my support group to not engage in unhealthy behaviors,” ​she says. Bulik recommends scoping out – and then avoiding – the rooms at a party that could be problematic,​ practicing graciously saying “no” ​to foods that will set you on a downward spiral and maintaining an inner dialogue to coach you through tough situations. “Be your own verbal therapist,” she suggests.

Stick to a schedule.
The holidays can disrupt anyone’s regular eating pattern, but eating three meals a day – plus snacks – is particularly important for people recovering from eating disorders. “If you move to that restrictive [eating pattern] so you can indulge over the weekend at all the holiday parties, it’s just going to put you in a bad place,” Sexton says. She avoids skipping meals to keep her on track.

Be flexible.
Still, it’s important to cut yourself some slack. “Slow down, enjoy food, be flexible and compassionate to [yourself] about what [you] eat,” says Susan Albers, a clinical psychologist at the Cleveland Clinic who specializes in eating issues. For Sexton, allowing some indulgences contributed to her recovery. “It helped me realize that I could eat that kind of food, and life would go on,” she says.

Speak up.
Unless they’ve gone through it themselves, most people don't truly understand what it’s like to struggle with an eating disorder. That’s why you need to spell out to your family what you need from them, whether it’s to shorten the amount of time you’re sitting around the table or for them to keep their eyes off your plate during meals, Cruze says. She suggests telling them something like: “I love you, the holidays make me anxious, this is what I have to do to stay safe – and I hope you do the same thing for yourself.”

Enlist a 'safe' friend.
If your family doesn’t get it, be sure to recruit someone who can support you during potentially challenging gatherings, Cruze says. “Safe friends are people who don’t judge you, fully support your recovery and who you set up times during your family events to check in with,” she says. If you've been through treatment, you can always call on a professional from your team. Otherwise, try an eating disorder helpline. ​ ​

Sexton remains careful not to overbook herself during the holidays “to allow for relaxation and renewal,” she says. ​De-stressing in ways that don’t involve food – be it a yoga class or just a few deep breaths – is important since eating disorders are more about emotions than food, Albers says. “If you’re feeling in a good place and less stressed, it’s going to be easier for you to navigate the food,” she says.

Don't take it personally.
Whether you’re told you need to "fatten up" or continually pressured to take seconds, keep in mind that in many families, food is a sign of love. Try asking for the recipe or simply changing the topic to one of the offender’s hobbies, Bulik suggests. “People respond brilliantly when you change the subject to the topic that they’re interested in,” she says.

If a loved one is struggling …

Know now's not the time.
If you’re worried about a loved one’s eating patterns, bite your tongue, Bulik says. Tell them you love them instead. “It’s really not the time to say, ‘You need more than that,’” she says. “Be gracious, focus on the person and try not to pollute the holidays with commentary about how much someone is or isn’t eating – unless they’ve asked you to help them.”

Use "I" statements.
If they have asked, voice your concerns using “I” statements that describe what you see, fear and hope, Cruze suggests. For example, “What I see is that you’re skipping your meals, what I fear is that you’re flipping into eating disorder behavior and what I hope is that you reach out to your treatment team to get the support you need,” she says. Then ask how you can help. “That’s very different from, ‘You need to eat your meal,’” Cruze says.

Don't talk about looks.
At Sexton’s first post-treatment holiday party, people told her how healthy and good she looked. All she heard was “you’ve gained weight.” “Being sick was an identity for me at that point; it became who I was,” she says. Try comments and questions that don’t involve appearance, Cruze says. “I love spending time with you,” or “How do you feel?” might work.

Don't focus on food.
Imagine you’re an ex-smoker in a room of people puffing and talking about how nice the cigarettes taste. “That would pluck your very last nerve,” Bulik says. The same goes for people trying to recover from an eating disorder, who don’t want to hear you raving over the mashed potatoes or complaining that you ate too much pie. “The goal with recovery is to have a healthy relationship to food and body,” Cruze says. “You want to normalize food as much as you can.”

Have fun.
​Instead of inviting your loved one to bake or go out to lunch, ask him or her to play a game, see a movie or take a walk. “Make them feel like they are normal because eating disorders can be very ​'othering' – even though they’re quite common,” says Brittany Shepherd​, a 21-year-old senior at George Washington University who has been in eating disorder recovery for two months.​​ "We really want to focus on connection because recovery is really about connection, Cruze adds.​

Be patient.
“People who are struggling aren’t the easiest to get along with,” Shepherd admits. They’re not going to get any easier to deal with over the holidays. “When you have an eating disorder, food is your No. 1 ​anxiety,” Sexton says. “So when you’re forced to face that fear nonstop, you’re going to be on edge and full of anxiety.” Her ​husband's ​best advice? Be patient.

Get educated.
A common concern among the patients Cruze works with is that their families don’t recognize the eating disorder or believe they need treatment. That attitude won't help. ​"Studies show that when a family is included in the recovery process, the recovery is stronger," she says. Shepherd suggests friends or relatives educate​ themselves ​by calling a physician, therapist or simply checking out resources such as the National Eating Disorders Association or the National Alliance on Mental Illness. Then, tell the person what you learn. “I guarantee it will make them​ feel so special that you took an extra five minutes to try to understand their condition better,” she says. “You can never really empathize, but you sure can sympathize.”

How To Cope With An Eating Disorder Over The Holidays was originally published on U.S. News & World Report.

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