Eating Disorders

By Manuel S. McCurley


For most people, the holiday season is a wonderful time of year. It is often a time of family reunion, socializing, and celebration - a time when families, friends, and coworkers come together to share good will and good food. The season is meant to be bright, happy, and full of the best of relationships. Yet, for those who suffer with eating disorders, this is often the worst time of the year. For those who are trapped in the private hell of anorexia, bulimia, or binge eating disorder, the Holidays often magnify their personal struggles, causing them great internal pain and turmoil.Over the past few years, during the Thanksgiving and Christmas holiday season I have felt horrible. I felt trapped and like the food was out to get me. I lied on endless occasions to avoid all of the parties and big dinners that go along with the holidays. I felt horrible about my body and did not want anyone to see me eat for fear they would make judgments about me." Eighteen-year-old woman These quotes from women suffering from anorexia, bulimia, and binge eating reveal the emotional intensity they feel during the holiday season. Their fear of gaining weight and becoming, in their minds, fat, gross, and disgusting, is the monster they must deal with every time they partake of any of the foods that are so wonderful and common to the holidays.

At Center for Change, we have asked many patients over the years to share from their private experiences what the Holidays have been like during the years they suffered with an eating disorder. The women quoted in this article are of different ages, but all suffered with the illness for many years. As you read the following passages you will feel something of the agony of suffering with an eating disorder at this festive time of year.

"My life with an eating disorder during the holidays is a living hell - constant hiding and fear, confused about life and hating every moment being surrounded by food. There was so much pressure, so many stares and glances, and days with endless comments. My whole life was a mess. There was so much pain and guilt inside of me and I didn't know where to turn, except to my eating disorder. I hated the pressure of eating the food, the constant worrying of offending others." -Twenty-two-year-old woman "It's hard to be around all the food and festivities. When I'm hurting inside and struggling with what "normal" food portions even are, I need the help, emotional understanding, and support of family and other people. "Handle with care, but please handle." Accept me the way I am. Let me back in the family" -Twenty-three-year-old woman.The Hidden Beast of Holiday Feasts Tales of Bulimia and Binge Eating.On the other end of the eating disorder spectrum, a woman with severe bulimia or binge eating disorder finds the holidays are a genuine nightmare because there is so much emphasis on food that they become preoccupied with it. Binge eating and subsequent purges become even more prevalent because many of the foods and sweets that are associated with holiday celebrations are very enticing to them. The holidays can be a time of convenient indulgence, but also a time of great shame and self-reproach because of their secret life. Some even use the binge eating and/or purging as a form of self-punishment throughout the holidays.

Women who suffer with binge eating or bulimia often live out this painful eating disorder hell in private and in secret, and often feel great self contempt. To many of their family and friends things may look positive and normal even while the sufferer feels significant despair and negativity about their loss of self-control. Those whose family members know about their eating disorder carry this awful feeling that they are the main attraction at the holiday dinner, where every trip to the food or to the bathroom is seen as a major defeat and disappointment to their family.Christmas is the hardest time with my bulimia. So much food, so much love, and so much joy, but I could not feel the love or joy, so I indulged in the food as a replacement. It was hard to see everyone so happy before I made the trek to the bathroom. I felt unworthy to be happy. I didn't deserve the love and joy. I've discovered that if I can focus on the love and joy, everything else falls into place" -Eighteen-year-old-woman

Some of the painful consequences of binge eating and bulimia are found in the time, planning, and dishonesty that is required to protect and cover up their eating disorder during the holidays. They often feel hatred for themselves for the ongoing deception to family and friends to excuse or explain their behaviors. In addition, they live in constant fear of being "found out" by their significant others, or in fear of continually letting others down because of their inability to stop their compulsive behaviors. Family and Friends - Turning Potential Triggers into Gifts of Support Holiday ideals epitomize what is good about family and other personal relationships. Activities during this time of year can involve family members and friends in intense and often emotional ways. Unfortunately, those with eating disorders can find it terrifying to be emotionally close with other people. In such situations they may feel vulnerable and unsafe, and then revert to their eating disorder to restore a sense of control and self-protection.

It can be helpful during the holiday season to break activities into smaller numbers of people, when possible.It is easier and less overwhelming to deal with five people than fifty people. Invite your friends or family members to participate in smaller, quieter, and less chaotic social activities and events. Simple talking and sharing as a small circle of family members or friends can do much to increase the sense of belonging and safety for someone with an eating disorder. Encourage your family member or friend to gather extra support around themselves during the holidays.

The following suggestions resulted from a survey question we asked patients in treatment: "What three suggestions do you have for family and friends who want to help the holiday season go a little better for a loved one suffering with an eating disorder?" The women offering these suggestions range in age from fourteen to forty-four, and their suggestions offer some valuable insight and understanding that could be helpful to you as a friend or a family member. Being compassionate about the struggles of the eating disorder illness can help make the Holidays less of a battle for those you love. The suggestions are: Do not make a big issue about what your loved one is eating. A little bit of encouragement is okay. - Do not focus too much on food, it may only fuel the eating disorder. - Ask her how she is doing and see if she needs any help. - Do not become angry about how the she feels, just do your best to support her. - Offer a lot of support and be aware of what may be creating anxiety and try and understand what she feels. Be understanding, kind, and supportive. - Spend quality time with your loved one. - Make sure that the primary focus of the holiday is not on the food but rather on the family and the valued time you will share together. - Allow for other activities that do not involve food, such as games, singing carols together, opening gifts, decorating, and spending time just talking together. - Allow her to make a dish that she would feel comfortable eating. - Before the Holiday itself, and before family gatherings, make agreements about how you can best help your loved one with food. Honor the agreements you make. - Do not give her loud and attention drawing praise when she does eat. - Do not talk about diets, weight loss, or weight gain. It causes great anxiety and may increase a felt need to engage in eating disorder behavior. - Do not stare. - Learn enough about the illness and the triggers to help your loved one develop skills as well as strategies to defy eating disorder thoughts and urges. - Know something about her struggles, triggers, and behaviors. Then, if you see those, you can approach her after a meal in private and suggest ways she might be helped in some of those behaviors and learn ways you can be helpful and supportive. - If you see her struggling, ask if she wants to talk, but ask this in private. - Focus on how she is feeling inside, what issues she is worrying about, what her fears are, what she needs, rather than just how much she is eating or not eating. - Try not to focus too much attention on the eating disordered behaviors. - Be patient and nurturing. - Treat her with love and respect no matter what is going on. - Let her know that she is loved. - Help her take her mind off of food by generating a conversation with her about general or important topics. - Don't allow her to excessively isolate. - Be there for her emotionally and physically with hugs and messages of love.

The importance of these quotes from clients in treatment for anorexia is found in their honest expression of the tremendous pressure and conflict they feel inside in response to the normal food and social activities of the season. Their internal suffering and pain are often hidden from those around them by their continual remarks about "being fat," or may also be hidden in their patterns of avoidance and withdrawal from social involvements."The secrecy and lying make it very difficult for me during the holiday season. I have to decide whether to restrict my food or to binge and then sneak away to purge." -Twenty-two-year-old-woman."Having an eating disorder during the holidays presents quite a contradiction in my mind. I anticipate all the food and get excited, while at the same time I dread the many family members around. I feel that the family is over to "watch". I know that they simply want to reach out and help, but I feel that a big help would be to make a concerted effort to shift the holiday focus from the food to the underlying purpose. I wish the food could be a minor deal, just an accessory to the holiday, rather than the focus." -Twenty-year-old woman

When going into a family or social event, especially if people are aware of the eating disorder problem, it is helpful that everyone talks honestly about what will help and what will not help during the event. Armed with this knowledge, family and friends can set up some structure around holiday activities that is agreeable to all parties involved. Give reassurance about your desire to "be supportive" of them without trying to control every problem. You can respond to their feedback about what may be helpful to them by making positive adjustments. It helps to express love, gratitude, respect, and acceptance for your loved one.

This is very helpful and it might make the victims of eating disorders feel more comfortable knowing that there are other people out there who are going through the same thing. Unfortunately, people are put under so much pressure to be thin by watching skinny celebrities all over the media be idolized. If they are being idolized does that means that they are good role models and their behaviors should be followed? No, most of the time, celebrities are not good role models. I believe that early childhood education is very important because I think that eating disorders start at an early age when children are naive and susceptible to being changed by others. Educating young kids about the media and how to criticize media is a very important step to reducing the number of people with eating disorders. Since media has such a big influence on eating disorders, children should be able to effectively criticize it and not fall victim to its schemes.




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