To many, the holidays are a much-anticipated time of love and togetherness. But for the 30 million people living with an eating disorder, the thought of holiday gatherings can trigger tremendous stress and anxiety. Navigating an abundance of food—and conversation about food—can be overwhelming for someone with an eating disorder.
In this Q&A, Newport Healthcare’s Kara Becker, LMFT, CEDS-C, National Director of Eating Disorder Programs and AAMFT Approved Supervisor, and Annaliese DiFabbio, RD, CEDS, Dietary Services Specialist, offer tips for managing holiday gatherings, whether you have an eating disorder or are hosting. They share best practices for planning, accommodating a guest with an eating disorder, and supporting a loved one during this special time of year.
What challenges do people struggling with or recovering from an eating disorder face?
Kara: For people with eating disorders, Thanksgiving can be the Super Bowl of all holidays. There can be a real or perceived pressure to present as recovered in addition to dealing with the chaos—and at times stress—that can accompany these holidays. Thanksgiving may be the first time in a long time, young people are seeing friends and family which may activate feelings of comparison and the need to be seen in a particular way. Also, our bodies change over time, and in our society, body and food comments are often made at holiday celebrations.
Annaliese: Holiday meals are usually comprised of foods we don’t typically eat, which can feel threatening and unfamiliar for people with eating disorders. Eating in abundance or ending up in a “food coma” is often normalized during holidays, which can contribute to disordered eating behaviors.
What are stressors people with eating disorders experience as they anticipate seeing family?
Kara: Our bodies are always evolving and changing, much like our environments and life situations. But if you haven’t seen someone for a while, they can become an unwelcome focus. Some young people, especially those who have been away at school, may be entering social or familial situations where they are likely to receive comments about any changes to their bodies, which can be anxiety-provoking.
Do you have advice for what “to say” or what “not to say” to someone with eating disorder?
Kara: For someone with an eating disorder, it is best not to make any comments about their bodies or their plates! It’s more helpful to focus comments or compliments on other areas of their identity, such as what they are studying in school, their friendships or relationships, or any other topic you know is easy for them to talk about. Thanksgiving and any holiday setting is not the time for hard-hitting decisions – those should be saved for family therapy!
How can someone with an eating disorder prepare to navigate family conversations?
Kara: We teach our clients to have a “cope ahead” plan. If there are certain comments or conversations that they know are likely to arise and trigger them, they can have a plan in place to manage those situations. The plan could be giving “the look” to a trusted cousin who will help you exit a tough interaction and step outside with you for a few minutes. It could also include making a list of conversation starters to help ease the social aspects of the meal. Or it could look like practicing radical acceptance—knowing that what others think and feel about their bodies is not how you have to think and feel about yours.
What are some best practices for hosting someone with an eating disorder?
Kara: Assigning seats at the table is one simple but effective strategy. If the host knows there are certain guests who are more likely to be triggering for the person with an eating disorder—a cousin who won’t stop talking about working out or an aunt who is always speaking about weight loss—they can make sure they’re on opposite sides of the table. Also, providing to-go containers gives a signal to guests that it’s okay to take food home and not have to consume all the food on their plate. Having a casual dress code is also supportive, to avoid additional stress around appearance and body image. Another approach is to simply ask them what they need and how you can best support them.
Annaliese: Having to-go containers is a great option and can feel supportive to someone who is trying to honor their fullness cues. However, it’s important not to pressure your loved one into taking leftovers home. You may be asking them to take foods that are challenging for them, so offer, but don’t push.
Should I plan to accommodate the family member/guest with a dish request?
Kara: This will depend on your relationship with the person. Whether you decide to make them something special or not, it’s important not to take it personally if they choose not to eat what you’ve made. For some people, just sitting at a table full of food may be challenging.
Annaliese: It can be helpful to let your loved one with an eating disorder know the menu in advance—as well as offer a special food accommodation. Knowing this information ahead of time can reduce anxiety around the unknown and allow them to set realistic goals or expectations for the meal.
Eating Disorder Treatment in Minnesota and Nationwide
You don’t need to maneuver disordered eating alone; we can help. Newport Healthcare and PrairieCare address eating disorder symptoms while treating primary mental health conditions, such as anxiety, depression, low self-esteem, and trauma. Our clinical teams work with you or your child to heal from disordered eating with a tailored treatment plan that includes comprehensive nutrition assessments and clinical care.
Across all of our eating disorder programs, we use a foundation of Family-Based Therapy. This approach gives families the tools to play an active role in supporting their loved ones, which has been proven to be an effective way to recover from an eating disorder. During this time, we help young people manage their physical and mental health through therapeutic and educational experiences that enable them to build lifelong resilience.
We offer the following options for care:
- Minnesota: PrairieCare’s specialized Healthy Eating and Living (HEaL) program is the only Partial Hospitalization Program (PHP) in Rochester that helps teens and their families heal from disordered eating. To get started, call us at 952-826-8475.
- Nationwide: Newport Healthcare’s outpatient and residential programs for teens aged 12–18 and young adults aged 18–35 address these underlying issues through tailored treatment plans. Contact us today at 866-675-0597.
Together, we can help you find the proper care that can make a difference. Get started today.