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Are Holidays Scary for People with Eating Disorders?
Dave Chawner used to starve himself for days before facing Christmas dinner at home in England. He expected to binge his way through the meal and felt that his body needed preparing. “I viewed these events like marathons,” says Chawner, now 25. “I knew I wouldn’t be able to resist the lure of such incredible festive food.”
And he was right: “When our family came round, all the food was laid out—Christmas cakes, chocolates, meats. It genuinely felt like I was possessed: I was stuffing food in my mouth. I wasn’t even chewing anymore. I was swallowing sausage rolls whole, trying to cram them in. I couldn’t stop.”
Doctors recommend that people with anorexia, bulimia or binge-eating disorder (BED) try to eat “normally” on a structured “food plan” in anticipation of the season’s table-buckling spreads—but that’s much easier said than done.
The obligatory feasts that take place at this time of year involve, by unshakable decree, an incredible quantity of food—and we’re shut in for hours, sometimes days, with just the people and predicaments that probably made eating so stressful in the first place.
Also, holiday menus feature naughty food. Amy Pershing, whose Pershing Turner Centers treat people with eating disorders in Ann Arbor, MI and Annapolis, MD, says that people go on eating rampages during Thanksgiving, Christmas, Hanukah or New Year’s specifically because they are trying to resist the decadence. “It might be that certain foods are forbidden by the ‘eating disorder voice,’” she says, “thus making a binge of scarcity more likely—i.e. ‘I don’t allow myself these foods any other time, so now is my chance.’”
It might be that certain foods are forbidden by the ‘eating disorder voice,’ thus making a binge of scarcity more likely—i.e. ‘I don’t allow myself these foods any other time, so now is my chance.’-Amy Pershing
Kelsey Osgood has had it with seasonal food-mania. She published a memoir about her own eating disorder and her success at conquering it, to some degree: “I feel like now, even though I don’t restrict my calories at all, I still have resentment towards times where we engage in culturally sanctioned binging,” she says. “When there’s an expectation––or even pressure––that a person eat beyond their comfort level, it kind of ends up not being fun.”
Others describe feeling hemmed in by the “fat talk” that classically picks up over the holidays. These are the conversations where people, stereotypically women, pinch their own belly rolls and call each other skinny:
“Oh, I can’t eat that. I’m so fat!”
“No, you’re not. Look at you in that dress. Now I’m the one who really needs to get to the gym.”
People suffering from serious eating disorders often feel compelled to participate in these circular little chats, i.e. to say out loud what they are already thinking about all the time.
The US National Eating Disorders Association says that 20 million women and 10 million men will have a “clinically significant” eating disorder during their lifetime. A 2011 study by the National Institute of Mental Health found that 0.3 percent of American teenagers have anorexia, while 0.9 percent have bulimia and 1.6 percent have BED.
BED is just as common among men as women; it was included last year for the first time in the latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The other two disorders are disproportionately female.
The goal of treatment is obsessing less about food or thinness or fatness and instead getting used to eating regular meals three times a day—this being one of those cases of addiction-type behaviors where abstinence is unfeasible.
Talking cures such as cognitive behavior therapy (CBT) can help to sort out body-image confusion. Sometimes antidepressants or antipsychotics are prescribed to people with anorexia (although it’s not clear yet that either of these work). There also may be some physical care required, to try to undo the toll of eating disorders on one’s body and/or teeth.
People who are severely ill with eating disorders are usually better off avoiding the holiday gorgefests altogether—but experts recommend three basic tips for those who do participate:
- Pause briefly when the urge comes to stuff your face.“My therapist suggested taking five minutes between the impulse to eat sugar and taking the action—to evaluate my feelings and to see if maybe the feeling passes,” says Grace, an actress and writer in her 20s. “Or I’ll just hide in the bathroom for a bit and text some friends or dick around on Facebook.”
Amy Pershing sometimes invites her patients to “play the tape to the end” while pausing: “Go through the binge experience in your mind: the eating of the foods, how you will feel during the binge, immediately after, and then the next day. Is it worth it?”
Joy Jacobs, a psychiatrist in San Diego, suggests filling the time with music, deep breathing or calling a friend, as long as it’s pleasant. The logic is clear enough: “If you don’t take that first bite of the binge,” says Jacobs, “then the binge does not happen.”
- Change up your holiday routine.
Look around for something to do that isn’t entirely food-focused and is in some way significantly different from last year. If Christmas is traditionally a dud, break the mold. “Instead of bonding over drinks or food, I’ll go for a run or a long walk with my family, mainly my dad,” says Grace. “It creates memories without guilt or a hangover, but it still feeds our competitive streak.”Lizzie Boyle, 30, recalls with some delight the year her parents decided to have Thanksgiving dinner in a restaurant, instead of at their home.
“I was very happy about this because the holiday that usually lasts all day would be cut down to the few hours spent in the restaurant,” says Boyle. “Plus, we wouldn’t be forced to eat leftovers for the next five days. I was happy to be able to choose my own plate and not be sitting across from my dad as he piled the gravy-laden mashed potatoes onto my plate.”
The extra bonus for Boyle of having Thanksgiving at a restaurant was that she was able to throw up all that food into a toilet in the anonymous restaurant bathroom…
Just because she felt better feasting in a public place didn’t mean she had conquered her eating disorder; far from it. The extra bonus for Boyle of having Thanksgiving at a restaurant was that she was able to throw up all that food into a toilet in the anonymous restaurant bathroom without worrying that her parents might find out.
Change is slow. People are ashamed of themselves for losing control of their eating and embarrassed in front of others, although not in a way that necessarily makes sense. Dave Chawner, for instance, explains: “Anorexia is such a competitive disease that you worry that you are not anorexic enough” to deserve treatment.
Adds Kelsey Osgood, “Even though I felt it would draw more attention to me if I were eating nothing in front of others, I still couldn’t get past the embarrassment of admitting to having an appetite.”
- Have a real plan.
Most of the over- and under-eaters interviewed for this article say the worst of their habits are behind them, but the holiday meals up ahead are loaded with pitfalls, nonetheless. They feel they need to impose some order on the mess, for better or worse.Emma O’Brien, 31, is focused on her family’s annual Christmas visit to see her aunt. “She always lays out food, and I always, always get a huge tin of chocolates,” says O’Brien. “I’m planning already how I can spread a calorie allowance across all of these things while not arousing suspicion.”
Osgood says she is doing her best to remember that Christmas is not her last “big” meal: “During the holidays, I find myself grappling with the urge to eat rapidly and past the point of satiety because I have this leftover anorexic fear that some day, maybe soon, this food will be inaccessible to me. It’s like I feel it’s my last chance to have cheese, let’s say, and I often have to mentally remind myself that I’m not in danger anymore.”
Chawner is better and better, in large part, due to his therapeutic career of performing stand-up comedy routines that include tales about his eating disorder. And as Christmas and the sausage rolls approach, he finds himself on a waiting list for entry into one of the UK’s best eating disorder treatment facilities.
Still, he worries about going home. Reached by email about a month before his family was scheduled to gather yet again for the meal of the year, Chawner said the event was front and center in his mind: “I am not going to lie; I am already scared.”
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