For most people, Christmas is a time of happiness, excitement and the one time of the year when we can put all our problems to one side and enjoy spending time with our loved ones. The most wonderful time of the year.
Christmas is a difficult time for people living with eating disorders
But for the 1.25 million people in the U.K. who have an eating disorder, it can be the darkest and most isolating time of the year.
When we think of Christmas, we think of indulgence - carelessly consuming chocolates, drinking red wine like it’s going out of fashion and piling up a plate of carbs without guilt. Because it’s Christmas…
This, however, is one of the scariest situations imaginable for someone whose thoughts and behaviours are consumed by an eating disorder.
Being able to eat, drink and indulge guilt-free on the 25th December and in the time leading up to it, is what Christmas is all about for most. But eating disorders don’t take the day off for Christmas and they don’t sympathise with the festive season. In fact, they only get worse. Because for people with eating disorders, this time of the year is the most mentally challenging of all.
Caroline Price is the Director of Services at BEAT; the UK's leading charity supporting those affected by eating disorders and campaigning on their behalf. I spoke to her to find out why Christmas is a particularly challenging time for people with eating disorders, how family and friends can support people with eating disorders during the festive season, and the kind of support that BEAT offer for both carers of, and those struggling with, the overwhelming mental illness.
“There is a common myth that people with eating disorders don’t eat anything - that they’re starving themselves. That’s not true. It’s a fear of gaining weight - for people with bulimia and binge eating disorders it’s a fear of being around food. These are people who eat to help cope with their emotion, and then engage in behaviours such as self-induced vomiting or over-exercising to purge, because of the feelings of guilt and shame that comes with it (eating).
“People tend to focus on anorexia when they think of eating disorders. At BEAT, we know there are a lot of people who are suffering.”
The term eating disorder is not just confined to anorexia. Although anorexia has the highest mortality rate of any mental illness, eating disorders also come in the forms of bulimia, binge eating disorders, emotional overeating, OSFED (other specified feeding or eating disorder) and ARFID (avoidant/restrictive food intake disorder).
Eating disorders - like all mental illnesses - can affect anyone, regardless of gender, age and ethnicity. They can also be overcome. The sooner treatment begins for eating disorders, the more likely recovery without relapse can be sustained. But it is important to know that no matter how long a person has lived with an eating disorder, it is absolutely possible to overcome them.
The lead up to Christmas is just as anxiety provoking as the day itself. With a focus on eating out and overindulging in food, any Christmas-related event can be highly distressing for a person living with an eating disorder. Social events, family gatherings and work parties are all centred around food. For people who engage in eating disorder behaviour, they find themselves planning, restricting and compensating to minimise the mental distress as much as possible. However, these ‘coping mechanisms’ are all part of an extremely vicious cycle which can lead to further problems.
It’s not just food alone that creates a significant amount of angst for sufferers of eating disorders. Caroline says that there are certain traits that come with eating disorders that can also trigger emotional and mental distress.
“There is an expectation of Christmas being a happy time of the year. A lot of the time, people with eating disorders are perfectionists, they strive for the best, and put a lot of pressure on themselves.
“The way that Christmas is commercialised, there is pressure to have a “perfect Christmas”, which includes not upsetting family. The rest of the year they can get by by avoiding, but Christmas is put upon them. The sole focus tends to be around food - that’s how society is.”
Reducing the risk of triggering situations for a person with an eating disorder is very important. If a carer, family member, or friend is aware and understands the disorder, this means they can act accordingly to avoid putting any pressure on a person in an eating situation. Family members who they haven’t seen for a long time might unintentionally put their foot in it, so it’s important to be aware of how to approach certain situations.
“One thing that our helpline hears from carers and people with eating disorders, is how to get through the Christmas period without it causing problems for the rest of the family.
“Commenting on how well somebody looks or how much food on their plate can be a trigger, leading to high anxiety.”
There is a clear link between Christmas and an intensified struggle for people with eating disorders. Last year, BEAT’s helpline received just under 300 calls on Christmas day.
“Eating disorders don’t take a day off, so neither do we” says Caroline.
“From Christmas Eve to the 1st January we are open from 4 until 8. For those who got in touch last year it was a time of extremely high emotion - some were at the point of suicide. A lot of people don’t expect a charity to be open over Christmas, but I dread to think what would have happened to some of those people who reached out last year if they didn’t have someone to turn to.
“Knowing there’s someone who won’t judge, that’s impartial and confidential, is so important.”
Understanding the nature of eating disorders and the behaviours that come with it is key to alleviating some of the distress around Christmas. Caroline says that there are things that family and friends can do, in order to minimise the distress.
“What we try to do in the lead up to Christmas is help people who call us on how to prepare, to reduce some of the anxiety of the situations they’re thrown into by planning ahead, to have open communication.
“One thing that works for some people is to be involved in what is eaten - to allow them to be a part of the cooking process and to prepare their own food, serve up their own portions so they’re not faced with a mountain of food piling up their plate.
“A lot of people have meal plans that they feel comfortable eating, but at Christmas, these meal plans go out the window. The strong eating disorder voice which tells them to restrict or compensate for the food can cause family argument, isolation and avoidance.”
One way for a sufferer to minimise the struggle is to practise distress tolerance activities. These are things that people can do to alleviate stress.
“Mindfulness, downloading an app, colouring books are all helpful ways to reduce stress and anxiety. Some people write poetry - creative outlets that use a different part of the brain allow people to take themselves away from eating disorder thoughts that consume them.
“Knowing when you’re feeling the urge to binge and purge, or for people with anorexia, having very restrictive thoughts, calling a friend and being honest about the struggle, can also alleviate the distress.
“Going for a mindfulness walk with friends will work for some people, too. People know themselves and what does and doesn’t work for them.”
Mindfulness has become an increasingly popular strategy in managing stress - for all people, not just those who struggle with mental illness. Self-help books, meditative apps and calming exercises like yoga work for a lot of people in decreasing the pressures of everyday life.
Mindfulness techniques and introducing self-compassion, self-love, and self-care, is another outlet which BEAT are promoting to people, if it works for them.
Caroline says that not everything is going to work for everyone, but having a go and finding something that does work is well worth it.
“People with eating disorders are generally very critical and hard on themselves, so practising self-love is a good starting point. Doing something just for yourself, whatever that might be. You may have had a bad day engaging in eating disorder behaviour, but remind yourself that you’re doing your best. Christmas is a tough time, and that’s understandable.”
BEAT offer a free helpline, youthline, and student line for anybody in need of an understanding, confidential and impartial chat. They also offer services such as online support groups, one-to-one video calls, and regulated pro-recovery support services. For more information on BEAT and the services that they offer, click here to go to their website.
BEAT helpline: 0808 801 0677
BEAT youthline: 0808 801 0711
BEAT student line: 0808 801 0811
Tagged in Mental Health