Handling Eating Disorders During the Holiday Season

“Eating disorders over the holidays are a living hell for me because I am constantly hiding and afraid, confused about life and hate every time that I am around food. So many people were staring and glancing at me, and I was bombarded with comments for days. My entire existence was in shambles. I was in so much anguish and guilt that I had no choice but to turn to my eating habit for comfort. The stress of having to eat and the fear of offending others were the worst parts of the experience”

The holiday season is a lovely time of year—  Festivities and socializing are typical at this time of year – as families and friends gather for food and fun. The season is meant to be a time of joy, happiness, and love. Nonetheless, the holidays may be a stressful time for many people with eating disorders. People who suffer from anorexia, bulimia, or binge eating disorder may find that the Holidays exacerbate their symptoms, which can lead to even greater psychological anguish and suffering. Possibly owing to the stress of the upcoming festivities and/or the prospect of the availability of tough (typically high calorie) foods in the weeks ahead.

Why are holidays such triggers?

Anxiety-inducing events such as holiday feasts have been found to be powerful triggers for people with eating problems. There’s evidence to support this theory, as research reveals that women with bulimia’s brains respond differently to eating when they’re under pressure than those who don’t suffer from the disorder. As a matter of fact, the design of holiday gatherings tends to raise the risk of holiday binging. People spend days running up to Thanksgiving either excited or worried about overeating at the Thanksgiving Day dinner. People with eating disorders are more likely to overindulge on Thanksgiving because the stress of either refraining or giving in to this delightfully gluttonous celebration may trigger more disordered eating for them. Anxiety surrounds holidays, especially since people suffering from eating disorders find it hard to conceal their challenging behaviors.   

“With my bulimia, Christmas is the most difficult time of year. Love and joy were all around, but they weren’t there for me, so I turned to food as a substitute. Before I made my way to the bathroom, I found it difficult to watch everyone in such good spirits. Because I felt unworthy of happiness, I was unable to enjoy it. Love and happiness were not mine to receive…”

You can get through it– When it comes to self-care, the holiday season is a great time to remember that. You need to figure out what is most likely to keep you grounded and unaffected. Taking care of oneself takes on various forms for various people. Allow yourself the freedom to do whatever it is that you need and whenever it is that you need to. Also, self-care is about being kind and forgiving to oneself. Allow yourself grace, avoid negative self-talk, prioritize connection with others or re-explore things you enjoyed prior to developing an eating disorder. What matters most is that you have a trusted friend or family member to turn to when things get tough.

How can loved ones offer support?

Avoid discussing diets, food, or weight in conversation. During Thanksgiving, it’s easy to casually comment on how “full” one is or how one will require a post-dinner workout. For someone who suffers from an eating issue, these kinds of remarks can be quite upsetting. Not only should you refrain from criticizing their appearance (even if it’s complimentary), but you should also refrain from urging them to consume more food. Again, these actions can be detrimental rather than beneficial. Set aside time for non-food-related activities. Going out to see the Christmas lights, playing board games, and watching movies can all be done without regard for food. 

Become familiar with the person’s specific disorder—the causes, the difficulties, and the coping mechanisms. You’ll be able to better understand their actions if you learn more about them.   Remind them of your love and affection. There are many ways you may show your support, from hugs and warm words to more subtle gestures such as making sure they’re part of the conversation and activities they’re a part of. The most important thing to remember is that you can only modify your own behavior, not theirs. You may help someone by supporting them in their journey, even if it means allowing them to make mistakes or face obstacles. By just being as thoughtful, empathetic, and observant as possible, you can assist them at every step.

References

Collins B, Breithaupt L, McDowell JE, Miller LS, Thompson J, Fischer S. The impact of acute stress on the neural processing of food cues in bulimia nervosa: Replication in two samplesJournal of Abnormal Psychology. 2017;126(5):540-551. doi:10.1037/abn0000242

Managing Holiday Meals When You Have an Eating Disorder. (2021, January 5). Verywell Mind. https://www.verywellmind.com/managing-holiday-meals-without-eating-to-excess-1138294.

Eating Disorders And Holidays – Mirror-Mirror. (2020, June 11). Mirror-Mirror. https://mirror-mirror.org/recovery/eating-disorders-and-holidays.

Christianson, D. (2019, October 18). 5 Tips for Coping With an Eating Disorder During the Holidays. Center For Discovery. https://centerfordiscovery.com/blog/tips-eating-disorder-during-the-holidays/.

How To Support Someone With an Eating Disorder During the Holidays | ResponseCenter. (n.d.). How to Support Someone with an Eating Disorder During the Holidays | ResponseCenter. https://www.jcfs.org/response/blog/how-support-someone-eating-disorder-during-holidays.

Coping With A Loved Ones’ Eating Disorder During the Holidays. (2006, October 18). Center for Change. https://centerforchange.com/coping-loved-ones-eating-disorder-holidays/.

Body Image

Throughout our childhoods, we are exposed to a wide range of absurdities, and these experiences shape our views of what is and isn’t acceptable. We take up on what society has essentially established as right or wrong. We are subconsciously influenced by society’s standards and norms. Body image differs according to society. Many of us internalize messages about body image beginning in childhood, which can result in either a favorable or negative body image.

Concerns over one’s body image frequently begin at an early age and could last a lifetime. By age 6, girls begin to show concerns about their personal weight and shape–expressing anxiety about their weight or risk of becoming obese. Additionally, nearly half of adolescent females and nearly a third of adolescent males engage in hazardous weight-loss habits such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives. It’s crucial to remember that each person’s experience with body image issues is unique, thus the onset age might vary widely.

What does body image mean?

The term “body image” refers to the collection of ideas and emotions about one’s body. Body image experiences can range from favorable to negative, and an individual may feel positive, negative, or a combination of the two at various times. Internal and external elements both influence body image. Your perceptual body image is how you perceive your body. This is not necessarily an accurate depiction of your true appearance. Your affective body image is how you feel about your body. While feelings can range from delight to disgust, they are sometimes summarized as your level of contentment or discontent with your shape, weight, and individual body parts. A person’s mental representation of their body is known as their cognitive body image. This might result in an obsession with one’s body shape and weight. Behavioral body image refers to the actions that you take because of your body image. When a person is unhappy with their looks, they may isolate themselves or engage in unhealthy behaviors in order to alter their appearance.

Positive body image means having a clear, accurate view of your shape; perceiving the various aspects of your body for what they truly are. Accepting one’s natural body shape and size and realizing that appearances have little bearing on one’s character or value as a person are all components of body positivity (or body pleasure). In contrast, having a skewed view of one’s body shape is indicative of having a negative body image. Feelings of shame, anxiety and self-consciousness accompany negative body image (or body dissatisfaction). Negative body image can also arise as a result of weight stigma, muscularity, sexual functionality, scars, noticeable face or physical differences, handicap, or changes in the body as a result of medical treatments or disease.

Individuals who have a high level of dissatisfaction with their bodies believe their bodies are imperfect in contrast to others, and these individuals are more likely to experience depression, isolation, low self-esteem, and eating disorders. Anorexia and bulimia aren’t caused by a single thing, but research has shown that body dissatisfaction is the most common factor in the development of both.

Body dissatisfaction

When a person has chronic negative thoughts and feelings about their body, this is referred to as body dissatisfaction. Although dissatisfaction with one’s looks is an internal emotional and cognitive process, it is influenced by external influences such as pressure to conform to a particular appearance ideal. Dissatisfaction with one’s appearance can motivate individuals to engage in unhealthy weight-control behaviors, most notably disordered eating. As a result, they are at an increased risk of developing an eating disorder. It is worth noting, however, that the majority of people who have body image problems or dissatisfaction do not have eating disorders, and some people who do have eating disorders do not have body image concerns.

In Westernized countries, body image dissatisfaction has become a major concern for adolescent health. More than 60 percent of females and 30 percent of males in the United States suffer from body dissatisfaction, which is a particular focus for adolescent health practitioners. In the 1980s, researchers around the world began studying the impact of a negative body image on eating disorders. Since then, the amount of research on body image has expanded tremendously. Many of these studies reveal that the type and degree of body image problems vary according to characteristics such as gender, age, ethnicity, peers, family, personal experiences, and socio-cultural influences. These studies provide a good starting point for further research. Women in Western cultures appear to be at the greatest danger, while those in non-Western cultures appear to be at the lowest risk, albeit this is more owing to a lack of relevant studies than a scientific conclusion.

A person is said to have a positive body image if they can accept, enjoy, and respect their physical appearance. You can feel unsatisfied with some elements of your body, but still, be able to accept it for what it is. This is not body contentment. In order to maintain a healthy body image, it is important to recognize and avoid the artificial and unattainable ideals of beauty and thinness depicted in the media. A healthy body image does not ensure good mental or physical health, but it can provide a protective barrier against poor self-esteem, disordered eating behaviors or yo-yo dieting, and, perhaps, other mental health issues such as depression, anxiety, and body dysmorphic disorder.

It’s becoming more and more common for people of various sexes, ages, genders, ethnicities, abilities, etc., to embrace their bodies as they are. Body variety must be embraced and all bodies recognized as valuable. In order to cultivate a healthy body image, it is important to understand and respect one’s natural shape, and then replace negative thoughts with positive ones that are affirming and accepting.

References
Greene, S. B. (2011). Body Image: Perceptions, Interpretations and Attitudes. Nova Science Publishers, Inc.

“Body Image & Eating Disorders.” National Eating Disorders Association, 22 Feb. 2018, https://www.nationaleatingdisorders.org/body-image-eating-disorders.

Body Image. (n.d.). Body Image. https://nedc.com.au/eating-disorders/eating-disorders-explained/body-image/.

Athletes and eating disorders

When it comes to eating disorders, young athletes are particularly susceptible. Gymnasts, runners, ballerina, bodybuilders, rowers, wrestlers, jockeys, dancers, and swimmers are more vulnerable. There has been an increase in studies into eating disorders in athletes during the previous two decades. Over one-third of female Division 1 NCAA athletes reported having attitudes and symptoms suggestive of anorexia nervosa, according to research. While the majority of athletes with eating disorders are female, male athletes are also at risk—particularly those who compete in sports that place a premium on nutrition, appearance, size, and weight requirements, such as wrestling, bodybuilding, crew, and running.

While athletics are an excellent method to develop self-esteem, increase physical fitness, and teach the value of collaboration, not all sporting pressures are beneficial. The pressure to win combined with a concentration on body weight and shape can be lethal. Competition in the arena of athletics can also have a detrimental effect on one’s mental and physical health. When the pressures of athletic competition are combined with an already prevalent cultural emphasis on thinness, the likelihood of athletes developing disordered eating increases.

There is a correlation between eating disorders and disordered eating, although they are not always the same. While all eating disorders are characterized by disordered eating, not every disordered eating meets diagnostic criteria for an eating disorder. When the term “disordered eating” was initially coined, it was considered a component of the female athlete triad – a diagnosis that also includes low bone mineral density and osteoporosis – and was characterized as “a broad spectrum of detrimental and frequently unproductive eating practices adopted in attempts to shed weight or achieve a lean appearance.” Later, the term “inefficient energy availability” was adopted to represent the function that insufficient energy plays in accounting for all physical activity, as well as in fueling regular biological processes such as growth and development, as well as in maintaining health.

Eating disorders are prevalent in all sports, but not equally so. As is the case in society, eating disorders are more prominent in women than males in athletics. One area where research findings are more conclusive is in “lean” sports, in which it is considered that a thin/lean physique or low weight provides a biomechanical advantage in performance or in performance evaluation. Women participating in these sports are thought to be the most vulnerable.

Athletes may face more stress than non-athletes because they must deal with not only the transition away from home and the responsibilities associated with college academic requirements, but also with the pressures involved with sport participation. Eating disorders are frequently used as a coping mechanism for such pressures. As society and culture place a premium on the “thin ideal,” comparable pressures exist in the sporting environment regarding being thin/lean and its alleged beneficial effect on athletic performance. This emphasis on body weight/fat loss to improve athletic performance may result in weight pressures from coaches (or even teammates) on the athlete, increasing the likelihood of restrictive dieting, as well as the adoption of pathogenic weight-loss strategies and disordered eating. Even the athlete’s notion that her coach believes she should lose weight can exacerbate weight-related pressures and raise the likelihood of developing disordered eating.

Athletes who wear exposing uniforms may be more self-conscious about their bodies and more likely to engage in unhealthy weight management measures. According to research, 45 percent of swimmers said their swimsuits were a stressor. Volleyball players’ self-esteem and performance were significantly impacted by their revealing outfits, according to a new study.

Female student-athletes have a more complicated relationship between body image and body dissatisfaction than the overall population. Disordered eating or an eating disorder can arise in either or both of sportswomen’s two body images, one in sports and one outside of sports. It’s also possible that a female student-athlete may feel uncomfortable about being viewed as too muscular based on cultural norms about femininity because she has a body that promotes sports performance but doesn’t fit the socially preferred body type.

Sports environments may also misperceive eating disorder symptoms such as diets, weight loss, and excessive training as “normal,” and personality characteristics/behaviors comparable to those of eating disorder patients, such as perfectionism and excessive training, as “good athlete” features.

In athletes, even mild variations of eating disorders should be treated immediately because they can have a negative impact on both their health and their ability to perform. For coaches and trainers, practical guidelines are provided on how to recognize the physical indicators of eating disorders as well as their psychological and behavioral manifestations. Athletes should be able to get the proper treatment and assistance when they need it through strong preventative and screening programs.

References

“Eating Disorders & Athletes.” National Eating Disorders Association, 27 Apr. 2018, https://www.nationaleatingdisorders.org/eating-disorders-athletes.

NCAA.org – The Official Site Of the NCAA. (n.d.). NCAA.org – The Official Site of the NCAA. https://www.ncaa.org/sport-science-institute/mind-body-and-sport-eating-disorders.

David M. Garner, Lionel W. Rosen, Declan Barry, Eating Disorders Among Athletes: Research and Recommendations, Child and Adolescent Psychiatric Clinics of North America, Volume 7, Issue 4, 1998, Pages 839-857, ISSN 1056-4993, (https://www.sciencedirect.com/science/article/pii/S1056499318302153)

Eating disorders

“…compulsive eating is basically a refusal to be fully alive. No matter what we weigh, those of us who are compulsive eaters have anorexia of the soul. We refuse to take in what sustains us. We live lives of deprivation. And when we can’t stand it any longer, we binge. The way we are able to accomplish all of this is by the simple act of bolting — of leaving ourselves — hundreds of times a day.”

 — Geneen Roth, Women, Food and God: An Unexpected Path to Almost Everything

According to the American Psychological Association, eating disorders are behavioral problems marked by severe and persistent disturbances in eating patterns, as well as upsetting thoughts and emotions. 70 million people worldwide are estimated to suffer from an eating disorder, according to the World Health Organization (WHO). Women between the ages of 15 and 35 are particularly susceptible to eating disorders.

Typically, eating disorders emerge throughout adolescence or early adulthood. Anorexia and Bulimia are rare disorders that develop before puberty or after the age of 40. 90% of instances are diagnosed before the age of twenty, while less than 10% of all cases occur before the age of ten. Clearly, adolescent stressful events, such as self-consciousness, puberty, and peer pressure, can contribute significantly to the onset of these diseases. An eating disorder frequently begins as a result of a stressful life experience. This could include exposure to violence, family conflict, school-related stress, or loss. It does not appear to be related to someone’s race or socioeconomic background. Rather, these conditions affect people of all ages and socioeconomic statuses.

Preoccupations with food, weight, or shape, as well as worry about eating or the consequences of consuming specific foods, are common symptoms of eating disorders. Restrictive eating or avoiding particular meals, binge eating, purging by vomiting or laxative usage, or compulsive exercise are some of the behaviors associated with eating disorders. Addiction-like behavior can be a result of these habits. They frequently co-occur with other psychiatric disorders, most frequently mood and anxiety disorders, obsessive-compulsive disorder, and issues with alcohol and other drugs.

It’s important to know that there are many different types of eating disorders like anorexia nervosa, bulimia nervosa, binge eating disorder, avoidant restrictive food intake disorder, other specified feeding and eating disorder, pica, and rumination disorder. Anorexia, bulimia, and binge eating are only some of the most common.

When anorexia nervosa–also known as anorexia–is diagnosed, the patient has an unusually low body weight, a strong fear of gaining weight, and an excessively distorted perception of weight. Individuals suffering from anorexia place a great premium on maintaining a healthy weight and shape, often by severe measures that significantly disrupt their lives. People with anorexia often drastically restrict their food intake in order to avoid weight gain or to maintain their weight loss. Vomiting after eating or using laxatives, diet pills, diuretics, or enemas as laxatives are two common methods of restricting caloric intake. Excessive exercise may also be used as a weight-loss strategy. However much weight is dropped, the worry of gaining it all back persists in the person’s subconscious mind. In the end, anorexia isn’t truly a food-related disorder. It’s a dangerous and potentially lethal technique to deal with emotional issues. It’s common for people with anorexia to see thinness as a sign of self-worth.

Bulimia Nervosa; People with bulimia may surreptitiously eat enormous amounts of food and then purge, seeking to get rid of the excess calories in an unhealthy manner. People with bulimia utilize a variety of strategies to burn calories and avoid weight gain. It’s possible that after a binge, you’ll self-induce vomiting or take laxatives or weight-loss pills, or diuretics. Fasting, severe diets, or intense activity can also be used to burn calories and prevent weight gain.

Binge eating disorder– characterized by recurring bouts of overeating. Binge eating is characterized by feelings of inadequacy during the binge, humiliation, sadness, or guilt afterward, and the absence of unhealthy compensatory behaviors (e.g., purging). It’s the most frequent eating disorder in the United States, according to the CDC. It is one of the most recently identified eating disorders in the DSM-5.

Avoidant restricted food intake disorder – is characterized by an abnormal pattern of eating that results in a prolonged inability to achieve nutritional requirements and severe selective eating. ARFID is characterized by food avoidance or a restricted diet. Infancy or early childhood is a common time for food avoidance or restriction to begin, and it may continue until adulthood. However, it can begin at any age. ARFID can have a negative influence on families regardless of the age of the person afflicted, resulting in greater stress during mealtimes and other social eating situations.

Causes of Eating disorders

Eating disorders are extremely complicated illnesses, and scientists are constantly discovering their origins. Although eating disorders are always associated with food and weight difficulties, the majority of specialists now believe that eating disorders are triggered by individuals attempting to cope with overwhelming feelings and painful emotions through food management. Regrettably, this eventually has a detrimental effect on a person’s physical and emotional health, self-esteem, and sense of control. Some people are more likely to develop an eating disorder because they have a genetic predisposition, but these diseases can also affect people who have no family history of the problem.

An idealized body type in the culture places unnecessary pressure on individuals to meet unattainable norms. Thinness (for women) or muscularity (for men) is frequently associated with popularity, success, attractiveness, and happiness in popular culture and media imagery. When it comes to young people, peer pressure may be a tremendous motivator. Pressure can manifest as teasing, bullying, or scorn based on one’s size or weight. A history of physical or sexual abuse may also contribute to the development of an eating disorder in some individuals. Emotional Well-Being—Perfectionism, impulsive conduct, and problematic relationships can all contribute to a person’s low self-esteem and predispose them to develop eating disorders.

Various treatments are used to treat eating disorders. Individualized treatment regimens for eating problems are available. You will almost certainly be assisted by a team of providers, including doctors, dietitians, nurses, and therapists. Psychotherapy, medication, nutritional counseling, and weight loss monitoring may all be used as therapies.

References

WHO- The Gender and Health Reserach Series, pdf

Mayo clinic- Eating disorders

Eating Disorders | NAMI: National Alliance On Mental Illness. (n.d.). Eating Disorders | NAMI: National Alliance on Mental Illness. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Eating-Disorders.

Gulf Bend MHMR Center. (n.d.). Gulf Bend MHMR Center. https://www.gulfbend.org/poc/view_doc.php?type=doc&id=11746&cn=46.

What Are Eating Disorders?. (n.d.). What Are Eating Disorders?. https://www.psychiatry.org/patients-families/eating-disorders/what-are-eating-disorders.