SWEDA Somerset and Wessex Eating Disorders Association
"serving those affected by eating disorders"

Coping with Christmas

This leaflet initially written by Leanne Carpenter of Kimmeridge Court Eating Disorders Service, Poole. It is so useful that it has been amended to be used by SWEDA (originally by SWEDA’s 18-25 Project); our thanks go to Leanne, Kimmeridge Court and Dorset Healthcare University NHS Foundation Trust for permission to use this material.

Coping at Christmas
Most people agree that Christmas time can be a stressful time of year for families. This can be particularly true when someone in the family is struggling with an eating disorder.

It might be helpful to get together with the person, and to think ahead about possible strategies that might enable you to help them to cope with any Christmas pressures. If this is not possible at the moment, because the eating disorder is very strong, this booklet contains ideas that others have found useful.

Christmas Difficulties
Past patients have told us that Christmas can be a particularly stressful time for them—with the season’s emphasis on family get-togethers and food.

Often the Christmas period is one time of year when many close and distant relatives meet up to enjoy time together. For the sufferer, this may mean the excitement becomes tinged with fear about being expected to eat meals with relatives who don’t know about their’ struggles with food, eating and body-image issues. The distress and anxiety provoked by this can cause tears, panic attacks, angry outbursts or total avoidance, which can lead to arguments and an atmosphere of tension.

There may also be fears about being pressurised to indulge in rich food, or having to take part in conversations about food and eating. Below are some of the common situations that an eating disorder might use to make the person feel bad:

Common problems:

• People watching every mouthful the sufferer eats, or commenting on the sufferer’s eating habits and behaviours,

• Comments about portion sizes or choices of foods,

• Encouragement to eat more, or to eat ‘fear foods’ such as chocolate,

• Having to eat in front of lots of people,

• People being uneasy around the sufferer, and not knowing what to say,

• Arguments about what and how much to eat,

• Relatives commenting on weight, shape or diets, their own and others.

• Although it is common for encouraging friends and relatives to mention how well someone looks, the person in recovery may think this is a polite way of saying they have gained weight and look fat.

• Many people have said that being rushed during a meal makes them very distressed. Gentle, sensitive reminders about the time can be helpful though. This can help prevent meals from dragging endlessly on.

What may help?
People who have had an eating disorder have come up with a list of strategies that they found helpful.

It is important to remember though that everyone is different, and what helps one person may be distressing to another. For this reason it may be more helpful to ask the person to decide what helps them, and what doesn’t. At the end of this booklet, after these lists, there are some questions that might be useful for this process.

General points

• It can help to firmly tell family members and friends who know about the eating disorder not to comment on the person’s appearance, or what/how much food is being eaten.

• It can be helpful to give family and friends information to help them understand more about eating disorders. It is often misunderstood and misrepresented in the media, which does not help the sufferer.

• It will be helpful to remember the level of anxiety people with an eating disorder can feel, and to act in a supportive, non-judgemental way.

• The person may find unsolicited questions about their problems difficult to deal with (especially whilst eating). If however they openly discuss a topic associated with their personal struggles, it can be helpful to talk about these.

• It is best to actively avoid talking about dieting, making weight or appearance related comments (about anyone).

The Environment

• It is best to try and achieve a relaxed, normal environment, which will help the person to remember that mealtimes are a healthy part of everyday life.

• It is good if there is no ‘rushing about’ at meal times.

Before a meal

• The contents and serving size of a meal should be decided in advance, because on-the-spot decisions can be much more stressful, and may upset the meal.

• It might be easier to serve the meals away from the table, so the person avoids the stress of wondering if their portion size is Ok.

• If everyone else is serving themselves however, it can draw attention, so it may be easier to have a supporter sitting next to the person, so they can copy their portion.

During a meal

• During the meal, it can be really helpful to initiate talk about general topics and light current affairs, because sufferers often like to be distracted from their anxieties. The struggle with the eating disorder can be very preoccupying though, which can make it hard for the person to be actively involved in the conversation.

• For distraction, it can be good to have music playing, or the radio on. This can also relieve tension in the room.

• The person will also find obvious staring difficult to cope with, as this is usually a very distressing time for them.

• Commenting on their meals/foods (especially portion sizes) can make the person feel very self-conscious, which will often make it harder for them to eat in front of others.

• Challenging food behaviours - sometimes the person may try to hide food, by smearing it over the plate, or hiding it in a tissue for example. Most sufferers agree that confronting this helps in the long run, but can feel very humiliating at the time. It is important that challenges are done sensitively and carefully, so that it doesn’t make the person feel guilty, embarrassed or ashamed. The eating disorder feeds on these feelings.

• It can help if you could quietly and sensitively say something like ”I can see you’re really struggling, is there anything I can do to help you?” or “Would it help to talk about what’s troubling you?”.

• It is also really important to blame the illness, not the person. The eating disorder can make your relative ‘not think straight’ and behave in ways they wouldn’t normally.

• With rituals, it can be helpful for some people to be reassured that they don’t have to carry these out.

After a meal

• It is normal to want to praise your relative after they have struggled to get through a meal.

• For some sufferers the eating disorder turns praise around, to make them feel more shame, guilt and self-disgust. This is often because they feel that they’ve done something they really didn’t want to.

• Others like their efforts to be acknowledged, and like it that others appreciate what an achievement each meal is. Generally praise is accepted if it said in this context, e.g. “I can see that was hard for you, well done” or “you’ve got through it, well done”.

• Many find it helpful to have an activity planned for after the meal, e.g. a board game, jigsaw or film to watch.

1. People with eating disorders have reported difficulties at Christmas. Have you found Christmas to be a particularly difficult time?   Yes / No

2. What particular things have you found difficult? (e.g. large family meals etc.)

3. What has helped you in the past with these difficulties? (e.g. support from friends; distraction)

4. What ideas do you have about things that could help you this Christmas?

5. How can your family help you this Christmas?

6. When being encouraged to eat, what words are particularly helpful?

Before closing for the holidays SWEDA will:-

• Change the recorded message on the answer phone

• Place an automatic reply on the email system

• Ensure that the Message Boards are running over the Christmas period

• Work mobile phones will be turned off so no messages or texts will be replied to during the holiday.

Christmas is a particularly difficult time for people with eating disorders, as the celebrations are centred around food and eating. To accompany this, there is an expectation to be happy and relaxed, and this is often not the case for many people

During this season, many organisations close down for holidays, resulting in reduced support for people.

We know Christmas can be a really hard time for people and when people often look for support unfortunately we also have to take some time off.

During this time you may email us but will not get a response until we are open again.

The SWEDA Message Boards will be available at www.swedauk.org
(you can use the message boards to find peer support).

If there is a medical emergency with someone you are with call the out of hours doctor or 999 for an ambulance.

You can contact SWEDA for information about eating disorders and the range of services offered (including: one-to-one support, self-help support and the telephone helpline) at :-

SWEDA’s telephone helpline, which is staffed by trained volunteers, many of whom have a personal experience of an eating disorder, can be reached on:-

Frontline Services

01458 448600
an answerphone is available when the helpline is closed.


support@swedauk.org
Email support and MSN Messenger contact ID

SWEDA is a registered charity (No.1056441)
and a company limited by guarantee (No.3208772)