How to manage eating disorder triggers during the holidays, according to experts

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This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.

This story makes mention of eating disorders that may be disturbing to some of our audience. To find support, contact the National Eating Disorder Information Clinic at 1-866-NEDIC-20.

The holiday season is often a time of increased social pressures, heightened emotions and stress.

Sure, in many ways it’s “the most wonderful time of the year,” filled with merry music and gift-giving and social gatherings. But for those struggling with mental illness, and more specifically those suffering from eating disorders, this time of year can present a host of challenging triggers that—without support and constructive coping mechanisms—may lead people to fall back into self-destructive, unhealthy behaviours.

Sue Bowles knows this all too well. Although the life coach and public speaker has struggled with food throughout her life, the holidays often make it particularly challenging to remain on her path of recovery.

“My eating disorder likes to whisper lies of incompetence, especially around cooking a holiday meal,” Bowles tells Yahoo Canada. “We lost Mom a year ago, and cooking was something she enjoyed and I endured. To now do the cooking without her to guide is hard by itself. Mix in an eating disorder and it gets worse.”

Bowles says conversations about diet culture, exercise plans and eating behaviours around the table can also send her into a tailspin. If she can’t be around family for whatever reason (like, for instance, a pandemic), the loneliness and isolation can likewise be a trigger.

“It gets tempting to just say 'forget it' for a day or two...to go back to restricting by skipping meals because I'm emotionally tired and don't want to make food decisions,” she says.

According to the National Initiative for Eating Disorders, as of 2016, approximately one million Canadians had a diagnosed eating disorder such as anorexia nervosa, bulimia nervosa, binge eating disorder, avoidance restrictive food intake disorder (ARFID) and otherwise specified feeding and eating disorder (OSFED). In the United States, that number is 30 million, according to the National Association of Anorexia Nervosa and Associated Disorders, or nine per cent of the country's overall population.

Research shows that the ongoing COVID-19 pandemic has had a detrimental impact on those already struggling with eating disorders, making this holiday season the cherry on top of an already taxing period for those who suffer from disordered eating.

“I think it’s a combination of all sorts of things,” says Sam Thomas, who's in recovery for multiple eating disorders.

“Once upon a time it was food and not being able to exercise that was the issue, but in later years it was more about that whole thing around family and the tensions, the anxieties that are attached to that.”

On top of trying to deal with the stress of strained family dynamics through his eating disorders, in the past Thomas would turn to an additional unhealthy coping mechanism to help him get through the holiday season: alcohol. The two destructive habits compounded, he says, and the holidays ultimately became a time of intense emotional turmoil rather than a period of merriment and enjoyment.

A decade ago, eating disorder counsellor Ruth Micallef found Christmas particularly triggering time while she struggled with severe symptoms of Orthorexia Nervosa, a disordered eating pattern characterized by an obsessive need to eat only “clean” foods.

“From panicking about non ‘clean’ foods being presented to me, to anxiety over the gym being closed and finding time to exercise, as well as the stress of avoiding all the things my food rules had deemed as ‘bad,’ it was incredibly stressful,” she says. “When you add a high number of people suddenly around you observing your actions and monitoring your food intake, it could all become too much.”

Now recovered, Micallef spends her time helping other people who struggle with eating disordres, and she says the most important thing to remember, especially around this time of year, is that an eating disorder is merely a mechanism people develop to cope with trauma and stress.

“This coping mode arrives a little like a defective superhero when we've had traumatic or adverse experiences which have been left unsupported or unprocessed,” she explains to Yahoo Canada. “So we save ourselves, in a way, via an eating disorder.”

With this in mind, it becomes possible to develop healthier, more productive coping mechanisms when a stressful situation can be anticipated, she says. And the number one way people can manage triggers during the holidays, according to Micallef? Boundaries.

Whether it be distancing yourself from specific people or places, not engaging in certain types of conversations or being extra aware of the content and media you are consuming, Micallef says “boundaries are pivotal to any sort of recovery.”

Setting boundaries is precisely what Thomas was doing when he decided to stop spending the holidays with his family a couple of years ago. He says removing himself from the triggers he experienced year after year was, without question, the right thing to do. It also allowed him to get sober.

Unfortunately, due to the pandemic, that has meant spending the last two Christmases alone, though Thomas says he’s enjoyed the solitude, freedom and stability. And he always makes sure to keep in touch with friends on the day to avoid feeling lonely.

But, if you are able, finding the folks who will be supportive and respectful of your needs and surrounding yourself with those people during the holidays can be another important way to get through the difficult period, says Dr. Allison Chase, a clinical psychologist and Certified Eating Disorder Specialist Supervisor.

Chase says it’s important to figure out who in your life is genuinely supportive and to clearly communicate your needs with them so they know how to be there for you.

For Bowles, that person is her brother, and she says she was able to talk to him about what she was going through when she was struggling during Thanksgiving this year.

“[He] just gave me a hug and said, 'Let's just tell ED (my eating disorder) to take a hike!’” she says.

Getting professional help is also incredibly important, and Chase says reaching out for extra support during challenging times can make things so much easier.

“My biggest coping mechanism is talking it through with my dietician and counsellor in advance so we can have a plan in place and work through potential scenarios,” says Bowles, adding that she also journals and makes sure to set aside extra time for self-care during the holidays. “Anticipation is usually worse than the actual event, and talking through my fears and concerns silences them some and gives [me the] opportunity to find a level-headed way to deal with the challenge."

For more information on eating disorders or to find a treatment provider near you, visit the National Eating Disorder Information Centre (NEDIC) or the National Eating Disorder Association (NEDA) for information outside of Canada.

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