By Samuel D. Horton
For most people, the holiday season is a wonderful time of year. It is often a time of family reunion, socializing, and celebration - a time when families, friends, and coworkers come together to share good will and good food. The season is meant to be bright, happy, and full of the best of relationships. Yet, for those who suffer with eating disorders, this is often the worst time of the year. For those who are trapped in the private hell of anorexia, bulimia, or binge eating disorder, the Holidays often magnify their personal struggles, causing them great internal pain and turmoil.Over the past few years, during the Thanksgiving and Christmas holiday season I have felt horrible. I felt trapped and like the food was out to get me. I lied on endless occasions to avoid all of the parties and big dinners that go along with the holidays. I felt horrible about my body and did not want anyone to see me eat for fear they would make judgments about me." Eighteen-year-old woman These quotes from women suffering from anorexia, bulimia, and binge eating reveal the emotional intensity they feel during the holiday season. Their fear of gaining weight and becoming, in their minds, fat, gross, and disgusting, is the monster they must deal with every time they partake of any of the foods that are so wonderful and common to the holidays.
At Center for Change, we have asked many patients over the years to share from their private experiences what the Holidays have been like during the years they suffered with an eating disorder. The women quoted in this article are of different ages, but all suffered with the illness for many years. As you read the following passages you will feel something of the agony of suffering with an eating disorder at this festive time of year.
"My life with an eating disorder during the holidays is a living hell - constant hiding and fear, confused about life and hating every moment being surrounded by food. There was so much pressure, so many stares and glances, and days with endless comments. My whole life was a mess. There was so much pain and guilt inside of me and I didn't know where to turn, except to my eating disorder. I hated the pressure of eating the food, the constant worrying of offending others." -Twenty-two-year-old woman "It's hard to be around all the food and festivities. When I'm hurting inside and struggling with what "normal" food portions even are, I need the help, emotional understanding, and support of family and other people. "Handle with care, but please handle." Accept me the way I am. Let me back in the family" -Twenty-three-year-old woman.The Hidden Beast of Holiday Feasts Tales of Bulimia and Binge Eating.On the other end of the eating disorder spectrum, a woman with severe bulimia or binge eating disorder finds the holidays are a genuine nightmare because there is so much emphasis on food that they become preoccupied with it. Binge eating and subsequent purges become even more prevalent because many of the foods and sweets that are associated with holiday celebrations are very enticing to them. The holidays can be a time of convenient indulgence, but also a time of great shame and self-reproach because of their secret life. Some even use the binge eating and/or purging as a form of self-punishment throughout the holidays.
Eating disorders have a big impact on society on a small and on a large scale; meaning both individuals and society as a whole dedicate significant parts of their lives to the struggles of dealing with eating disorders. A lot of money and time go into the troubles of dealing with an eating disorder, as well as into the measures taken in order to treat and prevent them. Eating disorders are very common amongst celebrities, mainly because their profession puts pressure on them to be skinny. The majority of celebrities that we see in the media are all skinny, and most of them are anorexic or bulimic. The fans of these celebrities look at the bodies of their idols and they want to be like them. The problem with this is that anorexic and skinny celebrities do not make good role models for their fans because their skinny figures are not a healthy look to follow. Famous people believe that in order to be successful they must be skinny. This is not true. Celebrities expose their looks and body image to the media where fans can see them and get the wrong idea that their idol's looks are acceptable when their idols are only trying to lose weight for their own "success". In a weight article, Monica Seles stated that "Women in society have much tougher pressure to be thin." It is like a cycle; celebrities are skinny in order to impress their fans and companies. They send their fans the wrong idea, thus making their fans lose weight. In the end, everyone has the idea that they must be thin and they must lose weight, thus, being skinny becomes the norm.
There is no need and there is no good time to feel guilty or at fault for your loved one's eating disorder. The Holidays are especially not the time. Eating disorders are complex illnesses that are not caused by one person or one relationship. It is also important for the eating disordered person not to feel responsible for their family and friend's emotional response to the eating disorder. One helpful agreement around the holiday season is, "We will spend time focusing on the need for nourishment as previously agreed upon, and primarily, we will spend time focusing on each other and the things that are available and that are meaningful in our family or social setting." Let them know that you can look beyond the outward manifestations of the eating disorder because you are also concerned about the hurt, pain, fear, and guilt they are feeling inside. In acknowledging the pain inside, no one has to be at fault or to blame for the eating disorder, allowing positive family associations and caring to become the emphasis. There is no need to "walk on egg shells", especially when everyone understands and acknowledges the underlying needs associated with the eating disorder. Compassion is a wonderful holiday gift for someone with an eating disorder.
It can be helpful during the holiday season to break activities into smaller numbers of people, when possible.It is easier and less overwhelming to deal with five people than fifty people. Invite your friends or family members to participate in smaller, quieter, and less chaotic social activities and events. Simple talking and sharing as a small circle of family members or friends can do much to increase the sense of belonging and safety for someone with an eating disorder. Encourage your family member or friend to gather extra support around themselves during the holidays.
The following suggestions resulted from a survey question we asked patients in treatment: "What three suggestions do you have for family and friends who want to help the holiday season go a little better for a loved one suffering with an eating disorder?" The women offering these suggestions range in age from fourteen to forty-four, and their suggestions offer some valuable insight and understanding that could be helpful to you as a friend or a family member. Being compassionate about the struggles of the eating disorder illness can help make the Holidays less of a battle for those you love. The suggestions are: Do not make a big issue about what your loved one is eating. A little bit of encouragement is okay. - Do not focus too much on food, it may only fuel the eating disorder. - Ask her how she is doing and see if she needs any help. - Do not become angry about how the she feels, just do your best to support her. - Offer a lot of support and be aware of what may be creating anxiety and try and understand what she feels. Be understanding, kind, and supportive. - Spend quality time with your loved one. - Make sure that the primary focus of the holiday is not on the food but rather on the family and the valued time you will share together. - Allow for other activities that do not involve food, such as games, singing carols together, opening gifts, decorating, and spending time just talking together. - Allow her to make a dish that she would feel comfortable eating. - Before the Holiday itself, and before family gatherings, make agreements about how you can best help your loved one with food. Honor the agreements you make. - Do not give her loud and attention drawing praise when she does eat. - Do not talk about diets, weight loss, or weight gain. It causes great anxiety and may increase a felt need to engage in eating disorder behavior. - Do not stare. - Learn enough about the illness and the triggers to help your loved one develop skills as well as strategies to defy eating disorder thoughts and urges. - Know something about her struggles, triggers, and behaviors. Then, if you see those, you can approach her after a meal in private and suggest ways she might be helped in some of those behaviors and learn ways you can be helpful and supportive. - If you see her struggling, ask if she wants to talk, but ask this in private. - Focus on how she is feeling inside, what issues she is worrying about, what her fears are, what she needs, rather than just how much she is eating or not eating. - Try not to focus too much attention on the eating disordered behaviors. - Be patient and nurturing. - Treat her with love and respect no matter what is going on. - Let her know that she is loved. - Help her take her mind off of food by generating a conversation with her about general or important topics. - Don't allow her to excessively isolate. - Be there for her emotionally and physically with hugs and messages of love.
Since eating disorders are such important problems facing society today, researchers have used psychological theories to try to solve these problems including group therapy, medical treatment, and nutritional counseling. Eating disorders are treatable, and a person who has an eating disorder does have a chance of getting better, however, if the media continues to idolize skinny celebrities and condone their extremely thin size, it will continue to aid people in trying to lose weight. Having an eating disorder is like a really bad habit that needs to be stopped. A lot of people do not have the ability to stop this bad habit on their own, thus they need help from professional doctors and even family. There are several different methods used to treat an eating disorder. Since an eating disorder affects individuals both physically and psychologically, the treatment for an eating disorder has to satisfy both the physical and psychological aspect of the disorder. Medicine alone wont help a patient get better. In order to get positive long term effects from the treatment, a patient has to receive a mix of medical and psychological help for their disorder. Some therapies that psychologists use to determine the problem and treatment of an eating disorder are cognitive behavioral therapy, interpersonal therapy, rational emotive therapy, and psychoanalytic psychotherapy.
A lot of people are confused about what "normal eating" is so they need nutritional counseling to help them get back on track. Not that many people who suffer from an eating disorder go to get treated for it. According to the South Carolina Department of Health , only 1 out of 10 people who suffer from an eating disorder go to get treatment. The cost of treatment for an outpatient is very expensive. Costs for outpatient treatment can be over $100,000. In the US, the cost of treatment for an eating disorder per day is anywhere from $500 to $2,000. On average, a person in inpatient treatment has to pay $30,000 a month. People with eating disorders need approximately 3-6 months of inpatient care in order to recover. The cost of treatment for an eating disorder is ridiculously high, and the high costs might be a reason that people do not go to get treated. It is very hard for most families to pay for the treatment of their illness, especially when insurance companies don't usually cover eating disorder costs. Another way to help reduce the number of people with eating disorders is to educate people about the dangers of eating disorders through media. The media is a good tool to help educate people on the dangers of eating disorders, but it is also a tool that hurts people by condoning the appearances of skinny people who suffer from such disorders. Another way that eating disorders can be treated and minimizes is through the "Doll Experiment". People were shown that if a human being had the same attributes as a Barbie doll, the body would not be able to hold itself because of its awkward shape and structure. This is a good way to show people that a Barbie doll isn't necessarily what women today should aim towards looking like. In the same way, the celebrities we see on TV are not people who we should try to look like either.
I believe that as long as the media continues to idolize thin celebrities, the effects of education about the dangers of eating disorders through the media will not be effective. For each step that they take forward to solve the problem, they take two steps back by continuing to idolize thin celebrities. It is not a question of what effects have a greater likelihood of causing an eating disorder, but it is a fact that media does contribute to people developing and maintaining eating disorders. There are other causes of eating disorders, such as interpersonal or biological factors, but if the problem of media influencing eating disorders can be changed, there will be fewer cases of eating disorders. We have to take one step at a time in order to solve this very serious problem of eating disorders, and a great place to start is to change the fact that media influences eating disorders. There is not one cause of eating disorders, but media is a big influence to them since media reaches so many people. Personally, I think that group therapy very helpful in the treatment process of an eating disorder. Victims of an eating disorder are able to ask questions and receive answers in order to better understand their situation.
