Food & DrinkEating disorders and Christmas: what to take into account...

Eating disorders and Christmas: what to take into account to facilitate these dates for those who suffer from them

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Gatherings between friends and family around a table full of food is, together with lights, nativity scenes and Christmas carols, one of the most characteristic traditions of the Christmas season. Although for many these are moments to share and enjoy good food, perhaps thanks to a somewhat unusual menu and the occasional whim, for people diagnosed with one of the many eating disorders (TCA), such as anorexia, bulimia or binge eating disorder, these last days of the year can become more complicated than usual.   

As the psychologist María González points out on the Instituto Centta website, each year the arrival of these dates is more anticipated and we are bombarded with “messages and announcements about typical foods , especially ultra-processed and more caloric foods, as well as beauty stereotypes, social image, family reunions, etc.” This means that a patient with eating disorders can live these days, in which everything revolves around the table and food, with more anxiety than they experience on a daily basis. 

“What is essential to emphasize is that, although we can give general advice for these situations, the person with ED must follow the recommendations of their therapeutic team at all times, which will be oriented and personalized,” he reminds Maldita.es Mariana Álvarez, dietitian-nutritionist specializing in eating disorders.

Not all eating disorders are the same nor do they cause the same complications in Christmas gatherings

As we anticipated, it is possible that people diagnosed with eating disorders experience the days of celebration in an intense and difficult way. “From those who suffer from the most restrictive disorder, to those who suffer from binge eating or bulimia, for example, who assume the opposite,” Álvarez explained to Maldita.es on Twitch. 

In those who restrict, this constant exposure to food, in addition, in abundance, can suppose an extra degree of nervousness . Also that there is more pressure from the rest of the diners and comments similar to that ‘you have to eat’ or ‘you must eat this food’, this being precisely one of the products that the person has labeled as ‘forbidden ‘ in their daily diet . 

But the same thing happens on the opposite side of the coin. In the words of Álvarez, the person who has binge eating disorder or bulimia, for example, manages their food intake with more difficulty than usual, since seeing so much quantity makes them want to eat more. “The anxiety that restriction implies for one person is excessiveness for another”, he sums up. 

To avoid these situations, it is vital to give food education its proper role, in this case making Christmas lunch or dinner ‘as normal as possible’. 

Better first, second and dessert than a snack-based lunch or dinner

In this type of Christmas events (especially those that we celebrate at home) it is common for a real display of appetizers and snacks to take place before the main meal itself. Canapés, sausages, perhaps the odd snack…  This, an apparently harmless ‘tradition’, can also complicate the situation for people with eating disorders.

If possible, it is preferable to opt for a regular meal structure: a first, a second and a dessert. “If this is normally how we organize them, the ideal is that we try to do the same in these events,” recommends Álvarez. 

If snacking is a tradition, if the rest of the diners are unaware of the diagnosis of the person suffering from an eating disorder, or if it is very difficult to change the structure of the meal, the expert advises separating the part of the affected person from common dishes, in larger quantities. or less similar to what a normal food serving would be.

This, actually, is a recommendation applicable to anyone: in the end, in a snack we lose track of what we have already eaten, of how hungry we are, we let ourselves be carried away by the environment, the talk and the music and we end up with: ‘I don’t know how many wedges of cheese I’ve eaten’, ‘I don’t know if I’m hungrier, if I have to stop or continue…’.

“For this reason, it is a strategy that can come in handy both in EDs and in food in general: separate more or less what I think is adequate to fill me up, eat it and manage it at my own pace and, if at the end I am still hungry, then yes , I can take a little more of that canapé that I liked so much. This way we can face the real sensations, what the body is really asking of us”, clarifies Álvarez.  

With all this, we do not mean that we should also stick to the usual food: we can opt for different recipes from the usual ones without having to fall into excesses or unhealthy preparations. After all, as Álvarez points out, we usually have more time and we can put more care into the preparation of each dish.

It is better not to leave food in sight during after-dinner meals (or candy trays) 

When we finish eating, and not only for food safety reasons that we have talked about at length in Maldita.es , the appropriate thing to do is to remove the leftovers and store them in the fridge. However, it would not be the first time that they join us in long after-dinner meals. Not only the products susceptible to contamination , but also another of the protagonists of these meetings: the tray of nougats and polvorones

In addition to doing without it as one more participant during those post-feast talks, “it is advisable that it be shown only at meal times, avoiding that they are in sight all the time every day,” as González points out.

Not doing so can be a difficult situation to manage for an eating disorder patient, both, leftovers and sweets, becoming triggers for that feeling of anxiety.  

However, we cannot always avoid it: at the family level it is difficult to change these ideas and customs. If the family is used to having long after-dinner meals and spending X hours around a table with food or does not even know that one of them has an ED, what can we do? How to fill that leisure time? Álvarez indicates that it may be a good time to dedicate it to hobbies for which we do not have time in our day to day. Yes, get up and turn our attention to something else. 

What should we take into account as relatives of a person with ED during Christmas gatherings? 

As González explains on the Centta Institute website, there are some basic recommendations that family members of people diagnosed with eating disorders can take into account to make these Christmas gatherings easier for them. 

In the first place, it is important that the family normalize this time of year as far as possible, in the sense of not altering traditions that have been carried out until the start of treatment. Also maintain feeding routines and schedules.”Although the tradition is a special dinner, it is important that the patient maintain the rest of the meals during the day,” says González. 

“From the point of view of dietitians-nutritionists, what we are trying to do is to normalize it and so that there does not have to be a specific, special or different dish from the rest of the family for the person undergoing ED treatment. The recommended thing is to make it as inclusive and normal as possible,” says Álvarez.

It is also advisable, according to the Cetta Institute, to avoid excessive observation and pointing out any reaction from the patient and focus the celebration not only on food, but on other aspects: conversation, company with family members, and even moments of leisure. fun like watching movies, board games, etc.

Releasing the patient from the expectations that family members, on many occasions, place on them is also recommended: “It may be very important for family members that the patient try a nougat on these dates, but in reality it is not so much. That moment will come when he is ready for it, ”says González. 

In the words of Álvarez, this is usually difficult to respect. Especially if we are dealing with a patient with a considerable restriction, weighing less than what is considered healthy and who is working to rehabilitate himself nutritionally. His environment may even think that Christmas, due to its close relationship with food, is the best time to regain those extra pounds. “However, it is probably the time when it will be most difficult for you to eat,” says the expert. 

First conclusion? empathy. “As there is a lack of knowledge, many times the problem that an eating disorder entails is minimized, when it really causes a very high level of suffering. It is a very serious psychiatric illness”, points out the dietitian-nutritionist. The second thing, she adds, is not to force, be very attentive or force them to eat. 

“In short, don’t put pressure on them, don’t make them a different menu from the rest, but don’t force them to eat something excessively caloric either. The ideal would be to design a menu that is appetizing but healthy, with a part of vegetables; play with fruit in desserts…”, concludes Álvarez. 

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