Every year, millions upon millions of American loosen their belts and get ready to throw down in an orgy of face-stuffing during the holiday marathon that lasts from Thanksgiving into the New Year.
Our usual fixation on healthy eating and calorie-counting goes out the window. Binging on starch and lipids and whatever is on the dessert table is not only tolerated, but encouraged. Even we, as a food publication, are complicit in that collective mania.
But for the 30 million or so Americans who struggle with an eating disorder—especially those for whom binging is at the root of their disorder—the holidays are a time when stress and anxiety are at their peak.
Leora Fulvio is a licensed psychotherapist who specialises in the treatment of eating disorders. Fulvio also runs Hypnotherapy for Wellness, which uses hypnosis and and guided meditation techniques to help people cope with their disorders. For her patients, it's probably the most stressful time of the year.
"It sets them out to mil for the rest of the year," Fulvio explains. "For most people, feeling full is a signal to stop eating, but for people with bulimia or binge eating disorder, it's a signal to keep eating. It's like, 'I'm too full and therefore, I'm a bad person, therefore I need to continue punishing myself with food.' So, what they tend to do is go home that night and eat even more. The next morning, they wake up ashamed, depressed, and then December comes, which is a difficult month. "
Think of it as a hangover—except, unlike as with alcohol, you need to eat more food to survive, which makes these disorders doubly hard to treat. "There's a deep sense of shame and wanting to hide and hating themselves," adds Fulvio.
And while the rest of the population gorges itself with the fam, said fam can have a huge impact on the outcome. Copious amounts of food, compounded by stressful family dynamics, create a perfect storm for people dealing with bulimia and binge eating disorder.
"The dynamics are different with every family, but it's difficult for many people," Fulvio says. "There's the stress of family, and with that comes sneak-eating for people with eating disorders, like grabbing food quickly while no one is looking. Also, not being able to concentrate or focus is a big thing, because they're obsessed with the food or obsessed with not eating it."
Fulvio is keenly aware of how family dynamics are a huge stressor for many of those dealing with eating disorders—fat-shaming grandmothers especially. "Some grandmas are the worst!" she laughs.
It's estimated that the average American eats up to 4,500 calories in one sitting during a Thanksgiving meal. But Fulvio has seen patients who eat as much as 10,000 calories in half an hour. She is also intimately acquainted with the pitfalls of eating disorders. "I was a chronic [calorie] restrictor and binger, so long periods of not eating and then periods of overeating, even when I was very young," Fulvio recounts. "After my recovery, I really wanted to help other people."
People like Laura*, who suffers from binge eating disorder and is currently in recovery. "It's an anxious time for me," she says. "A lot of people are excited to see family and friends and eat massive amounts of food, but I get stressed about it. In the past, it hasn't really been an enjoyable time for me. It's a little different now, since I'm getting better, but it's usually a fear of going into the events and seeing the sweet stuff."
It might be hard for the general population to understand what it is to be in the throes of an eating binge. Sure, we all overeat once in awhile, but Laura describes a trance-like state, which often begins with a small portions and turns into hours of eating.
"It's like the Tasmanian Devil. It's honestly like, I would go numb, and nothing else in the world matters, just 'What am I eating next?' I'm impatient, it's all I care about. Then I'm miserable, I can't eat anymore, and I come back to life, and it's like, 'Oh my God, what did I just do?'"
And that's when the self-loathing kicks in, but it's also where treatment can help. "The whole point of recovery is to be more mindful and focus on your thoughts and, 'Why are you doing this?'" Laura explains. "I've gotten to the point where I'm more comfortable with myself, so it's just a question of breaking the habit."
Leora Fulvio proposes to look inward for the solution. "When you do the hypnosis, you find peace within your body and mind. You're learning how to slow down but also how to visualise things and feel relaxed. It teaches them to feel more safe around food."
So, what about practical advice for those dealing with an eating disorder during the holidays but who aren't seeking professional treatment?
"It's important for people to realise that the urge isn't going to kill you. It's just a want or a desire," Fulvio says. "Have an intention around what you want to feel like at the end of the night and really visualise that. Then, have a team or a support person there who you can talk through your plan with. It doesn't have to be a therapist, it can be a friend or someone who you meet online and who's doing the same thing. Talk about how you're going to stay safe on Thanksgiving, and text them during the meal as often as you need.
"If your grandma says she thinks you're fat during dinner, you can definitely get help fight the urge to go in the kitchen and eat a whole pumpkin pie."
*Laura's name has been changed. She is not a patient of Leora Fulvio's.