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How to Head Off an Eating Disorder Relapse During the Holidays

Even for people in recovery, unfamiliar circumstances or foods combined with too-familiar families can lead to relapse.

by Marianne Eloise
Nov 12 2019, 7:42pm

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Over the holidays, socializing increases, much of which focuses on consuming food. When the new year begins, diet culture hits a spike, as people moralize eating and try to rectify the “wrong” they believe they’ve done. For those in the midst of active eating disorders, the focus on food during the holidays is triggering. This effect is well documented, with helplines anticipating record number of calls yearly. But what about for people who have, technically, recovered? Whether someone has previously suffered with anorexia, bulimia, binge-eating disorder, or more generalized disordered eating, the chances of negative thoughts around food resurfacing over the holidays are high.

For much of my life, I’ve battled a generalized eating disorder and exercise addiction, which climaxed in my late teens and early 20s. All I thought about was how to avoid food and work it off, so I hid myself from the world, fearing a loss of control if I had to go anywhere. The holidays were a minefield—I knew that being faced with comments from distant relatives on my body coupled with the pressure to eat would set me off, and I had no way of avoiding being triggered.

I wasn’t able to confront my all-consuming obsession with food and weight until my 20s. Realizing how many years I’d wasted hiding was a big turning point, and with the support of friends and my partner, my relationship with food day today is better than ever. I still struggle, but I consider myself mostly recovered. The holidays, however, often see me back in the thick of all-consuming disordered thoughts. I can stick to recovery day to day, under my own schedule, but doing so when I have no say in what or when I eat is terrifying.

This isn’t unusual. Caroline Price, the Director of Services at eating disorder charity Beat, says that the holidays are difficult for people with active or dormant eating disorders, for different reasons. “The pressure to eat large amounts can be triggering for people with binge eating disorder and bulimia, as well as causing anxiety for people with anorexia,” she said, adding that even if one considers themselves recovered, recovery is “tricky to quantify.” “For some people it might mean that they never have another disordered thought again. For others it means that, although these thoughts are still there, they happen less frequently, and they’re able to control them through the coping mechanisms they’ve learned.”

For people in recovery, that might mean being blindsided during a difficult period. Ellie, 20, has had disordered eating for most of her life. After a few unsuccessful recovery attempts, she considered herself recovered in the summer of 2016. Her recovery was disrupted in November that same year after a breakup, and she found herself relapsing for an entire year after the holiday period. She pinpoints moments in her journal where she starts to experience disordered thoughts again: “I feel harsh and I am tired of being a rock for others when I can’t even be a rock for myself and rocks make you ache, anyway. I need to be better for myself but I want to shrink away and the two do not go hand in hand,” she wrote on Christmas Day in 2016.

For people in recovery or who have managed to land in a good place, a return to these thought patterns can be unexpected. But psychologist and director of Eating Disorder LA Lauren Muhlheim said that they are extremely common when one is “faced with foods they haven’t had for a long time, foods they don’t get to enjoy on a regular basis, and larger amounts of it. These situations are more challenging and can tax the recovery skills of many. Each element that adds complexity or uncertainty to the environment presents an additional challenge.”

Holidays may contain triggers that daily life doesn’t, and these variables might be enough to catch you off guard. Ellie managed to spend the holidays last year not actively indulging disordered behaviors and can now pinpoint specific triggers. For her, it’s the disruption to her normal schedule, but also a difficulty with being seen as “wanting.” “I find it very difficult to look hungry, to crave, to eat with pleasure and gluttony in the most decadent and not moralized sense,” she said. “That’s what the holidays are all about—eating together and sharing—but what happens when your brain won’t let you move your hands to your mouth and you’d rather dig your own grave and lie in it than dig into a pile of roast potatoes?”

When those feelings rise, Muhlheim said it is important to not get disheartened. “This is completely normal and not a sign of failure. It’s more a sign that your recovery skills are being taxed by difficult situations,” she said. “By trying to anticipate where you might struggle, you can reduce the impact of these challenges.” She added that the most important thing is that you shouldn’t restrict in anticipation of the holidays, especially if you suffer with bulimia or BED. “Beware of all-or nothing thinking about eating and try to resist the temptation to either resorting to restricting or entirely giving up and just bingeing and then restricting after the holiday. This is a common trap.”

Being organized and prepared can help to prevent being caught by surprise. “I always suggest planning and preparing as much as possible. Have a plan for each situation. Think through who will be there, what the food environment will be, and how you can best manage it,” Muhlheim said. “For example, try to anticipate how you will navigate the different food situations and the various social challenges,” she said, adding that it’s important to, “identify who can be a support if you notice you are struggling, what coping skills you have used in the past to navigate challenges, and how you can practice them.”

Muhlheim said that it’s important to “accept that it’s normal to indulge at holidays. That is OK and part of the joy of celebrating,” but admitted that it isn’t always that simple. It’s often not only your relationship to food contributing to disordered thoughts; your relationships with other people also play a role. “A sufferer may see friends and relatives they haven’t seen for a while, and they may be sensitive about judgment about their bodies and any changes they’ve experienced in their body,” she said. Price agreed that eating with people you don’t see frequently can be a trigger. “People with eating disorders often try to hide their illness,” she said, “and when eating is a social occasion, they may feel ashamed and want to isolate themselves.”

As someone who has spent most of their life attributing moral value to food, it’s difficult hearing someone else do it. My disordered thoughts rise up whenever other people talk about food, and hearing someone promise to “be good” in the new year stops me from being able to eat my food. A key part of recovery has been understanding that my disordered thoughts about food are not normal or healthy, but hearing someone without an ED refer to food as “bad” or “good” normalizes my thoughts, making me feel as if I should also be “good” and stop eating. When this happens, I try to remind myself that it’s normal to indulge and enjoy food, but it’s tough.

Triggers often come up when the holidays are over too, when, for Ellie, the “diet culture alarm bells start ringing.” When people start talking about their weight loss resolutions, Ellie says, it’s claustrophobic. “Every day I have thoughts about losing weight and restricting, but I’m at a place where I acknowledge that, figure out what caused it, and move on. When everyone around you is acting on it and having those conversations and doing it in a way that glorifies thin bodies and ‘self control,’my god, is that painful,” she said. When encountering diet talk, Mulheim said people may not feel comfortable confronting their own issues head-on, but they can try to change the subject. “If you are more comfortable with the company, you might model some anti-diet thinking. Who knows, you may help someone else who is struggling.”

Another stressor of the holiday season, Price said, is that your support network may not be available. That means that when triggering thoughts crop up, you only have yourself to rely on. There are options: Beat runs a helpline over the Christmas period, from 4 p.m. to 8 p.m. December 24 to January 1, for those who are struggling. In the US, the National Eating Disorders Association runs a helpline, and have resources on navigating the season with various disorders. While its helpline is closed on Thanksgiving and Christmas Day, they are available around that time. Alternatively, the Crisis Text Line is available in the US 24/7. If you already work with a therapist or specialist, it may be a good idea to warn them in advance that you anticipate the holidays might be tough. They could have resources in your area or online that they can recommend.

Recovery isn’t linear for anyone, and it can be frustrating and disheartening to realize you can still fall victim to disordered thoughts. But relapsing, whether briefly or for a longer period, doesn’t mean you’re back at square one: People who are in recovery are overall better equipped to battle thoughts when they arise. The holidays, and the pressure to eat in front of people or listen to ignorant comments about weight can be painful, but you are neither alone nor a failure for falling into old patterns.

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addiction
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