Planning, Flexibility, and Balance: Families, Anorexia, and the Holidays

by Maureen Dymek-Valentine, PhD

Many parents have told me that battling an eating disorder in their child is one of the biggest challenges they face over the course of their time as parents. Add the holidays to the mix and you can have a recipe for serious stress … for both kids and parents. Many kids and adolescents with eating disorders find the holidays very triggering – they are often exquisitely sensitive to celebrations centered around food, can interpret big meals with rich entrees and elaborate desserts as extremely threatening, and may feel overwhelmed by less structured days away from school and predictable activities. Not to mention traveling, near and far, to relatives homes — or to host family and friends in their own homes. Stresses for parents also abound. Seeing extended family when your child has an eating disorder can lead to unhelpful and sometimes judgmental comments by others. Travel, visitors, time off from work, shopping, high expectations can all lead to a lot of stress. In the hopes of protecting their children, parents may question past family traditions, menus, and social activities. It is important for parents to be sensitive to their children’s triggers, but this doesn’t mean avoiding much loved traditions because they may be challenging. As with non-holiday times, it is important to find a balance between challenges and safe zones for your child.

So how do you get through it? I have found three key concepts to be central to getting through the holidays without making things worse: (1) planning, (2) flexibility, and (3) balance. Many kids with eating disorders (and kids without eating disorders, for that matter) do best when they know what to expect. A week or two ahead of time it might be helpful to sit down as family and plan your days. What activities will you be doing on which days? For how long? With whom and where? Help your child anticipate and prepare for what will come. Will people make comments about her/his appearance? How can you and your child respond? Would it be better to talk to extended family members ahead of time, or would it be best to just see what happens? What are some positive time-out activities you and your child can have available when things feel too much?

Planning is also important around meals. When, what, where, and with whom will you be eating? Will you, as parents, be in control of the menus, or will someone else? If it is someone else, it will likely be helpful to have some adult discussions about the menu ahead of time. Before the meals occur, it is important for parents to agree on the expectations of what and how much your child should consume. Remember, just because it is the holidays, your expectation that your child receive adequate nourishment is still non-negotiable. Talk ahead of time about how you will handle it if your child is not successful? Most parents find it best to have a plan for this, before finding yourself in the midst of it.

So with all this talk about planning…what about flexibility and balance? As you know, mealtimes for people with eating disorders can be quite rigid, with strict preferences around eating at the same time each day, the same types of foods, etc. All this can be shaken up around the holidays. The main meal might be at 3 pm, for example, not 6 pm or noon. Instead of having immediate family around the table, there may be many other less familiar faces present. Instead of the typical foods that a family prepares, there might be a host of new tastes, textures, options and a greater amounts of food on the table. This is where flexibility and balance come in. If your child is uncomfortable with the concept of eating at 3 pm, scared of the menu, and tense about the thought of eating in front of many others, what can you do? The answer will look different for different families. For one family it might work best to decide to eating at 3 pm with the extended family, but allowing the meal itself to be “safer” (but of course enough). For another family, it might work best to eat separate from others, but to expect that your child partake in several holiday challenge foods.

While holidays can be stressful, they can still be successful. With preparation, lots of communication, and the ability to be flexible your family can still find joy in the holidays. In the end it will be important not to allow the eating disorder to run roughshod over your family traditions — but it’s also important not to expect too much adaptation from your child, depending on where she/he is in recovery. We at the UNC Eating Disorders Program wish all families the best during this holiday season.