It’s the Most Wonderful Time of the Year… Or is it?
December 17, 2018 • Written by Nikki Pagano, LCSW and Amanda Jowell, MD
If you are the parent of a school- or college-aged child, then you’re well aware that the winter holidays offer a unique opportunity for family togetherness, with all of its joys and stresses. In working with families with teens and young adults affected by eating disorders, we’ve learned some ways in which our patients and their parents can be uniquely impacted by the season and have been encouraged by the ways families can come together, with creativity and compassion, to keep a steady eye on health and recovery.
Talk to your child:
If you’re feeling stressed by the season, it’s likely your child is as well. Talk openly about what most worries and most excites your child about the holidays. Problem-solve together around the potential challenges (for instance, eating in front of extended family, Aunt Susie’s talk of her new no-carb diet, or a family member commenting on your child’s appearance) and how you can help.
Help your child eat well over the holidays:
For kids who need to restore weight (or who are trying to maintain a weight restored state), we like to think of food as medicine. This may be a particularly helpful stance around the holidays. How can your child get their “dose” of medicine? There isn’t one way to do this, and you’ll have the think through what would work best for your family, but here are some ideas:
Have your child eat before the gathering and plan for another dose when you get home.
Eat with your child in another room, separate from the rest of the gathering, and then re-join the festivities when they’ve completed the meal.
Make your child’s plate for them.
Have an exit plan. If it seems like your child won’t be able to eat adequately (i.e., take their dose) at a holiday get-together, be prepared to have a plan B. This might involve leaving early and eating with your child at home.
For kids who eat in secret, in the absence of hunger, or who sometimes experience loss of control while eating:
Have your child eat their regularly scheduled meals and snacks before going to the gathering. Skipping meals and feeling hungry can leave your child vulnerable to experiencing a loss of control while eating.
If you’re hosting, try not to have food sitting out the whole time and instead have designated times where eating will take place.
If you’re able to help with organizing the celebration, try to incorporate other structured activities that don’t involve food. This gives your child something else to look forward to and engage in either before or after eating and sets a timeframe around eating.
Anticipate unhelpful comments:
Some families choose to have conversations with their extended family/friends about their child’s eating problems and related sensitive topics such as:
discussions that involve labeling food as “good/healthy” and “bad/unhealthy”
the latest fad diet or weight loss New Year’s resolutions (looking at you, Aunt Susie), or
comments about appearance.
Other families prefer to deal with the comments if / when they come and then discuss what could be helpful in the moment. Families have described success with various strategies depending on the circumstance, including leaving the room together or letting the person know that their comment was unhelpful, and why.
And of course, reviewing what went well, what was hard, and how your child experienced different moments of family gathering after the fact can be illuminating for all.
If your family celebrates holidays with special, seasonal foods:
Depending on what type and which phase of treatment your child is in, eating special, seasonal foods might be an excellent way to challenge the eating disorder. This is especially true if this was a food your child enjoyed before the onset of the eating problem. If you decide to use the holidays as an opportunity to work on flexibility and diet variety, it’s important that you set your child up for success.
Take note of what has been helpful when you’ve had success in the past.
If your child is working to overcome restrictive eating, this could mean eating this food only with close family, setting an expectation of what will happen if your child does not eat the food while acknowledging that you know this is very difficult for your child, or making sure there are distractions before, during and / or after eating this food.
If your child is working to overcome loss of control eating, take note of which seasonal foods might be particularly challenging. Encourage your child to enjoy these foods a single serving at a time. To limit access to large quantities of this food, your family might choose not to keep lots of tempting seasonal treats in the home and instead to give leftovers away to your guests.
If your young adult child is coming home for an extended break from college:
If your child is coming home from college for winter break, you each may have different expectations regarding autonomy. For example, your child likely experiences almost complete autonomy in college, deciding when he/she eats, sleeps, socializes and exercises. Extended winter breaks warrant taking a moment to get on the same page. How can you help your child with the transition home? How can he or she demonstrate the progress made while living away from home? What makes sense in terms of treatment continuity? It may be useful to explore the option of having members of your child’s support team call your child over the break or to help with scheduling appointments with clinicians.
If your family will be traveling for the holidays:
A regular eating pattern – 3 meals and multiple snacks daily – is the cornerstone of sustained recovery from an eating disorder.
How can this be maintained given your family’s travel schedule? For example, if you are going on a day-long adventure exploring a new city, be mindful of when and where you can purchase foods. Consider how much walking will be involved and be mindful of any activities involving energy exertion if the goal is related to weight restoration. If the goal is developing a healthy relationship with exercise, pay attention to whether your child is engaging in physical activity in a way that might be driven by the eating disorder, and encourage mindfulness of how family members talk about and exercise their own exercise needs. Finally, remember that your child may also find restaurant or hotel meals to be difficult for a variety of reasons including eating in public, ordering off of a menu, and managing the uncertainty of what foods the restaurant will have.
This blog was originally published by the Columbia Center for Eating Disorders on The Feed Blog.
