The holidays bring together family, friends, and food. While this may seem joyous, it can be a major source of anxiety and stress for children and teens with eating disorders. Both the child and parents will have to navigate uncommon situations during this time.
“Festive get-togethers often include well-meaning family members who may comment on the level of consumption, and exert subtle or overt pressure to take part in food consumption or comment on their lack of appreciation or enjoyment of the food on offer,” Dr. Monica Vermani, Clinical Psychologist, Tedx Talks speaker and author of A Deeper Wellness, tells LittleThings.
“People with an eating disorder can find such situations and settings where their reticence and discomfort are open to commentary. They can feel targeted and scrutinized for their weight, and/or eating habits, and feel pressured to fit in and perform as though enjoying what can be an extremely distressing and uncomfortable social dynamic.”
Dr. Vermani notes that there are various food-related issues that can impact a child. “In addition to anorexia, bulimia, and binge eating disorder, a relatively unknown eating disorder, Avoidant Restrictive Food Intake Disorder, (ARFID, a new diagnosis in the DSM-5, previously known as Selective Eating Disorder) is also a common eating disorder among children and teens,” says Dr. Vermani. “ARFID refers to individuals who severely restrict their food choices, refuse and reject new foods, and avoid many foods. Often a severe level of avoidance results in poor nutrition, which, over time, negatively impacts growth and concentration.”
The causes of eating disorders in children are just as varied. “Often, children develop an eating disorder as a result of a food-related trauma that they have experienced (such as difficulty swallowing an item or choking), or from family/life trauma due to dysfunction, sudden illness/death, abuse, or being bullied at school,” says Dr. Vermani. “Children can also develop an eating disorder as a result of a family history of anxiety, depression, eating disorders, or maladaptive modeled behaviors of members of their household or close community.”
Dr. Vermani shares, “Most eating disorders occur between the ages of 12 and 25 and are much more common in females than males. Most literature suggests that 90% of cases are diagnosed before the age of 20.”
The holidays are a triggering time for those with eating disorders. “Many of my patients describe the holiday season as a time fraught with triggers,” says Dr. Vermani. “They fear reverting to harmful negative patterns of food restriction, binging, or relieving anxiety, stress, and other emotions by purging or taking laxatives. Many people avoid holiday get-togethers altogether as a means of managing their anxiety because they don't know how to set boundaries with people or not take personal comments that come naturally from people who speak about weight on a regular basis.”
Children and teens have additional worries. “When we are adults, we have autonomy and can pick and choose what events we attend, and our comings and goings,” says Dr. Vermani. “But children, on the other hand, often do not have the opportunity to pick and choose their holiday schedules, and often feel powerless and trapped, and forced to endure extremely distressing social events, where the pressure to conform and endure the scrutiny of others feels inescapable.”
To help their child prepare for holiday gatherings, Dr. Vermani suggests that parents learn relaxation techniques to share with their child (for example breathing and meditation practices to connect with their senses to bring them into the moment and away from the challenging symptoms), schedule check-ins with mental health professionals, work with a dietician to navigate the often overwhelming array of foods at a festive gathering, and create a game plan that helps them make healthy choices in stressful situations and settings. Parents can also help by encouraging kids and teens to engage in positive self-talk, avoid perfectionism, and ease pressure they place on themselves. Additionally, Dr. Vermani encourages parents to spend time with their kids doing something they enjoy to ensure that they are positively connected to good moments in their day.
Preparing your child for events is one part of navigating the holidays, but the other side is managing friends and family who may not know about the situation. “Well-meaning friends and family members can unintentionally cause significant hurt and harm to a child who is struggling with an eating disorder,” says Dr. Vermani. “In our society, many people feel that they have the right to comment on the level of attractiveness, body size, and actions of others — especially children, and female children in particular. While a compliment on one’s physical appearance may be appreciated or tolerated, the negative comments typically reserved for those struggling with an eating disorder, are overwhelmingly negative and distressing. Even loving family members can unintentionally cause tremendous hurt and harm.”
Dr. Vermani shares tips for parents:
- Check your own urge to scrutinize and comment on your child’s appearance or food choices.
- Make an effort to understand your child’s triggers, especially the subtle ones.
- Ask your child how you can be of help to them in social gatherings. Allow them to feel a sense of control, and that they can take charge and set boundaries with people who challenge their food consumption, and/or comment on their physical appearance or weight. This will help your child cope with their fear of scrutiny, judgment, and self-doubt, and allow them to feel capable of managing.
- Talk with family members and friends to let them know what supportive, helpful, and appropriate interactions are, and what sorts of comments are hurtful, inappropriate, and distressing.
- Assure your child that you have communicated with others and that you want them to come to you if they are feeling upset and triggered at a social gathering.
- Have compassion for yourself, and your struggles and issues. Take steps to address your body image issues, and come to terms with your child’s clinical disorder. By doing so, you will be better able to advocate for them and help them feel safe as they process their anxiety and feelings of being overwhelmed related to the eating disorder.
- Reinforce the message that it is OK for your child to be unapologetically themselves. Your permission to speak up for themselves and let other people know when a comment has upset them can be very empowering for a child.
- Encourage healthy boundary setting for your child. Explain to your child that many times people say things out of ignorance, rather than an intention to harm. Role play with them ways in which they can communicate healthy boundaries with such individuals, rather than personalize such comments.
- Be prepared. With your child, come up with a plan for times when they are feeling disrespected or unsafe in a social setting. Create a safety plan that allows your child to let you know when they need to leave, and that you will leave without question if they need to go. Knowing that you are on their side and that you are prepared to make a quick exit from a distressing setting if need be goes a long way to helping your child feel supported, loved, understood, and safe.
*Disclaimer: The advice on LittleThings.com is not a substitute for consultation with a medical professional or treatment for a specific condition. You should not use this information to diagnose or treat a health problem without consulting a qualified professional. Please contact your health-care provider with questions and concerns.
