Whatever holidays you celebrate, at some point you’ll probably be gathering with friends and family over big plates of delicious food. While these meals are some people’s favorite reason to be jolly, when you’re struggling with an eating disorder, this part of the season can be a real source of holiday stress. Based on personal experience and expert input, here’s how to help friends and family navigate the holidays (or survive them yourself) when coping with disordered eating.

Symptoms to Look Out For

A woman smiles down at a holiday meal

The term “eating disorder” covers a few different conditions, but the commonality between them is an unhealthy relationship with food. The conditions you’ve most likely heard of are anorexia nervosa (in which the person attempts to continuously lose weight by restricting food and overexercising) and bulimia nervosa (which swings between bingeing — eating a lot of food in one go — and purging — inducing vomiting or finding some other way to “compensate” for the intake).

“For anorexia, symptoms to look out for include dramatic weight loss; preoccupations with food such as counting calories or restrictive dieting; avoiding meal time with other people (e.g., turning down social engagements that have to do with dinner); cessation of a monthly period [for people who normally menstruate]; and gastrointestinal symptoms such as stomach pain and constipation,” advises Dr. Navya Mysore, a family medicine practitioner with One Medical. Symptoms of bulimia include “taking trips to the bathroom right after meals, bad breath from purging, and buying large quantities of indulgent food. Physical signs to look out for are gums that are eroded from acid in vomit and scarring on knuckles from eliciting vomit responses.” Two other indicators for either bulimia or anorexia, she adds, are excessive exercising and wearing baggy clothes that disguise the wearer’s body.

How Does It Feel to Have an Eating Disorder?

As someone who recovered from anorexia, I can tell you that living with the illness often feels very lonely. A common misconception is that people with eating disorders are shallow and judgmental — that they want to be skinny because they are trying to live up to unrealistic beauty norms. In fact, while no two experiences are the same, eating disorders are often less about wanting to look a certain way for the sake of it or for judging others and more about trying to feel in control of one’s life by controlling one’s body.

The holidays are a particularly stressful time because sharing food is a big part of these celebrations. When your brain is triggering anxieties and guilt about eating certain kinds of food, it makes you not want to join in — or want to purge if you do — and then you feel even more isolated. This isolation, in turn, makes you return to the coping mechanisms of your eating disorder: restricting, bingeing, purging, overexercising, etc.

How Should You Talk to Someone About Their Eating?

Friends enjoy a candlelit holiday dinner

As with many mental health issues, talking about eating disorders can feel really awkward, especially during the holidays, when we feel pressured to gloss over uncomfortable topics in order to make everything seem happy and perfect. How, and if, you bring up the subject really depends on the person and your relationship. If they haven’t acknowledged their eating disorder to anyone, it’s not a good idea to corner them on a big family occasion to try to discuss it, as this will potentially make them feel embarrassed. However, if it’s someone you’re close to, there are definitely things you can say and do that will help.

“While every patient is different, don’t feel the need to wait until after holidays to approach a loved one if you’re worried,” recommends Dr. Mysore. “If you see that they are struggling, it’s okay to bring it up and ask about their well-being, especially if the problem is already known in the family or group. If you avoid the topic or walk on eggshells around that person, it can become even more isolating for them.”

A lot of people struggle to understand the thought process behind eating disorders: They might make comments or think, “I like food too much to be anorexic!” or “Why don’t you just eat a sandwich?” Even if you don’t fully relate to the illness, try not to pass that on when you talk to the person you care about who is going through it. “Acknowledge how they’re feeling and offer support for their experience, as opposed to chastising them for the problem or their symptoms,” Dr. Mysore advises.

Disordered Eating Isn’t Fixed Overnight

Recovering from an eating disorder goes beyond one meal or even one holiday season; as hard as it can be to watch someone suffer, try to understand that you can’t fix it for them. While it might be tempting to force them to eat a full meal or to try to stop them going to purge or exercise, this might make them feel more lonely and misunderstood, which could send them even further into that spiral. The most loving and thoughtful thing you can do is to be supportive, offering open and non-judgmental communication when they want it.

There is a fine line between supporting and enabling someone, but since you can’t stop the eating disorder yourself, focus on trying to help lessen the stress, which in turn can sometimes help reduce the urge to act on those disordered behaviors. “Make time to learn how they’re going to cope around the holiday,” suggests Dr. Mysore. “Partner with them to come up with a proactive strategy to address the situation.” Expecting a big family meal or a dinner party situation? “It’s a good idea to speak with the eating disorder sufferer ahead of time, to talk about what the meal might look like and find ways to make it less overwhelming. Finding ways to avoid making food the focus of the celebrations could greatly reduce anxiety ahead of time.”

One part of being a supporter might be helping the person face interactions with friends or family members who are less sensitive to their illness. Well-meaning people sometimes compliment others on losing weight or comment on the fact they’re not eating, especially if they haven’t seen them for a while, which can be embarrassing and painful. If you notice this happening, step in and lightly change the subject, or ask your friend to help you with something so they have an excuse to leave the conversation. “Be an ally in advocating for how they feel, and, if the topic comes up, help deflect attention and diffuse the situation,” Dr. Mysore encourages.

If You’re Concerned About Your Own Eating

A woman carves a turkey at a Christmas dinner

If you know or even just suspect that you have an eating disorder and are worried about what the holidays will bring, one of the best ways to push through this particularly stressful time (and also the illness itself) is with the support of people you trust. Specifically, lean on people who won’t push you more than you can take, who will be there when you need them. Depending on how open you are about your experience, you can also take the initiative to preempt some of the stressors before they come up.

“If you’re comfortable with it, take control of the situation by sharing your anxieties with your loved ones,” says Dr. Mysore. “Create a plan together, whether that’s making dishes you’re comfortable eating or focusing on celebrations beyond the dinner table. If that’s too much for you, find support elsewhere: See a therapist or support group, or talk privately with someone who you are comfortable with, such as your primary care physician or a close friend.” In terms of resources, she recommends, “National Eating Disorders Association has a great community blog with learning resources, and Eating Disorder Hope also has a lot of helpful information.”

In addition, please know that you are not alone. You are not stupid, or silly, or superficial. You are not a bad or rude person because you don’t feel like you can join in with all the holiday eating, so please don’t worry about that right now. Finding your way to recovery can be hard, and it can be slow, but take every day at a time, know that you are worthy of being able to eat without feeling stressed about it, and you can get there, with a little help from your friends.

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(Photos via Getty)