Chocolate advent calendars, candy canes, mince pies, roasted chestnuts, figgy pudding, eggnog, turkey roast...'tis the season for feasting. But for someone with an eating disorder, there's little merry about Christmas time.
Whether currently struggling with anorexia, bulimia, binge eating disorder or EDNOS (eating disorder not otherwise specified), or in recovery, the sheer prevalence of food during the Christmas season is very difficult to cope with.
Turn on the television and you're greeted by an advert for sumptuous Christmas fare; go to the supermarket and you're bombarded by brightly-packaged goodies; brave a work party and you're confronted by a towering pile of buffet food; go to a family gathering and you're offered food, food and more food.
An alcoholic can avoid situations in which people drink. A compulsive gambler can avoid betting shops. A person with an eating disorder can't, however, avoid eating and food - and therefore Christmas, with its focus on feasting, is often the most difficult time of the year invoking overwhelming feelings of panic, anxiety, fear, and even revulsion.
For many with eating disorders, the pressure of Christmas can cause a worsening of behaviours.
Pippa Wilson, 31, from Kent recalls the Christmas when she was 19, that her anorexia descended into bulimia: "I just couldn't cope with the all the food everywhere", she says, "I lost the self-control to keep starving; I lost all control around food. But I didn't want to ruin Christmas for those around me, so I pretended to be fine, but purged behind closed doors. By my second Christmas with an eating disorder, I was so terrified of all the eating that I skipped Christmas altogether and spent it alone."
But as much as someone with an eating disorder may try to protect their friends and family from their illness at Christmas, it invariably has an effect on what should be a happy family time.
"I first got diagnosed with my anorexia in November, so that December was just awful, not only for myself but also my family", says Lauren Jackson, who is 23 and from Scotland. "My mum and dad didn't know what to do and found it difficult. I remember refusing point blank to eat the Christmas food my mum had lovingly prepared. I skipped many Christmas parties and refused to go out with friends because of the fear and anxieties I had. My family longed for a happy Christmas, but it was one of stress and worry."
But as Anna Caseldine, 19, from Devon explains, Christmas is whatever you make it, and is an excellent opportunity for family and friends to support those with an eating disorder: "I struggled with Christmas every year of the five years I suffered with anorexia", says Anna, "and as I recovered the way I coped with the day became a marker of my improvement. As I struggled with a late lunch, my family changed the Christmas meal to suppertime, which I could cope with. I think it is important for Christmas to be a day off from your eating disorder, and to think of the values of the day, not the food, such as family time, love and sharing; this is vital so Christmas doesn't become a day of food terror, but rather a day to celebrate love, family and friends."
With her support, Jenny Langley's son recovered from his anorexia. She offers the following tips for friends and loved ones of those with an eating disorder this Christmas:
1) Keep Christmas in perspective. A good trick is to draw a line down the middle of a large piece of paper and divide it into 12 months/52 weeks /365 days. Then highlight the bit that is Christmas. Suddenly it looks very small and hopefully more manageable.
2) Take the focus off food, and put it on family time. Perhaps even have an ordinary meal on Christmas day. Then, once it is eaten, all the food goes away and the family can focus on other things they enjoy doing - taking a long walk together, playing games, watching a film and so on. Plan fun activities for the whole Christmas period.
3) Keep unhelpful relatives in check. We all have a well meaning granny or uncle who will trample over fragile emotions: "Haven't you done well eating that meal?" "Shouldn't you eat a bit more?" "Gosh you've put on weight" are not helpful comments and can ruin progress someone with an eating disorder is making. Brief those relatives beforehand that such comments are unhelpful and unwelcome, or if you can't trust them not to say something potentially inflammatory then think twice about inviting them.
Mary George, spokesperson for Beat, the national eating disorders charity, offers this advice: "Christmas is such a difficult time for someone with an eating disorder, and what the person needs is compassion and understanding from those around them. Breaking with tradition can be worthwhile if it allows the person freedom around food and eating - what matters is that the person feels they can cope, not that they eat 'normally'. And for the sufferer, it's important to acknowledge that you might need more support around this time. Don't be afraid to let others know how you feel, whether friend, parent, carer, relative or colleague. And remember that on the Beat website (www.b-eat.co.uk) you can find advice on coping at Christmas, and our helplines are open over the festive period [adult helpline: 0845 634 1414; youth helpline: 0845 634 7650] to offer support and information."
The ultimate message is that however hard Christmas is now for those with an eating disorder, and their loved ones, have faith that it won't always be this way. Recovery is possible. Pippa, who once found Christmas so awful she vetoed it altogether, is now happy and healthy (she's the author of a book called Letting Go of Ed: A Guide to Recovering from Your Eating Disorder).
"I love Christmas now", she explains. "I'm as excited as my three-year-old son as the anticipation builds in December. I love having family around, and spending time together. Food is part of the fun, but I don't focus on it much. I eat what I want, when I want, without worrying; and in fact this means I don't over-indulge like many people, but enjoy myself. The best bit of Christmas for me is making mince pies with my little boy - they're usually inedible because I'm a terrible cook, but I like to look back and see how far I've come. Once you've recovered from an eating disorder, you can enjoy Christmas in a whole new way, because you appreciate how hard it used to be."Suggest a correction