*Trigger warning: bulimia, anorexia, and binge-purge anorexia nervosa*
For most of us, the Christmas period is about indulgence. Eating whatever you like and not worrying about it until the new year.
However, for those suffering from eating disorders, Christmas can be a troubling time. A month-long nightmare as shops get into full festive swing and the build-up to the big Christmas dinner begins.
"I'm worried I'll ruin the day for everyone," says Claire Greaves simply. The 23-year-old spoke to HuffPost UK from hospital, where she has been in and out of for the past few months after her battle against anorexia took a bad turn.
On Christmas Day, Greaves will be at home for the first time in several weeks - and she's worried she'll struggle.
"I'm feeling nervous. There's an expectation for everything to be fine and for struggles to stay hidden. I feel anxious about the food I will be expected to eat. We aren’t having Christmas dinner in my house so there is slightly less pressure but there will still be chocolate and treats around.
"I’m most worried about not being okay on Christmas Day. I’m worried I’ll struggle being home from hospital."
Claire has previously been sectioned because of her anorexia
"I'm particularly apprehensive about this Christmas," says Rhiannon Morgan, from Chester.
The 19-year-old is currently studying philosophy at university but is debating taking a year out so she can focus on recovering from both anorexia and depression.
"The festive period is one of the hardest times of the year for me with respect to my eating disorder, as it was around this time four years ago that it all started," she says.
Although Morgan has relapsed every Christmas for the past three years, she is hoping this one will be different.
"Perhaps it's particularly hard as it brings back memories of the triggering event, but it does not help that everything seems to revolves around food.
"The thing that worries me the most is perhaps not being able to cope as well as I'd like, as I don't want to drag the whole Christmas down for everyone else if I struggle."
Morgan hopes to put on a "brave face" and plan out her food in advance to prevent further anxiety and worry.
Rebecca Field, head of communications at eating disorder charity B-eat, told HuffPost UK planning is "hugely important".
"Christmas and New Year can be an incredibly difficult time for someone struggling with their eating disorder. It is a time where food is central to any social calendar which can cause increased anxiety, [pressure and feelings of guilt, that they can’t “join in” like they hoped.
There are some things that you might be able to do as a family to make the Christmas period easier for someone with an eating disorder to deal with. Planning is hugely important. talk about what you are going to do on Christmas day and the period thereafter and when and how food will be involved.
"Once meals are over put food away and find activities that don’t revolve around food - wrap up warm and go for a walk, play games, find a good film to watch, for example."
"I'm hoping this Christmas will be different," says Rhiannon Morgan
Although Habiba Khanom doesn't celebrate Christmas, the 22-year-old's family does get together for a big meal, which she says "terrifies" her - because of the focus on food.
"Normal people would be excited for Christmas, but those with eating disorders like myself dread it.
"Everyone is talking about food and bringing food. Not just any food, but the most triggering food there is, such as chocolate, sweets, cakes, mince pies and so on - which is always on my 'banned' food list."
Khanom suffers from binge-purge anorexia nervosa, a vicious cycle which sees the sufferer restricting their food intake and then engaging in binge eating and purging behaviour.
"Christmassy food is a major binge food and it gets too hard to avoid," Khanom, a London-based journalist for the BBC explains.
"I feel like there is nowhere to hide. You are surrounded by it and the eating disorder voice gets very loud."
All three young women say their families are supportive of their condition.
"I think they worry about me a lot. I think they are scared," says Greaves.
Khanom adds: "They still find it hard to deal with the fact that I am different when it comes to food. When everyone is eating the same normal Christmas food, I am sat eating something healthy and safe."
Morgan says her family are as supportive as they can be with the "confusing disorder".
"I think they have the hopeful approach that nothing is going to go wrong and I will be happy like them," she muses. "It is difficult to explain to others, but due to past events happiness at Christmas time feels almost false and exaggerated. Perhaps it doesn't help struggling with depression on top of this.
"It all creates a complicated mixture of emotions and general disorder, which for family is difficult to understand, regardless of us being a close-knitted family."
For Emma Healey, Christmas is about making sure her younger sister Ellie is OK.
"It's something I’m very aware of, and I’m far more conscious of what I’m saying and what I am eating around her at Christmas," she says.
Emma (right) with her younger sister Ellie
Two years ago, Ellie spent eight months in hospital being treated for anorexia, which she has suffered from since the age of 14.
"I know she finds it so difficult, especially as she spent Christmas in an eating disorder unit – so I try to do anything I can to make it a bit easier for her. Last year, we spent Christmas dinner at my aunt and uncle’s house which is what we normally do for Christmas – but my dad plated up all her food for her so she had set amounts to eat.
"This year we are just having a small family Christmas with my mum, stepdad, and sister – she’s determined to challenge herself and have a glass of wine with dinner. I know she’s very worried though about not having done enough exercise to compensate for the extra food.
"It hugely affects my Christmas," Healey adds. "but I try to act as normally as possible whilst still being mindful of her feelings.
"I know that in my family we often have competitions over who can eat the most at Christmas dinner, and that’s okay to still do – but don’t make it a huge part or a big talking point. It’s not worth making her more uncomfortable for something that really is so insignificant in the long run.
"I think my number one piece of advice though would be to be there for them, they are going to find it hard, but with you supporting them they can get through it."
"The Christmas period is a really beautiful but difficult time of year," Greaves adds. "Pressures and stress involve more than food - there are often many social situations which trigger thoughts of guiltiness and unworthiness. My way of coping is to know I have people to talk to, and are accepting that it is what it is.
"I check in on my emotions and their intensity. I prepare coping strategies beforehand and make sure I am compassionate to myself. I also find it useful to journal how the day has gone so I can look back on it next year."
Morgan copes with Christmas by planning, saying it's her "number one key".
"Christmas is definitely the most difficult time of the year for me personally, and I know from talking to others that it can be the same for them. The main difficulty is putting on a front constantly and trying to appear happy when really you're fighting an internal war 24/7.
"In those circumstances it is hard to keep going. Sometimes the happiness feels so false that it reminds you of a perfectly laid table, and you just get this urge in your head to pull the table-cloth as it's too 'false', and you almost feel like your feelings aren't welcome, if that makes sense."
She continues: "Food around Christmas time is chaotic for people with eating disorders, as meal-times and routine is completely shaken up. Planning creates a sense of security, as then you are prepared in advance.
"With respect to big meals - such as Christmas dinner - it really depends how comfortable you are feeling in recovery, but the past two Christmases I have prepared a different dish for myself that has been planned in advance. It is helpful if it is quick and easy to cook Microwaved as cooking in a messy kitchen can be particularly stressful. So far, this has worked, and I can't wait for a Christmas where I can tackle food like everybody else.
"My advice for others would be: be honest and plan in advance. It is important that you are honest with family about your difficulties, and also to sit down and negotiate your strategy for food and emotions."
For Khanom too, planning is the key to coping with Christmas day, as well as making sure she keeps herself busy.
"I'd say plan the day beforehand. If you're prone to binging, perhaps plan your own meals to have. Remember, you do not need to eat what everyone else is eating. Do what feels comfortable to you. There is no pressure.
"I would also suggest taking yourself out of the situation if you are feeling overwhelmed. Go outside, take a breather and go back in when you feel ready. Most importantly, do not isolate yourself. Make sure you are around people and focus on something else rather than food.
"What I found helps get me through it is keeping myself busy with something that doesn't involve food. Which of course can be hard. I play with my little cousins, which helps. I try and get myself out of the situation, even if it is for a short amount of time. I try to take a minute alone to catch my breath and not let it overwhelm me."
She adds: "Christmas is definitely one of the most difficult times of the year for eating disorder sufferers but what we need to remember is that, Christmas is not just about food.
"It is about joy and laughter. It is having fun and enjoying time with friends and family."
See Also:
Useful websites and helplines:
SEED eating disorder support service has collated a coping with Christmas guide. It also runs a helpline: 01482 718130
Beat, call 0345 634 1414 or email help@b-eat.co.uk
Samaritans, open 24 hours a day, on 08457 90 90 90
Mind, open Monday to Friday, 9am-6pm on 0300 123 3393