Coping at Christmas With an Eating Disorder

Last year, in the midst of a relapse, I'd just been discharged from NHS services, told that I didn't meet the criteria for outpatient support, despite the fact I desperately needed it. The timing was particularly poor as a number of external events were also affecting my stress levels.

When I reflect back to last year and think about my preparations for the festive season then, and how I have prepared mentally and physically this year, there is a wealth of difference.

As I write, I have just been given clearance from my dietician to take up sport and exercise again (healthily) and I am starting to think about food, nutrition and well being with a much healthier approach.

The same could not be said for last year, the year before and so on.

I have found Christmas and the festive period to be a challenge every year, where food dominates and family stresses run high. Even when I have previously had a routine that has been working, the festive season kicks in and that has been a challenge to keep up with, with the regular family gatherings, buffets, snacks and high calorie meals.

"It's the most wonderful time of the year"...unless you have an eating disorder.

Last year, in the midst of a relapse, I'd just been discharged from NHS services, told that I didn't meet the criteria for outpatient support, despite the fact I desperately needed it. The timing was particularly poor as a number of external events were also affecting my stress levels. As Christmas drew closer, I felt myself both mentally and physically preparing for Christmas by restricting, in readiness for the festive binge that was about to unfold. I've described this as like running a marathon without doing the training; my body and mind simply could not cope. It's not just Christmas day, but a whole fortnight and each day went by, me feeling increasingly aware of how much I'd eaten, feeling desperately unhappy and extremely unwell.

I came home early, and went into an extreme cycle, punishing myself and as a result ended up in hospital with dangerously potassium levels - a result of laxative abuse, over-exercise and malnutrition.

Experts warn against this very pattern, as there are a number of problems which can occur, which adequate preparation could mitigate against.Severely malnourished people should be aware of re-feeding syndrome; and when re-introducing food should introduce food gently, rather than in a desperate binge that could put pressures on the cardiac system.

The starve-binge-purge cycle leads to extreme mood swings, which at a time of year when tensions are high, can increase stresses especially if emotions surrounding food and eating haven't been dealt with. Eating irregularly also contributes to low mood and increases susceptibility to bingeing on high energy foods, making the sufferer feel increasingly out of control.

A year on, and I've been really lucky to have had almost a year's worth of therapy and dietetic support (albeit, it's been private), but it's got me to a much more stable place.

I have been slowly getting towards a place that involves a more "normal" pattern of eating, although I admit my amounts of food are far from what is normal for a person of my age and activity.

I have recently discussed with my dietician a meal plan for the festive period, considering managing difficult scenarios, such as our buffet that is traditional for our family on Christmas day and problem solving by only putting some food out in the first instance, and allowing people to help themselves later on.

A second coping strategy has been developing my assertiveness, and self confidence. I have experienced people challenging the portions of food I'm having, or questioning why I am not having x or y...I have discussed with people such as my mum the why and the importance of what I am doing. I have a container I use to portion out food, which is making me feel safer. Sometimes, I need to remind people around me that I'm doing this and this is aiding my recovery, because people aren't perfect. Assertiveness and being confident in your own judgement is a skill, but if it helps you, then keep doing it.

Plan, plan, plan! I've sat down with my dietician and my family to discuss the food I will be eating (and what the family are having) and made compromises where necessary. I have my plan on my laptop and I can mentally plan ahead, as well as physically, such as remembering to bring breakfast and lunch for when I go to stay with other members of the family.

Make your plan manageable.

I looked over my plan and I reviewed it a couple of times and took some things out and on a couple of days decided to not push myself so much, because I'm already taking a significant step this year. If your big step is getting in three small meals, can one of those meals be a banana on one day for example? On Christmas day, I know this is an indulgent day for the family, so I have decided not to push myself with breakfast and have gone for a lighter breakfast.

Always set manageable goals.

Try and allow days to indulge

One of the things that I've learnt is that in normalising my eating, Christmas is where people do indulge. I don't have to eat everything in the fridge/house etc. I don't need to eat loads, but I could eat some things that are luxurious on the festive days. It's worth building this in, because everyone else around you will be eating like this. But it doesn't mean that you need to eat everything that everyone else is having, for the whole day and for the whole of the period.

Think about timings

You should aim to space out eating to roughly every 4 hours, to allow yourself to below satiated.

When you're eating, mindful eating is important to allow your body to feel full.

Breakfast should be consumed usually 30 minutes after getting up, and is also really important in regulating your moods, but also keeping your weight definitely worth it over the festive period. By having small regular meals (generally) and also over the festive period, you're less likely to eat the whole box of Lindor.

Give yourself time...

It's not going to be easy - if you found it easy that would be great.

Allow yourself some time to yourself if things get stressful.

I like listening to music to de-stress myself, I also find watching TV really helps.

Going for a walk (or in my case, taking my dog for a walk).

Talking to a friend is another good coping mechanism. I've asked my friends to send me motivational messages.

If you have hobbies which you can do over Christmas, then try and find space and time to do these whilst you're feeling things are difficult; finding time to unwind when you're feeling vulnerable helps to bring your mood up again.

I also recommend yoga or mindfulness.

There's a great online forum called the Big White Wall, which is another good option if you simply need to talk to someone virtually. They also have options to express yourself creatively.

Pacing yourself is important. It's better to take things bit by bit, and being nice to yourself.

Stay positive, and remember you're not alone.

As well as the Big White Wall you can also get help via NHS 111, the Samaritans 08457 90 90 90

Mind, 0300 123 3393 or call 999 or go to A & E if you are in crisis.

Hope this helps.