December is here and the trees are decorated here at Ellern Mede children’s wards. Many of our young people will be home with their families for Christmas. Ellern Mede Family Therapy team have the following suggestions for managing Christmas when your child has an eating disorder.

Christmas can be a very stressful time for a young person with an eating disorder and their family. The young person may experience anxiety about memories of difficult past Christmases or anxiety about the food that might be served and expectations of the day.

With its emphasis on elaborate food preparation, abundance and treat-style foods, thinking about and managing Christmas dinner can be very anxiety-provoking for the young person. In turn, this can may create conflict, upset and tension with other family members.

Young people with eating disorders often prefer structured timetables and activities to distract them from their difficult thoughts and feelings. This is all the harder around Christmas time which brings with it many very different routines, such as travelling between different houses, having food made by unfamiliar people, being visited by groups of friends and family, an emphasis on long mealtimes, the expectation that relaxation and socialising is in a larger group. All of this is likely to be very challenging and perhaps overwhelming for a young person with an eating disorder as they already have high anxiety and possibly few resilience skills with which to manage uncertainty and change.

We would suggest it can be helpful to try to keep expectations low and to minimise sources of stress whenever possible.  Consider the following.

1. Take a calm moment to talk

Take a calm moment to talk to your child about Christmas and together identify possible ‘tricky’ or challenging moments and what support plan might help. Think together about some activities the young person can do to distract themself.  Plan a way they can easily signal to you that they are becoming overwhelmed and need help, or a break.

2.  Plate the food

It is often helpful to plate and portion the young person’s meal for them. Keep the portion size similar to their ordinary family meals.

3. Choose the guests with care

Consider having a small group of family and friends who understand the situation and are supportive. Prime the wider family to focus attention on each other and other children, leaving you to have the most focus on the child with an eating disorder. Alert visitors in advance that your child will find this time difficult and give them advice on what NOT to say to your child. Eating Disorder experts warn one should never start any sentence addressed to someone with this condition starting with the words: ‘You look..’)

 4. Plan Activities that don’t involve food

Plan a few stress-reducing enjoyable activities that family members can engage in together that may act as a distraction from the emphasis on food and some of the post meal guilt that your child may experience.

5. Give reassurance of love and acceptance

While most of the family will relish receiving gifts, it may very well be different for the child with an eating disorder. Receiving presents can be difficult for a young person with an eating disorder as sometimes they experience guilt and feel undeserving due to their low self-esteem and their knowledge about how the eating disorder has affected family life. Give them their gifts with a lot of reassurance that they are loved regardless of their illness. Acknowledge their feelings and struggles. Reassure them they still deserve nice things and nice experiences.

6. Plan self-care for the Christmas host

Remember that hosting Christmas can be exhausting. Trying to give everyone the best time shouldn’t mean you sacrifice yourself. It is only by being calm and relaxed yourself that you can find the resource of compassion and encouragement within yourself to give to your child during difficult moments. Plan for your own needs. Think ahead on a strategy to find support yourself if there is a difficult moment.