By Karen Wolf and Sarah Emerman
The holidays, especially Thanksgiving, can be a stressful time for both clients and family members. Clients in eating disorder treatment often worry about what foods will be served for the Thanksgiving meal, potential comments made by family members, holiday-sized portions of food, following their meal plans, and avoiding behaviors. Their loved ones may also have concerns about feeling like they have to walk on eggshells around the client for fear of saying the “wrong” thing. This can make for a tense environment during what’s supposed to be a time for appreciating family and being together. Therefore, with help from some of our clients in our day treatment program, we have compiled a list of dos and don’ts on what to say (and what not to say) to loved ones in eating disorder treatment during the holidays.
Don’t comment on how your loved one looks. For instance, avoid comments such as “you look good”, “you look healthy”, and “you look like you’ve gained/lost weight”. While you may be trying to compliment your family member on all of their hard work in treatment, these comments may be interpreted as “you look fat”, regardless of the intent behind them. It may be best to avoid appearance-oriented conversations altogether.
Don’t comment on your loved one’s portion sizes at the table. The client most likely has a meal plan or is on a family-based treatment plan and will base their meals off of those guidelines. Drawing attention to portion sizes can result in increased discomfort and anxiety around food choices, and may encourage eating disorder urges and thoughts.
Don’t talk about your own anxiety about what you’re eating. Making comments about the calories/fat in food, talking about post-Thanksgiving diets, or making plans to exercise the next day can encourage eating disorder thoughts and worries for the client. It also sends a message that being full on Thanksgiving is not normalized or acceptable.
Do enjoy the food and model healthy eating behaviors. This means not fasting prior or after to the meal and including a variety of foods in your Thanksgiving meal.
Do tell your loved how happy you are to see them and at some point, if it feels appropriate, remind them how much you care about them. Eating disorders are isolating illnesses and family support is often appreciated.
Don’t watch your loved one eat. This may make them feel self-conscious, alienated, and singled- out.
Do plan activities to enjoy with your family. Distractions for the client will be important, both before and after the meal. (Suggestions include board games, football games, movies, conversation, outings…).
Do ask your loved one if they’re comfortable helping prepare and clean up the meal. Individuals with eating disorders think about food and eating constantly and a mental break can help ease discomfort. Instead of helping with cooking, ask your loved one to help set the table, decorate, and tidy up.
Do have normal conversations with your loved one that don’t include talking about therapy and treatment. If they are in treatment they are most likely sick of talking about their eating disorder. Allow them to direct the conversation to treatment if they wish.
Do remember the spirit of Thanksgiving and honor the traditions of spending time with family, togetherness, and enjoying each other’s company.
Please note that these suggestions are not based in research, but rather the experience of our clients. These suggestions may not be appropriate for everyone and every family.
This list is published with the permission of our clients.
Next Week: Eating Disorder Education: Should it be evidence-based?