The winter holidays are a time for family, celebration… and eating more than we do the other ten months of the year. I’m exaggerating (kind of), but there’s no doubt that our holidays are focused around foods. Right now, in the Adolescent Medicine office, there are at least three plates of homemade cookies from three different staff members, plus some salted caramels and walnut fudge.

Most people have no problem with having a few delicious cookies, but for teens with eating disorders, the rich foods flying around can cause severe distress. Teens that restrict their diets may not be able to resist a cookie or two, and then suffer intense guilt and shame. Teens that binge-eat may find themselves overwhelmed with- and binging on- the ready sweets and treats that the holidays present.

You may have a teen with an eating disorder, or you may have a relative or friend who does. These are some tips to help make the holidays easier for these teens and their families. My work was cut out for me with this post; our nurse Gail Allen already came up with a patient education flyer to give to families during the holidays, and I am simply paraphrasing her work!

  • Plan some holiday activities that do not involve food. Christmas caroling, a walk in the woods, a game of Dreidel for real coins, going to an ice-skating rink… the possibility are endless.
  • If clothes shopping is part of your holiday experience, try shopping for accessories instead of for clothes; for teens who have body image or size issues, it can be a relief to look for a one-size-fits-all purse or hat.
  • Preparation is key. Talk to your teen before family gatherings or meals- at least a few hours beforehand. Let them know who will be there, what food will be served (to the best of your ability), how it will be served, and plan “escape routes” if he or she might need some time away from the crowd.
  • Continue to eat regular meals and snacks before any holiday feasting occurs. If you are not eating regularly, your teen has a better excuse to avoid it.
  • If your teen wants to bake or cook holiday meals, that is great; provided they eat what they make. Teens with eating disorders sometimes like to make beautiful, rich food and then give it all away. Obviously, this is not healthy behavior! It only makes sense that if your teen is making something delicious, that they have some too.
  • If your teen binges, or binges and purges, make sure you talk to them before the house is full of holiday treats waiting for a party or cookie swap. Talk about whether or not it’s appropriate to have these things in the house- and bring their therapist or nutritionist into the discussion, if they have one.
  • Don’t talk about your own eating. If you feel stuffed like a turkey after a holiday feast, that’s normal- but don’t complain about it. If you feel you gained weight, don’t say it out loud. Any talk regarding having eaten too much, or gained weight, can cause anxiety in teens with eating disorders, or reinforce their eating disorder further.
  • Be a good example! Eat treats and holiday foods in moderation. Enjoy the unusual delicacies and stop when you are satisfied. If you overeat, relax, don’t stress about it, and recognize that it happens this time of year. You’re setting a great example for your teen.

The holidays have a reputation for being warm, relaxing, and full of cheer. While this may be partly true, for many of us it is also a time of family negotiation, frustrating travel, emotional tumult, and stress. Having a teen with an eating disorder is hard at the best of times, and the holidays tend to put pressure on the teen and the whole family. Try not to expect a picture-perfect holiday. Communicate, enjoy the celebrations, and remember that the holiday season will be over (for a year, at least) on January 2nd, 2012!