Surviving Thanksgiving With an Eating Disorder

Food and Family Make a Stiff Challenge

What makes Thanksgiving so hard to handle when a person has an eating disorder? Some problems are obvious, and some not so much, but any discussion of Thanksgiving and eating disorders obviously must begin with food.

Thanksgiving Food a Natural Problem With Eating Disorders

The massive Thanksgiving spread is clearly an issue for a person with an eating disorder.

For someone with anorexia nervosa, large quantities of food increase anxiety. There's more opportunity to eat, and eating is considered the enemy. So the pressure is on. The internal reaction is, "How can I avoid eating, and how can I look as though I'm eating when I'm not?"

Binge-eating disorder poses different problems. Chances are that there are foods present that can easily trigger a binge. Often, there is an effort not to eat too much while knowing how easy it might be to binge. Naturally, this creates tension. In my own work with clients who binge, I've seen people who struggle with binge eating have fairly normal meals at the big gathering, and then go home and eat large amounts of food. This relieves the tension (though it also leads to feeling terrible).

In addition to binging, a person with bulimia nervosa will often be concerned with how to eat enough to create a binge, and then to make sure that there is easy access to a place (usually a bathroom) to purge.

But Food Isn't the Only Thanksgiving Problem

Thanksgiving creates more problems than a massive spread at a work party or a big dinner with friends. The holiday's meaning could make dealing with food even harder.

If a family (or group of friends) intentionally focuses on giving thanks, it may create more pressure for a person with an eating disorder. Thankfulness is hard to achieve when a person feels a huge sense of shame. There just isn't "room" for kind thoughts of gratitude when a person has a low view of herself (or himself). Set against the internal thoughts of a person with an eating disorder, gratitude might seem trite.

But how often do you hear someone say, "I'm not thankful at all"? That would disrupt the celebration. A person without thankfulness might think the whole holiday is silly, but she will most often stifle her emotions.

And Then There's the Family Themselves

Of course, if there are any negative family dynamics among the people gathered, simply being with them can be a problem. Getting together with family members can bring back old memories of a time when an eating disorder began to take hold. Some examples:

• Being urged to eat by a parent or other relative
• The telling of embarrassing stories that feel shaming
• Getting shut out of conversations or being ignored...as usual
• Feeling as though you have to help with the meal while a bunch of others (generally men) watch football...
• ...and of course, comments about weight, body size, or body shape

Can Thanksgiving Deepen Eating Disorders?

One danger of Thanksgiving for a person with an eating disorder is that the holiday might reinforce the problem.

For binge eating and bulimia, the opportunities to binge are clear. But when a person can learn to binge (and purge, where applicable) with so many people around and without being found out, there can arise a certain sense of relief: "Wow...I can turn to binging and purging even in tricky spots." This reinforces the behaviors as reliable, trusted fallbacks -- "aces-in-the-hole," so to speak. That makes them even more valuable than before, and more likely to be guarded.

In anorexia, the situation is similar. Resisting food under so much pressure bolsters the notion that the person is special (a common pursuit in pro-anorexia [pro-ana] circles): "There were 40 people there, and everyone was stuffed except me. I left hungry!" It can be a powerful feeling that unfortunately makes avoiding food seem more legitimate.

What You Can Do About Thanksgiving With an Eating Disorder

You're not without options. Thanksgiving is no day at the beach, but your preparations can make it tolerable -- or perhaps even positive.

1. First, plan your day ahead of time. It's going to be a challenge, so find out what you can beforehand. Who will be there? Where will it be? When will the meal take place? Visualize eating a normal meal under those conditions.
2. Don't diet leading up to Thanksgiving. It isn't worth it. The dangers of dieting are increased around Thanksgiving: Many diet beforehand so they can feel OK about gorging themselves. That puts a lot of hope on one day. What if your favorite dish gets burned? You might be resentful. And that's another reason to consider the next suggestion...
3. Have a goal that doesn't involve food (or avoiding it). Do you have a relative with whom you'd like to spend a bit of time? See if you can arrange it beforehand. Know that you're going not just to be involved in a big meal but to ask your aunt/uncle/grandmother/cousin that question you've always wanted to ask.
4. If your struggle involves binge eating, it's rarely going to be helpful to avoid your favorite foods. But you can eat them "better." Don't eat the slice of pumpkin pie over the sink, trading comments about work with an in-law. Put it on a nice plate, if available, and focus on it while eating it. You'll enjoy it more, getting more out of the experience, so you'll be less likely to go back for more. If someone interrupts you, politely say, "Please give me 10 minutes to enjoy this pie. I'll be a much better conversation partner when I've finished." Don't think you could make a slice of pie last 10 minutes? Practice a little sensual eating beforehand.
5. Talk with your therapist beforehand. A therapist who knows your personal bent will have solid suggestions for you.
6. Talk with your dietitian, too. There's no reason to face that smorgasbord without accurate nutritional information. Maybe the foods you like aren't as dangerous as you think.
7. Keep a journal beginning a week before and going at least two or three days after the holiday. Include thoughts on food, but only if you've also written down how your emotions are impacted by what you expect to happen (and afterward, by what did happen).

It's not easy, but you can survive and even enjoy Thanksgiving. Take it one conversation, one journal entry, and one bite at a time.