Plan ahead for holiday meals with persons who have eating disorders

Holiday celebrations focused on food are difficult for persons recovering from eating disorders, and challenging for their family and friends.

Many well-meaning persons may find themselves wondering how to behave around persons recovering from eating disorders. Should they encourage their loved one to eat or ignore his or her eating disorder entirely?

“Ideally, family and friends should be sensitive to the fact that their guest or loved one has an eating disorder,” says Theresa Fassihi, PhD, a psychologist with the Eating Disorders Program at The Menninger Clinic. “Respect that, while the meal may be a joyous occasion for you, it may be stressful to a person with an eating disorder, especially one who has recently completed treatment.”

Food-centered events may trigger eating disorder behavior, such and bingeing and purging, for some persons in recovery. To prepare for an upcoming meal, persons recovering from eating disorders often plan in advance what they will eat and may have dietary restrictions that prevent them from eating certain foods.

Dr. Fassihi offers some do's and don'ts for families and friends celebrating the holidays with persons recovering from eating disorders:

Do:

* Offer food to family and friends instead of forcing it on them. Instead of saying, “You have to eat some of my famous pecan pie,” say instead, "Would you like to try a piece of my pecan pie?” Graciously accept “no” as an answer if your family member with an eating disorder turns down a particular dish.

* Treat your loved one with an eating disorder like the rest of the family or friends. Singling out the loved one will make him or her feel uncomfortable and want to avoid being around others.

Don't:

* Don't watch your family member with an eating disorder eat or ask questions about what he or she is, or is not, eating.

* Don't talk about shape or weight--theirs or yours, including complimenting them on their appearance. This could trigger negative feelings or difficult-to-manage thoughts about body image in a person with an eating disorder.

If you suspect someone at your dinner or party has an eating disorder, talk to that person at a later time about your concerns, Dr. Fassihi says. Encourage him or her to see an eating disorder specialist to be evaluated for an eating disorder. If your friend or loved one denies a problem, emphasize the tremendous health risks of eating disorders, especially heart problems, permanent bone loss and death. Early intervention offers people with eating disorders the best prognosis.

Sidebar:

Does your college kid have an eating disorder?

Parents may notice changes in their college-aged child's eating behavior during the holiday season, because many students return home for more than a day or so for the first time since summer. Signs of eating disorders include:

* Weight loss or change of weight – Watch for a sudden loss or gain. Persons with eating disorders commonly try to hide their weight loss by wearing baggy clothes. A person is considered anorexic if his or her body mass index (BMI) is 17.4 or less.

* Picky eating – Be wary if your child used to eat a variety of foods, but now will only eat some foods and not others, or refuses to eat any foods that aren't fat free.

* Sudden diet or decision to be a vegetarian – Diets and becoming a vegetarian provide a socially acceptable way for a person with an eating disorder to restrict his or her diet and to reduce calories. Ask your child about the reasons he or she is going on a diet or becoming a vegetarian.

* Obsession with exercising – “It should raise a red flag if your child gets anxious or scared if he or she has to skip a day of exercising,” Dr. Fassihi said.

* Frequent trips to the bathroom or showers – Young adults with bulimia often attempt to control the amount of calories they consume by purging after a big meal. They may make frequent trips to the bathroom to purge and turn the shower on to muffle their vomiting.

* Large amounts of food missing – Young adults who binge eat may eat normally when in the presence of others. When alone, they eat large quantities of food at one sitting—such as whole bags of cookies, tubs of ice cream and bags of chips. Missing food may the only clue.

* Change in personality – “Eating disorders change your personality completely,” Dr. Fassihi said. “A normally outgoing person often becomes shy and withdrawn and may avoid social events or eating with family or friends.”

The Menninger Clinic is an international specialty psychiatric center, providing treatment, research and education. Founded in 1925 in Kansas, Menninger relocated to Houston in 2003 and is affiliated with Baylor College of Medicine and The Methodist Hospital. For 17 consecutive years, Menninger has been named among the leading psychiatric hospitals in U.S. News & World Report's annual ranking of America's Best Hospitals.