Tips for people with eating disorder

Dec 9 2009

Many people equate the holidays with food - big meals equals big times. Americans, especially, attach a lot of social and personal value to what, and how, we eat, often through family rituals or attitudes. For many, family gatherings are positive events, but for the 9 million men, women or young people who have an eating disorder, the holidays, without proper planning, can feel like nightmares.

Three out of four American women have "disordered eating" behavior, and 10 percent have an eating disorder such as anorexia or bulimia nervosa or binge eating disorder, says Cynthia Bulik, Ph.D., the William and Jeanne Jordan Distinguished Professor of Eating Disorders in the UNC School of Medicine's department of psychiatry and director of the UNC Eating Disorders Program. Her latest book, "Crave: Why you binge eat and how to stop," was released in early 2009.

If you have an eating disorder, plan ahead. Bulik and the UNC Eating Disorders team offer the following suggestions to navigate the food minefields of the holidays:

•Have a "wing man" - someone you trust to help run interference at family get-togethers or office parties. This should be someone who knows your triggers and can help distract you from temptations (or someone pushing your buttons), change the subject or assist you while you handle the stress.

•Make up a code signal or phrase with the wingman before going to the holiday party. If you start to feel overwhelmed give your friend the signal so that you can both step out of the room and they can offer you some support.

•Keep your support team on speed dial and call them at any time during or after a party. Talking relieves the pressure. You're not overburdening them. They will undoubtedly have stories to share, too.

•Potlucks are your friends. Don't hesitate to take a food you prepared that feels safe enough to you so that you will have at least one manageable entrée.

•Lavish holiday spreads don't have to be the enemy. If faced with one, channel your inner Boy Scout or Girl Scout skills and be prepared! Before stepping in line, and before getting a plate, evaluate the options. Mindfully consider which foods you'll sample, portion sizes and whether you feel comfortable trying a "feared food." Make a decision and stick with it!

•If your treatment team has given you a meal plan stay on track so you aren't starving when you get there.

•Listen with your heart, not your head. Hear the happiness and caring in a person's tone when they tell you that you look "so much better." They are saying they care about you. Don't let the eating disorder lead you to misinterpret those words in a way that deprives you of hearing that people really care about you.

•Get Real! People too often have a fantasy about how "perfect" the holidays are going to be. When family members fail to live up to unrealistic expectations, it might be tempting to restrict or overeat in an effort to feel better temporarily. Try to anticipate some of the possible emotional traps in advance so you can cope (and maybe even laugh) when you encounter them.

•The well-known HALT slogan works for any type of recovery. Don't let yourself get too hungry, angry, lonely or tired. This is especially important over the holidays.

•'Tis the Season to Forgive, so forgive yourself if you have an eating slip.

•Try your best not to skip appointments with your treatment team. It's an important time to stay in touch with people who can help.

If you think you might have an eating disorder, the best first step is a comprehensive evaluation. The UNC Eating Disorders Program offers comprehensive evaluations and referrals for the appropriate level of care.