The holidays can be a real challenge for people who are in the weight recovery stage of recovering from an eating disorder. There is a lot of food around, and a lot of stress in the air. If your child or adolescent is currently in the weight restoration phase, being out of a normal routine, and around relatives who are well-meaning but not helpful, can be very disruptive.
Below is an interview we conducted with Dr. Renee D. Rienecke regarding this topic:
My biggest advice for families who are in FBT is to plan ahead as much as possible. Think carefully through the actual holiday and the school break, and plan meals, snacks and rest into your schedule. Choosing your child’s meals, plating the food for them, serving it to them, and sitting with them while they are eating can be really challenging if you have people staying with you or if you are staying with others during the holidays. Each family will figure out their own path for this situation, but it’s important to know that there are a lot of options – the main goal is just that you think it through.
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- Calming strategies
If your child is in weight restoration, maybe consider taking a year off from staying at a relative’s house. Keep in mind during the holidays that it’s OK to simplify this year if you need to. You don’t have to do everything like you normally do because your life isn’t like it is normally. There is next year. Looking for ways to simplify your life around the holidays is good advice for anybody, but especially for someone in treatment.
A pitfall that families run into during the holidays is that when kids are off school, they tend to sleep in, and then they are more likely to miss breakfast and throw off their eating schedule and eating plan. During the holidays, everyone gets busy, and it’s easy for parents to take their eye off the ball. It’s a challenge for parents to stay focused, but it’s really important. You don’t want to let a week go by without any progress.
Families have a lot of balls in the air this time of year, and things are probably not going to go perfectly. Plan ahead, do your best, but remember, the holidays are going to be over soon. You’ll be back to your normal routine soon. Things are not going to be perfect, and that’s OK.
Whether or not you share the information about your child’s treatment plan is really dependent on your individual situation. It’s always a balance between respecting the desire for privacy, but at the same time not feeling embarrassed about your situation. The unfortunate truth is that not everyone you tell is going to react the way you want them to. Think through carefully who to tell, and what sort of information to share. If you do share the situation, it’s best to discuss it individually with each family member or guest. Let them know what’s going on, what will be helpful to talk about, and what topics to avoid.
If your kid has requested that you not tell anyone about treatment, then you will need to work together on how to handle comments that might come up from unknowing relatives and friends. Just talk about what might come up, and how your child or you will respond if someone comments on weight, either positively or negatively. Also, be prepared for well-meaning curiosity about diet and eating habits. It can be hard to hide that there is something going on when in the weight recovery phase, so the more you prepare, the better.
What many of my families have done is to speak with relatives individually before social gatherings and let them know personally what’s going on. It allows for more conversation. They may have a lot of questions, so having a conversation really allows them to have more back and forth. If you do tell people about your child’s weight restoration and eating disorder recovery, it can be helpful to have some ground rules so they understand safe and unsafe topics during this time. Here are some basic suggestions:
- Don’t comment on appearance
- Don’t comment on what they’re eating
- Don’t comment on food (good/bad)
- Don’t talk about your own weight loss plans/experiences
- Don’t talk about other people’s weight
Plan an Escape
Weight recovery can be a difficult time in eating disorder treatment, so it’s good to have an escape plan for meals and events just in case your child becomes overwhelmed. Some parents will limit the time of the event, also, saying we’ll only go for 2 hours. If the meal gets too hard, there can be a code word that the patient can use to signal to the parent that they need help.
Renee D. Rienecke, PhD, FAED, is the Director of the MUSC Friedman Center for Eating Disorders at the Medical University of South Carolina. She earned her Bachelor’s degree at the University of Michigan, her Ph.D. from Northwestern University, and completed her clinical psychology internship and postdoctoral fellowship at the University of Chicago. Her research interests include the role of expressed emotion in treatment outcome for adolescent anorexia nervosa and bulimia nervosa. Website