This article contains references to eating disorders and disordered eating.
I have something of a complex relationship with Christmas. Don’t get me wrong. I’m a sucker for sparkles and I love a party. I see lots of friends, work gatherings abound, and I spend time with my family who are my most cherished people. But I’ve had anorexia for 19 years, since I was 19, and nothing is more agonising than huge amounts of food and forced fun in a confined space. Whilst smiling over it.
Christmas has always been a challenge, eating food that deviated from what I felt was normal, especially with other people around. I'm obsessed with calories and content, whereas Christmas is meant to be a 'let your hair down' kind of event. My sister would always want special breakfasts whereas I wanted to stick to my rules. I remember bursting into tears at the sight of a roast dinner. I'd find excuses to skip parties, and insist on doing exercise in the cold and snow, just to try to make up for any anticipated 'extra' food. It was miserable, and I can't say it's something I'm proud of. I'd stare at the boxes of chocolate or mince pies, willing myself to have one, but holding myself back. I have just about got comfortable eating what I deem to be safe meals with my immediate family (mum, dad, brother, sister and partners) but hate eating in front of anyone else, so we have super low-key Christmases with Christmas dinners that I'm sure some people would think are a bit half-hearted.
But a fun Christmas is something I want, and part of the life that I’m trying to build for myself. I’d love a whirlwind of spontaneous Christmas parties, free-flowing fizz and endless mince pies, and I still hold out hope it might happen. But for now, anorexia has placed restrictions on my life that mean I just can’t do it.
Eating disorders don’t stop for Christmas. Whilst everyone else is kicking back and having fun, the anxiety and torment that comes from a severe and enduring eating disorder is very real.
And I’m not the only one. For the 1.25 million people living with an eating disorder in the UK, Christmas isn’t always a sparkling wonderland of delight. The pandemic saw numbers soar – and they haven't gone down. We’re also seeing an increase in rates among men, and women in middle age. This isn’t a teenage girl issue.
And it's not just the sheer volume of food at Christmastime that ED patients find difficult. For me, I find it hard to eat around people, and eat food cooked by others. I just about trust my mum to make what I call a ‘safe’ roast dinner, in which my food is weighed and plated up in the kitchen, so I know it's what I consider the ‘right’ amount. I always feel an absolute idiot (which by the way, if you are suffering, you’re not, you’re sick. And if you’re caring – please never call someone an idiot for a mental illness). But it’s also how I manage things.
This Christmas ‘routine’ has changed recently. I’ve been married for 18 months, which means there are two families to deal with. My in-laws are wonderful, but I still feel a little bit uneasy eating around wider family – and hate that I put the rules and restrictions on my mother-in-law to make me a ‘safe’ meal. There are children in my husband’s family, and I want to model good behaviour for a younger generation. But the huge fear takes over if I do try to deviate from the norm.
I’ve also got back into my running. For the most part, it’s been good for me. Sometimes I feel strong and proud of my body rather than always loathing it. I want to eat because eating is fuelling to run further, faster, better. But the mix of cold weather, slippy roads and a social diary to rival the best of them means it’s hard to fit in exercise. And good god that gives me anxiety.
The obsession with calories and rules is something typical of anorexia, and actually got worse when I was diagnosed and given meal plans, as this seemed to be a maximum amount I could eat, and anything over this I now consider to be too much. The anxiety starts early on, when the first Christmas foods appear in the supermarket and songs start playing on the radio. What will be expected of me, and can I manage this? I think that's part of the problem – the high pressures and expectations to make this The Happiest Time of the Year, when really, for those of us who suffer with disordered eating, it's nothing short of terrifying.
NHS Dietitian Sarah Fuller at East London NHS Foundation Trust begins planning with the children and young people she works with in November. By including Christmas foods in the regular meal plan, and starting to encourage people to embrace new things in a safe setting, the idea is that they will feel more comfortable once it comes to doing so in front of new people. She says: “With early planning we help our young people feel as confident as they can with Christmas activities. They learn from that practice, and know what they can manage easily, and what feels more of a stretch.”
Incorporating family and friends into recovery has been an important practice for me, too. Me, my husband or my mum always remind people we are spending time with not to comment on my weight, what I’m eating, and to avoid diet talk. We change the subject if it does come up, because unfortunately these toxic narratives are so prevailing in society that it’s the norm for someone to jokingly berate themself for a Yorkshire pud or a slice of cake. We start planning early on what the meals will be, who we will be spending Christmas with, and what times we will be eating. We also discuss where there are boundaries. Where they can push, and where to draw the line and let me do what feels comfortable. It's about creating an environment that, at times, may be challenging – but never feels unsafe.
It's almost like drawing up a contract, says recovered anorexic and registered nurse Mandy Scott, founder of the Personalised Eating Disorder Support (PEDS) charity, which has helped over 800 ED patients since its inception in 2014 Their mission is to ‘build a life to get well for’ which can encompass Christmas parties and festive fun, if that’s what you want. One of Mandy's recommendations is to “have a contract with negotiables and non negotiables. Negotiables might be whether you have a roast potato or a Yorkshire pudding as one of your carbs. A non-negotiable is that you won’t skip afternoon snack no matter how long lunch goes on. You might be allowed to take yourself off for half an hour to your room, but going off for half an hour to exercise is a negative ED behaviour, and not welcome.”
Dr. Sham Singh is a psychiatrist with a holistic approach to mental health at WINIT Clinic. He says: “Planning ahead can make a big difference. Talk with your loved one about what makes them feel comfortable, be that when meals will be served, where they will sit, or what dishes will be served, so they can mentally prepare themselves. If they are working with a therapist or dietician, ask them to include coping strategies or meal plans given by their care team into the holiday events.
"Another important feature is allowing flexibility and acceptance. If they want to leave the table or take their participation down a notch, let them do so without calling undue attention to it. You can also lighten up the tension on meals by centring activities around something other than food, such as decorating, playing games, or watching holiday movies, to shift the emphasis to togetherness rather than food.
“Looking after yourself as a carer or family member is very important. Since the emotional burden of supporting a loved one with an eating disorder may be substantial, make sure you are referred to resources that include support groups and counselling to help you work through these times.”
Andy, my husband, also offers some words of wisdom. “I think we manage to tackle what can be a very stressful time for Francesca, and everyone who loves her, by talking. We make a plan, and that plan has one or two things that are non-negotiables and the rest has some flex. And we communicate throughout the few days, checking in with each other. But also we’re realistic. Christmas is a just a week out of the year. It’s what happens every other day that really influences recovery.”
It will be hard, and that’s ok. Planning ahead and being aware of what challenges and triggers you can help you tackle it. That’s what Chloe Quinn, 29, an ED campaigner who was first diagnosed with anorexia since she was 12, but now feels she has finally recovered, recommends: “Be aware of the fact that you’re going to be challenged more than normal. You’re going to have to fight (and fight hard) against your internal critic. Be mindful but don’t allow it to ruin the season. If we can identify the triggers and do our best to either avoid them or safely challenge them, then it makes the experience that bit easier.”
No matter how well I’m doing, even if silent and barely noticeable, it’s always there.
For me, big triggers are diet talk and comments on weight and appearance. “Diet starts in January.” “Let’s go for a walk to burn off lunch.” “Oh, I’m so naughty.” If you can, have a chat with the people who might be around over Christmas and ask them not to use this language. Feel free to walk away if they start. Equally, don’t comment on my weight or appearance. Whenever anyone says I look well, I burst into tears – because in my head, they're saying I look fat. My mum often has a quiet word in advance with family members who have a habit of being well-meaning but insensitive. This is also why Sarah recommends “wearing something spangly or glittery, so people comment on that, rather than your weight or appearance.” I LOVE this idea. We are more than what we eat.
I know the day won’t be perfect. There might be wobbles. I know my anorexia will shout loud and kick out. But I also know there is so much opportunity for not following my eating disorder rules. I can make it another day that the eating disorder rules my life, or enjoy it as a celebration. I can toast that glass of fizz. I can grab a chocolate when the tin is passed round. Consider a fancy breakfast not just porridge. Maybe this year I'll try and relax what I eat, and try something new. For just a few minutes, maybe I won't think of myself as a person with anorexia, but just me. And that will be enough.
- Start preparing and planning early, so you're not taken by surprise on the day.
- Plan non-food-related activities, particularly after meals so that there's a distraction from any urges or triggers or uncomfortable feelings.
- Speak to family members you trust and raise your concerns.
- Make a list of non-negotiables, that you simply must do.
- Stick to a regular meal plan in terms of timing, and having all the food groups, but see where Christmas food can fit in.
From the 24th December to 3rd January, the Beat Helpline will be open from 4pm till midnight every day and the online support groups will be running as normal. They have also just launched a new platform for carers, The POD, which has advice from eating disorder professionals on caring for a loved one during the festive season.
