Print This Article

Surviving Holiday Meals

Reprinted from Eating Disorders Today
By Tami J. Lyon, MPH, RD, CDE
Fall 2002 Volume 1, Number 3
©2002 Gürze Books

Holidays such as Thanksgiving, Christmas, and Hanukah pose unique challenges for people with eating disorders. Worries about holiday eating tend to fall into two major categories: (1) fears of familiar holiday meals and (2) fears of new and unknown meal settings and situations.

Familiar holiday meals
Familiarity with a holiday meal can be both an asset and a liability for clients. For many individuals, Christmas and other food-oriented holidays are a known entity. That is, they know who will host the meal, who will be attending, which foods will be served, and who will prepare them. And, for the most part, they also know in advance what will be the greatest challenges. For example, every year Brittany goes to her grandparents' home for Christmas dinner. Her Aunt Edna always makes pecan dressing with giblets, and it's always served with turkey and gravy. Every year Brittany is faced with platters of food and must decide how to handle so many choices. Because she has had her eating disorder for some time, Brittany's family members are focused on her eating and wait to see if this will be the year Brittany eats Christmas dinner. Brittany is familiar with this pattern and the many stresses it brings, and dreads it every year. The challenge here is to help Brittany use her familiarity with the experience to her advantage.

Planning ahead is the key to the challenges of holiday meals and should be started weeks beforehand. Advanced planning gives the client plenty of time for gathering information that can be used to develop realistic goals and menus. This in turn can really work to reduce anxiety about the meal. I begin by asking my client to describe the holiday meal in detail, including where it will be held, who will attend, and the foods most likely to be served. Then we list the foods and categorize each one as "safe," "risky," or "forbidden." Starting with the "safe" list, we then identify sources of protein, carbohydrate, and fat that could be included in a nutritionally-sound meal. After ruling out the "forbidden" foods and exhausting the "safe" foods list, we turn to the "risky" foods and try to incorporate safe portions of some of those. Next we assess how this meal will be assembled at the event. Will the client have to help prepare the meal or will the host prepare it without help from the guests? We talk about the importance of being able to decline some of what is offered without being insulting. Brittany needs to be able to meet her own needs without bringing excessive attention on herself.

Planning ahead is one key to enjoying the warmth of friends and family at holiday celebrations.

We then focus on the composition of the meal, including specific foods and estimating how much to take. A good tool is for Brittany to use her fist or palm as a way to estimate portion sizes. By doing so, she will always have her "measuring tools" with her, and we can also practice with sample portions in the office before the event. For example, her Christmas meal may be a piece of turkey the size and thickness of her palm, a roll, and a serving of salad the size of her fist. She can also plan on putting a spoonful or so of sweet potatoes and dressing on her plate to be polite, whether she tastes them or not. Food exchanges, established food plans, or a special food plan for the day also work very well in such situations.

Unfamiliar holiday meals or situations
For others in recovery, the holidays may mean encountering entirely new eating situations, where they not only do not know who is preparing the food but don't know what will be served. They may be spending their first Christmas with different relatives or celebrating the holiday at a restaurant. Just as with familiar meals, gathering information and planning ahead are the keys to success in this situation. Much of the fear and anxiety come from what is unknown about the situation.

As part of nutritional counseling, we identify the time, location, hosts, and guests who will be at the holiday meal. If it is appropriate, the client can call the host or restaurant and determine what's on the menu. If the meal will be at a home, it's often possible for clients to bring a food item they consider "safe." This can be used as an "anchor" from which to develop the food plan. For example, if Brittany is going to her cousin John's house for the first time, she can call ahead and ask about the meal menu and offer to bring a dish. She may choose to bring a salad with a "safe" dressing,so that she knows she has at least one food she can eat. For someone recovering from an eating disorder, asking questions about the menu or bringing "safe" food along are necessary ways of taking care of themselves.

The rest of the meal plan can be assembled from foods known to be at the meal or those that probably will be served. For example, Heather will be celebrating Christmas at a friend's house for the first time. She has offered to bring rolls to the meal, which has relieved lots of stress because she now feels she has an alternative to mashed potatoes. From this food anchor, she can select a protein, such as turkey breast, and a vegetable, green beans.

If an unfamiliar restaurant is the setting, the client can call ahead and ask about their holiday menu. This information can be reviewed with your counselor and a meal plan can then be developed.

Fitting the meal plan to the type of eating disorder
The strategies that we develop during the counseling session will vary, depending on the pattern of the eating disorder. For a client with bulimia, who has a history of bingeing on holiday meals and doesn't want to fall into old habits, counseling will focus on factors that contribute to his or her binge-eating. For example, if Alex always binges on the coconut pie at Christmas, we would examine what his eating pattern is like on Christmas prior to dinner. What time does his family usually eat Christmas dinner? When and how do the binges occur? What other starches are served at Christmas dinner? How can Alex change the environment to prevent bingeing? He may repeat a positive affirmation to himself throughout the day and enlist a support person to help keep him on track at the meal.

Many people with eating disorders may avoid talking about these challenging holiday meals because it is just too stressful. However, planning ahead and using proactive nutritional counseling and family support can help them develop strategies to make holiday meals bearable and even enjoyable.

The Author
Tami J. Lyon, MPH, RD, CDE, has a private practice, Healthy Living, Nutritional Counseling and Consulting, in San Francisco, CA

click here to order
Eating Disorders Today!

Discounts Available for AED and IAEDP Members
or
Call 1-800-756-7533 to order
We accept Visa, Mastercard, and American Express

Read More Articles From Eating Disorders Today

Additional Resources:
Five Stages of Lifelong Recovery
Full Lives
Getting Coverage for Eating Disorder Treatment
Herbal Agents Used by Eating Disorder Patients
Herbal Products: Balancing the Good and Bad