Eating Disorders And The Holidays

As someone 'recovering' from anorexia, here's my take on what happened over the holiday: I was re-triggered 3 times by people watching every liitle thing that went in my mouth. I will not eat in front of people (again) because they're always watching and causing me a great deal of stress over trying to eat even modest portions. I've already begun further restriction and am only doing coffee in front of people.

Part 2 anne
As regards sexual abuse, I do believe that research re: this is mixed:
??? Eating disorders and sexual abuse: Lack of confirmation for a clinical hypothesis
Stephen E. Finn, Ph.D. 1 *, Marilyn Hartman, B.A. 1, Gloria R. Leon, Ph.D. 1, Loralie Lawson, M.A. 2
1University of Texas at Austin
2University of Minnesota

*Correspondence to Stephen E. Finn, Department of Psychology, Mezes 330, University of Texas, Austin, TX 78712

Abstract
Undocumented clinical reports have suggested that, among women in psychotherapy, women who have been sexually abused manifest an increased prevalence of eating disorders. The relationship between these two phenomena was investigated in a sample of women (N = 87) who were receiving group psychotherapy. Individual interviews were used to document the presence of a sexual abuse history. Diagnoses of anorexia nervosa and bulimia were based on DSM-III criteria. Rates of abnormal eating patterns in the absence of a fully diagnosable syndrome were also assessed. The following rates of eating disturbance were found in the total sample: 21% bulimic, 1% anorexic, and 82% with at least moderately abnormal eating patterns. Comparisons of women with and without histories of sexual abuse suggested no association between the occurrence of eating disturbance and a history of sexual abuse. The frequent co-occurrence of these two phenomena in female therapy clients may be sufficiently explained by their high base rates in this population but may have led clinicians to perceive a relationship where none exists.

??? As regards the control issue in eating disorders, I view this more as a difficulty with self-regulation. Anyone that vastly over or under eats, induces weight control through extreme measures such as vomiting, laxative abuse or extreme exercise is not in control, but more aptly out of it. Really, it seems to me more an extreme difficulty with self-regulation is the appropriate term.

4) It is personal when your child is very ill. It is personal when your child could die. It is exceedingly personal, you???d better believe it. Feeding your child/adolescent/teen/young adult and even loved older one is a very personal. It is at the heart of parenthood. It is at the heart of caring. I realize that my child didn't think she could die (although occasionally she said herself she was scared of her own behavior). With love and klndness, to the best of my imperfect ability, I said, "I cannot, will not allow this to happen. I love you too much. Period.

I took it very personally. I'm glad I did. I would encourage all family members to do so.

Part 1 from anne

This article is a disappointment to me. I believe it reflects "old school thinking". My understanding is that current research puts eating disorders squarely in the "moderately heritable" category of mental illnesses. This means they are biologically based illnesses with factors in the environmental that may 'set them into motion' or 'maintain them' but do not cause them. Here are my concerns about this article:

1. "Strategize": While I'm glad to hear that families should be included in talks about the holidays, families should be included as much as possible the rest of the time too. Families are often the best source of support a sufferer may have. For younger patients in particular, I recommend looking at the Maudsley based approach (also known as family-based therapy or FBT). Here the family is actively encouraged to "take charge" of their loved one's meals until the return of full health, both physical and mental. While most Family-based treatment currently centers around younger people still living at home, research trials are going on to see if this approach is feasible for older patients with longer duration of illness (e.g. support by a spouse, for instance). I am very hopeful that it will be.

2 and 3) Don't force and Don't focus on the food: Okay, common on. That is like ignoring the elephant in the room. I was told this when my 14 year old lost 40 lbs. in 4 months. You tell me what sane parent is easily able to listen to this advice. The Maudsley approach takes a different view. IT IS ABOUT THE FOOD. FOOD IS MEDICINE. YOU MUST EAT. LIFE STOPS UNTIL YOU DO. This don't/do focus and don't/do force is at the heart of much conflict in the ED world. It is bewildering to parents. I want to shout to all ED professionals out there, this issue must be address and consensus built. And the above approach--FBT-- just makes such common sense to me as a parent and human being. I am not negating talk therapy for anxiety/depression at all either. This can be extremely helpful. But, food is first.

I assume the article is referring to adults with eating disorders. My daughter is a teenager with an eating disorder. We have had great success in helping her learn to eat normal meals (full nutrition and a variety foods) in different settings, with different people. She will happily sit down to Christmas dinner as she did for Thanksgiving and yes, she will also enjoy pumpkin pie and Christmas cookies. Personally, I find letting people with eating disorders continue to suffer from their eating disorder unethical. We found that full nutrition, full tiime is the only way to recover.

Accolades for some great points and sugestions. Controling eating habits can be helped by sticking to a regular schedule of eating several small meals throughout the day, or, at least, three usual & customary meals....all of good nutritional quality and don not forget proper nutritional supplements. Peace, Love And World's of Happiness this Holiday Season, Dr. Dave at www.Fit TrimHealthy4Life.com

"The holidays can definitely be a stressful time especially for those who suffer from eating disorders. The Center for Eating Disorders at Sheppard Pratt recently wrote a blog entry with helpful tips for the holidays. They provide 10 great ways to manage holiday stress and anxiety.
Click here to read more: http://eatingdisorder.org/blog/2008/11/25/thanksgiving-with-an-eating-disorder-10-tips-to-help-you-get-through-the-holiday/
"

Continued: I especially worry about the little girl b/c my eating disorder started when I was 9 or 10 & it has severely & negatively impacted my life & been very difficult to heal from.

Despite almost dying on three seperate occassions, I am blessed to still be alive...actually, it is a MIRACLE I am alive. I have re-learned how to eat, re-learned how to walk, & there's NO WAY I could've done it on my own. I desperately need more help & the right treatment, but can't afford it...so I'm doing the best I can & pray I make it to the next day. I have been blessed with amazing friends who have stood by me, sometimes carried me, walked with me, & given their love & support. I wish I could say the same thing about my family. I know my recovery would be soooo much easier & would probably be quicker if I had empathetic, compassionate, loving support from my family.

Every day is a painful struggle for someone living with an eating disorder. It's an illness that literally affects a person from the very top of their head to the tip of their toes. It's one thing to live with an illness that is completely life altering & devastating...let alone live with the stigma, criticism & judgement of insensitive (maybe hurting in your own way) people like you. People who suffer from anorexia are NOT evil. THE ANOREXIA IS EVIL!! There's a HUGE difference. NOBODY is their eating disorder. I am not taking what you said personal & I'm certainly not choosing to beat myself up over something someone as ignorant as you says b/c I know that your comments are nothing more than a reflection on the kind of person you are. And who knows, maybe the things you see in people that have eating disorders, & you don't like, are in fact the very things you don't like about yourself.

I am grateful for this article & hope that continued education & awareness will be printed. Love, support, compassion, empathy, sensitivity, & encouragement GREATLY assist people who suffer from eating disorders. If you're going to contribute...do & say things that will positively benefit others. In doing so, you create a world where people can learn to love, accept, & forgive themselves...gaining freedom & heal shattered lives.

lee1010 - before you decide to post asinine comments that clearly show how little you know about eating disorders, why don't you do some research on the subject. most people with eating disorders HATE THEMSELVES - they are far from "too in love with themselves" - and have serious underlying psychological issues; food is simply how these issues are dealt with. your suggestion that anoretics are somehow "evil" is jsut about the most asinine thing i have read today. on top of this, OCD is actually found very often in eating disordered patients. don't open your mouth when you clearly have no idea what you're talking about.

you know what, lee1010? you clearly no NOTHING about eating disorders. most people with EDs HATE THEMSELVES, and have serious underlying psycjolgoical issues. food just happens to how these issues manifest themselves. in fact, OCD is HIGHLY comorbid with eating disorders, especially anorexia nervosa. do some research before you make asinine comments.

This is a great article. However, it really depends on how far in or out the sufferer is from the disease.
For example, if it has been long enough in remission, a great way to help is to let the person with the ED help a little in the kitchen. Letting them feel as if they have a little control is nice. However, if they are still heavily in it, this is a poor idea, as they will use it to their advantage if they can.
Overall, I appreciated this article.

Anything you do is a trigger. The truth is, everything is a trigger. They are asking you to give up your life for theirs. These are not normal addicts, OCDs, or anything else. They are control freaks - gone wild - for lack of a better term. There are plenty of more evil people, but don't fall for the anoretic. They are far too in love with themsellves.

"another few slices of ham can be very harmful. "It can trigger them into an oppositional and defiant stance" games,games,games

anorexia is a power strugle game. eat and get a real life or starve to death.

I suffered from an eating disorder that almost killed me as a teenager. I'm now in remission, but every single day is a struggle. Spending time with family is stressful enough, because you know they are watching to see if you've changed your eating habits since the last time you saw each other. My tip for those who have to stay with relatives over the Holidays, is to scope out the nearest gym. I find that when I'm on vacation, it's almost more stressful than staying home because I don't have control over the grocery shopping and am staying fairly stationary. Spending $10 on a couple visits to the gym will help relieve anxiety over bad eating habits that are out of your control. Obviously, don't over exercise - just enough until you begin to feel zen (cheesy - but it works!). Another idea is offering to make some healthier dishes for the family meal. I've always loved making food and watching others eat, because I wish I could be enjoying the food with them. Consider portion control for the less healthy options and then load up the rest of your plate with the food you made. One more option: Tell your family/friends that your going vegetarian for your New Years resolution and want to start a little early. That will instantly exclude several dishes (meat, animal broth based) and the hosts wont feel insulted if you eat less than the others.

I suffered from an eating disorder that almost killed me as a teenager. I'm now in remission, but every single day is a struggle. Spending time with family is stressful enough, because you know they are watching to see if you've changed your eating habits since the last time you saw each other. My tip for those who have to stay with relatives over the Holidays, is to scope out the nearest gym. I find that when I'm on vacation, it's almost more stressful than staying home because I don't have control over the grocery shopping and am staying fairly stationary. Spending $10 on a couple visits to the gym will help relieve anxiety over bad eating habits that are out of your control. Obviously, don't over exercise - just enough until you begin to feel zen (cheesy - but it works!). Another idea is offering to make some healthier dishes for the family meal. I've always loved making food and watching others eat, because I wish I could be enjoying the food with them. Consider portion control for the less healthy options and then load up the rest of your plate with the food you made. One more option: Tell your family/friends that your going vegetarian for your New Years resolution and want to start a little early. That will instantly exclude several dishes (meat, animal broth based) and the hosts wont feel insulted if you eat less than the others.

I was very happy to see this article. I am recovering from a disorder and I was at my parents church that I attend when I am home from college. I recently helped out at a dinner we had for the elderly members of the church and everyone kept trying to force me to eat even though I did not want to. I really couldn't take it, as I believe I shouldn't have to eat if I am not hungry. I ended up just taking off for a while until everyone was done eating and came back to clean up. Does anyone have any advice as what to do? I really do not want to be rude to anyone, I try to be as respectful as I can to my elders, but how can I handle the situation if they are not returning the same level of respect, in my opinion. I know they think they are being helpful, but to me they are putting too much emphasis on food..

What a nice article. Sensitive and non-judgemental. It is also correct. The holidays can add an enormous amount of stress for someone who is anorexic or bulemic especially if they are in a recovery phase or have an awareness of their problem. Thank you.