Many of our holiday traditions center around food. We begin the season with a Thanksgiving feast and continue throughout the holidays; parties often have elaborate food tables with more food than the guests could possibly consume. And while our focus this time of year is on family and connecting with those we love, we often do it surrounded by food. Many people worry about overeating during this time of year, but for those with eating disorders, the holidays can be especially difficult.

Types of Eating Disorders

There are three main types of eating disorders:

• Anorexia nervosa – those with anorexia often refuse to eat and meticulously count the calories of what they do consume each day. They are extremely anxious about body image and weight and may exercise compulsively to burn off calories of any foods they eat.
• Bulimia nervosa – those with bulimia may eat excessive amounts of food and then purge their bodies of the food through vomiting, diuretics or laxatives. They are often ashamed of their behavior and will purge in secrecy.
• Binge eating disorder – those with this type of eating disorder will go through periods where they eat excessively and feel they can’t stop eating. Binge eaters do not purge their bodies of the food but may still feel ashamed of their behavior and may be obese or overweight.

Many people with an eating disorder have an intense fear of being fat or are preoccupied with their weight and how their body looks. There is a high rate of anxiety disorders in people with eating disorders and research has shown that the anxiety disorder often comes first and that an anxiety disorder may increase the risk of developing an eating disorder.

The Holidays and Eating Disorders

During the holiday season, many people worry about gaining a few pounds but resolve to go back to regular eating habits in January and lose the extra weight. But for those with eating disorders, the holidays are particularly challenging. Those with anorexia may have a hard time hiding their eating disorder, with family watching what they are eating. While other members are filling their plates with turkey, stuffing, mashed potatoes and string beans, the anorexic might eat one slice of turkey and a cracker. Excuses, such as “I’m not really hungry right now, I’ll eat later,” or “I am going to a friends and want to save my appetite for their house,” or “I ate earlier with a friend,” don’t completely ring true and concerned relatives may make the stress even more difficult to deal with.

For those with bulimia or binge eating, holiday meals pose a different type of problem. They will over-eat, filling their plate with everything and not stopping until having several pieces of cake and pie. Binge eaters may eat only a little during dinner, but will later go back, to eat in private – and then eat large amounts of food. Binge eaters will later feel guilty and ashamed of their behavior and the bulimic will find a bathroom to purge their body of all the food they have eaten.