You are currently viewing Preventing Eating Disorder Relapses During the Holidays

Preventing Eating Disorder Relapses During the Holidays

A Relapse Prevention Plan for Eating Disorders: Christmas and New Year’s

If you have an eating disorder (ED) like anorexia, bulimia or other eating disorders, then holidays can be filled with fear instead of fun.  If that feels like you, it’s important to have a plan to prevent eating disorder relapses during the holidays.

Over the last decade in my nutrition practice, I’ve worked to fine tune holiday relapse prevention plans with hundreds of eating disorder clients. Here are some dos and don’ts that can help bring the holidays back to what matters to you.

Timely Tips for the Table

Knowing you will be at a table during mealtime can be incredibly painful and stressful when struggling with an eating disorder. At the table you have to eat.  For someone with anorexia the idea of eating is overwhelming as it is. At a holiday table filled with family and friends, you may feel like everyone is watching.  For others it is how do I get myself to stop eating? How do I stop myself from binging after the meal or using other compensatory behaviors?

Imagine having to spend the weekend with your emotional trigger. Imagine it always being there during the holiday time.  Those with eating disorders will feel the pull to “keep themselves safe” by engaging in eating disorders. 

So it’s important to have a table plan for preventing eating disorder relapses during the holidays.

  • It’s ok to step away from the table if you need space. Plan a safe space in the house or outside. The bathroom is not one of those rooms. It’s ok to let one or two people know you might do this if that makes you feel safer. If you don’t have someone like that at the table that’s ok. You have license to get up and take your space. This is about keeping you safe.
  • Have an affirmation ready on your phone. If you’re feeling triggered, take a moment to bring up an affirmation that you know has centered you in the past.
  • Bring a tactile object, such as wristband, bracelet or necklace with charms on it. Or perhaps something in your pocket with ridges. The important thing is this object reminds you of your commitment to recovery. Rubbing it can connect you to all the work you’ve put in already towards your recovery and healing.

Make Safe Spaces Ahead of Time

For a holiday relapse prevention plan it’s helpful to create safe places and safe people ahead of time. Your host might be planning seating charts, but you should be planning your safety chart.

Set up a safe space in the holiday home: a bedroom you will be sleeping in or perhaps a room you can escape to.  Can you have a safe person you can pinch when you’re feeling triggered?  Can you speak with your friends or family in advance to discuss what your needs are?

Preparing for the worst ahead of time might sound negative, but it’s a plan on how to stay positive and give you the greatest chance of enjoying family for the holiday.

Don’t Come Hungry

This might sound like counterintuitive advice if you restrict as part of your eating disorder, but don’t show up to a holiday meal starving. We want to be engaged in positive recovery behaviors throughout the entire day (not just at the holiday table). That means a balanced approach for the entire day and not forgetting to pay attention to your emotional hunger and fullness.

Showing up to a holiday meal completely starving makes it more difficult to make choices based on what you are really craving. You will be more likely to eat rapidly and not connect with your fullness cues.  Fullness cues are hard to identify during the holidays as it is.

Take a balanced approach to the day and give your hunger and fullness cues the attention they deserve.

Make Space for Soothing Behaviors

If you’ve been in treatment, you’ve likely been coached on using alternative behaviors to sooth like knitting, a puzzle, playing a game. That works well when you control your space, but it’s harder to pull off at Uncle Ned’s table. That’s ok. Make space and time to use these tactics before and after the meal.  If you’re feeling triggered during the meal and need this crutch, that’s ok too.  Step outside. Take the time you need. Read a positive mantra on your phone. Use a soothing behavior that’s comfortable for you. Your primary responsibility is to yourself and your recovery, not whatever is happening back at the table.

Prepare for the After Holiday

Coming back home can be just as difficult as going.  You may feel the need to correct what was or was not eaten during the holidays. Don’t engage in these behaviors.  Go home and get back to your daily routines.  Look back on the success of the holiday season. Find some laughter. Did your uncle make corny jokes? Did the kids have a blast? What lessons did you learn from this holiday season? Try and use each potential triggering experience as an experience to learn and grow from instead of seeing it as a failed experience.

This holiday season, give yourself the time and space you need for the gift of recovery. 

Learn more about how ExtensionMD helps with your safe recovery plan.

Marisa Sherry

Marisa Sherry is the founder and CEO of ExtensionMD, a remote patient monitoring provider for clinicians and patients of eating disorders. As a dietician, she has spent two decades helping HIV patients with wasting syndrome, children with deadly food allergies and for the last 10 years severe eating disorders. She has a master's in Clinical Nutrition from NYU.