How to Help Your Child

Holidays can be a fraught time for anyone with an eating disorder, but especially so for parents with children struggling with this group of mental illnesses. Holidays are often full of food and expectations surrounding meals, which can present unique challenges for kids who are already sensitized to their own consumption. 

According to the National Eating Disorders Collaboration (NEDC), eating disorders are serious mental illnesses that are characterized by disturbances in attitudes and thoughts about food, eating, and/or body weight and shape. With that in mind, it makes sense that the holidays can be difficult. We spoke to experts so you can identify when your child is struggling—and how to help them best. 

Common Eating Disorders Among Children and Teens

Eating disorders are often under-diagnosed in children, though there are many manifestations of disordered eating. In fact, in a meta-analysis performed by the Journal of the American Medical Association (JAMA), surveying 32 studies including over 60,000 participants, the authors concluded that up to 22% of children and adolescents showed disordered eating. In the United States, the percentage of eating disorders has risen steadily since the 1950s. And the International Journal of Eating Disorders even completed a study suggesting that 34% of 5-year-old girls struggle with disordered eating.

With all that in mind, it’s safe to say that eating disorders are prevalent, so it’s important to know how to identify them early. Kara Becker, LMFT, CEDS, AAMFT approved supervisor, national director of eating disorder programs for Newport Healthcare, lists these common eating disorders:

  • Anorexia nervosa, characterized by an intense fear of weight gain, results in restrictive food intake and a distorted self-image.
  • Bulimia nervosa involves episodes of binge eating followed by compensatory behaviors like vomiting or excessive exercise to prevent weight gain. 
  • Binge Eating Disorder (BED) entails consuming large quantities of food rapidly without compensatory actions, often accompanied by feelings of being out of control and guilt.
  • Avoidant/Restrictive Food Intake Disorder (ARFID) involves limited food preferences and avoidance due to factors such as sensory issues that interfere with social functioning.

Recently, there has been a push to not just study the physical effects of eating disorders, but also their behavioral aspects and causes. This includes taking into account situations like holidays, full of dinners, parties, and family expectations. 

Why Are the Holidays Challenging for People With Eating Disorders?

Holidays are a time full of food and pressures around consumption. As someone who has struggled with their own body image and weight, I know first-hand how easy it is to slip into disordered eating when presented with a plethora of foods often labeled as “unhealthy.” 

Shelly Bar, MD, chief medical officer at MyClearStep, clinical assistant professor of medicine at the Stanford University Medical school, and eating disorder and young adult specialist, says that holidays are often meal-centric, creating added pressure for kids who might already be struggling with ideas around food.

“The abundance of food, elaborate meals, and emphasis on indulgence can heighten anxiety and feelings of guilt or shame,” Dr. Bar adds. 

These feelings of guilt and shame can add up to social isolation, too, especially when family dynamics come into play. 

“For those who have distanced themselves from social activities due to their eating disorder, holidays may involve interacting with people they haven’t seen in a long time. This can be stressful and may exacerbate feelings of social anxiety,” Dr. Barr says. 

This kind of stressful event can lead kids with already heightened and disordered awareness of food and their bodies to compare themselves to others, triggering disordered eating. Becker says that management of stressors is key for your children around the holidays. 

“Holidays in general can be stressful due to travel, changes in routine or social expectations, leading to emotional distress that can exacerbate disordered eating behaviors. Holidays also mean engaging with family, which can be stressful and unpredictable for many,” she elaborates. 

Tips for Helping Your Child Cope With an Eating Disorder Around the Holidays

We all want our children to be as healthy as possible around the holidays, and any time of year, and that includes helping them manage any instances of disordered eating. With that, here are some ways you can help.

Set Boundaries With Your Family Members

To start, you might want to tell other family members that comments about your child’s body or food intake could be triggering to them. “Encouraging family members to redirect conversations toward more constructive topics and reinforcing positive behaviors can generally contribute to a more supportive atmosphere,” Becker explains. 

You’ll want to be as proactive as possible when it comes to setting boundaries. Call family members ahead of time, if feasible, so you don’t have to “correct” them in person and draw attention to he situation.

It’s important to tell anyone who will be sitting at your dinner table that those well-meant comments, such as “what a big plate,” or, “you’ve lost so much weight” could actually backfire in your child’s recovery. “Remember that setting boundaries is a continuous process, and it’s okay to revisit the conversation if needed,” Dr. Barr says.

Offer Support and Set a Positive Example

If your child has a meal plan that they developed with their care team, it’s vital you help them stick to it. If part of their plan involves safe foods, or foods they feel comfortable eating that don’t trigger their anxiety, make sure there’s plenty of those on hand.

Additionally, it’s also important to set a positive example around your own eating, says Becker. “Creating a family culture that prioritizes health, self-acceptance, and respect for individual choices can help establish a foundation for positive communication around body image and food,” she confirms.

Talk With Your Child Before and After the Holiday

Ahead of the holiday event, talk with your child about the possible feelings that may come up before or during meals, and remind them that they can come talk to you if they’re feeling triggered or anxious. Discuss available coping strategies; it’s always advisable to have two or three on hand for your child to choose from.

After the holiday or meal, find a quiet moment to check in with your child and debrief. You may consider asking them how they felt, or what parts of the holiday were easier and/or more challenging than expected. This is helpful information for you to have for going forward, and you can adjust any future holiday plans accordingly.

When to Seek Outside Help for Your Child’s Eating Disorder

An eating disorder is something your child might struggle with for a long time, so it’s important to know the warning signs of falling back in their recovery. If they continue to display disordered eating despite your attempts to redirect them, especially after an event like a holiday dinner, it’s time to reach out for help. Identifying disordered eating early can help prevent further serious issues as your child grows.

“It’s important to seek help from a mental health professional for your child and yourself if there are unresolved issues with disordered eating,” Becker confirms. 

It’s also important, she adds, to deal with your own disordered eating if you experience this as well, so you can best support your child in their recovery.

Eating Disorder Resources for Families