Christmas celebrations in the UK often centre on food, drink and family gatherings, but campaigners warn that the party season can place additional strain on those living with eating disorders.
"It's tricky even years down the line to watch the happiness and festivities at Christmas," says Katie Scott, 21, who is in recovery from an eating disorder.
"I have always loved [the time of year] – I love the food, I love being with my family. But now it's difficult because of the eating disorder."
She adds: "No matter how hard I try or want it to be carefree or eating-disorder free I know that it can't be – it's bittersweet."
Her comments come as new guidance is published to help those living with eating disorders over the festive season.
Katie first became unwell at the age of 14, restricting her food intake and falling into depression. She was initially diagnosed with eating disorder not otherwise specified (EDNOS), and later with anorexia aged 16.
She describes her first diagnosis as the beginning of a "long and ongoing struggle" with eating and her weight, mood and self-harm, straining her relationships with her family and friends.
"It left me feeling desperate and isolated," she says. "It was a life-threatening situation."
Katie dropped out of school for periods of time, undergoing inpatient treatment. She was finally discharged from hospital aged 18, joining the year below her at school to finish her education before going to university.
"I had to rebuild my life from rock bottom," she says.
Katie explains that she has found Christmas "an especially difficult time" both while unwell and in recovery, often feeling unable to get fully involved with the festivities.
"The celebrations are obviously very focused around food," she says. "I love food, but I'm scared of it so I have this contradiction – the fear factor.
"I've found Christmas quite hard to deal with in the past because I wanted to look forward to it, but all of the elements that I love [about it] became stressful and scary."
She adds: "I think anorexia might be an extreme version of losing the magic of Christmas. It's still a lovely time of year but it's not quite the same.
"I kid myself each year that it will be but it's never as easy as it was before. It can be disappointing."
The charity Beat estimates 1.25 million people in the UK have an eating disorder, with anorexia known to have the highest mortality rate of any mental illness.
Offering support at Christmas
The NHS and eating disorder charity Beat have published new guidance on how to support people with eating disorders and their families at Christmas.
The advice aims to help friends and family of those of any age with such an illness navigate the festive period – while continuing to manage a condition.
Some of the suggested techniques, based on experience from clinicians, patients and parents, include:
- Serving food as a buffet rather than as sit-down meals
- Minimising the social expectations of people with eating disorders over the festive season
- Treating meals on and around Christmas Day as routinely as possible
- Planning well ahead and thinking about how food features in the day
- Once dinner is over, shifting the focus on to other activities such as playing games
- Making loved ones aware to avoid questions about weight or appetite
For Katie, planning the structure of the day is key, including what she will do if she is feeling stressed – whether that is stepping outside or going for a walk.
She also advises finding someone to confide in. "Try and have one person who is at least aware that you might struggle," she says.
Beat has also published advice on how to spot the signs of an eating disorder on its website.
Katie says the Christmas period can also be a hard time for her mother, who, she notices, is focused on keeping her safe and feeling OK amid the celebrations.
"She's had a few very difficult Christmases with me," Katie says. "It's almost worse for mum because she has to deal with me and can't anticipate how I'm going to react."
Dr Prathiba Chitsabesan, NHS associate clinical director for children and young people's mental health, says sRead More – Source
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