The Challenges of Eating Disorders at Christmas

According to the song, Christmas is the most wonderful time of the year, and if we are fortunate, it can be. But for many people, Christmas is a trying time that tests their mental health. According to YouGov, while two in five people say their mental health improves over Christmas, more than two out of every five of us feel stressed during the holidays, with one in four struggling with anxiety or depression.

So, while December is a happy time for many, it is a trial for others. With food playing a big part in the festivities, this can be particularly so for people living with eating disorders.

Nerissa and Mel: Experts by Experience and Training

We spoke with Nerissa Shaw and Mel Nelson from OMH partner SWEDA, a Somerset-based charity supporting people affected by eating disorders.

Nerissa explained, “I am the clinical lead for SWEDA and oversee the strategy and clinical services within the organisation. We’ve got lots of different teams and things going on.”

Mel is a trained counsellor and Therapeutic Support Worker. “I counsel adults and children. My role can be really varied, including support calls and assessments as well as counselling sessions. I also offer monthly support at colleges.”

Both Nerissa and Mel undertook years of psychotherapy training for their roles, but perhaps more importantly, both have hard-won, real-life experience that underpins the support they give to others.

Nerissa says, “I have got a history of an eating disorder and quite a lot of other mental health problems. I’ve been right through the system a number of times. I had various different sorts of therapy, which I found very helpful, and when I was better, I thought, maybe I can do something with this.”

The desire to turn the knowledge and empathy gained from living with an eating disorder into something that can help others motivates Mel, too. “When I was younger, I had my own mental health problems, and I think that if they had been looked at earlier, things could have been different. That’s my inspiration: making sure people don’t go through the same sort of journey as I did.”

What is an Eating Disorder?

It’s estimated that 1.25 million people in the UK have an eating disorder. Most of us have heard of Anorexia Nervosa, a particularly dangerous illness with the highest mortality rate of any mental health condition, but eating disorders come in many varieties. You don’t have to be underweight to have an eating disorder, and the majority of people who have one aren’t.

Eating disorders are serious mental illnesses that can affect anyone of any age or gender. They cause a severe disturbance in people’s relationship with food and eating and can have a big physical, social and psychological impact.

Nerissa explains that it’s difficult to easily define an eating disorder as there are different ways of approaching the subject. Forms of disordered eating can have some things in common while other aspects can be very different, but “essentially, it is a situation where somebody struggles with food and has concerns around food and eating that become a source of distress and discomfort. They might show certain behaviours like restricting food, binge eating or doing things to compensate for what they have eaten such as extreme exercise or making themselves sick. Often, people also have worrying thoughts about their weight and body shape. The worries take over everything to the extent that their life is affected and controlled by thoughts and feelings about food, weight, shape and frequently a sense of shame and guilt.”

“Food and thoughts of food dominate their lives. It’s a myth to think that people with anorexia, for example, don’t think about food; sometimes they think about it all the time. It becomes a sort of obsession with food and body image and this can involve perhaps a fear of eating in front of others. That fear attaches to things like Christmas because of the association with food.”

Mel agrees, adding, “In the media, we’re almost given this snapshot of what an eating disorder should look like or what an eating disorder is. There is this kind of one-size-fits-all view of an eating disorder, and that can be really difficult for people.”

The Pressure of Christmas Meals

So much of what we do at Christmas involves eating. There’s the office party with slices of cake, get-togethers with friends who’ve laid on special treats, and, of course, the big day itself with Christmas dinner.

For someone living with an eating disorder, the family gatherings, work functions and social events of Christmas bring heightened anxiety that can be utterly overwhelming.

Nerissa says, “Christmas is a food-centric celebration. There’s a lot of emphasis on what’s going to be eaten and people getting together. It’s a massively difficult thing to negotiate. There are family gatherings, having to eat in front of people, different foods around, and the potential of being pressured to eat. All these things can come together to make it incredibly stressful. It’s not just the big meal on Christmas Day. For many, it’s Christmas Eve, Christmas Day, Boxing Day, and maybe New Year’s. That sense of being together around a meal can feel like a constant pressure.”

Mel adds, “People with eating disorders like routine, and they like to know where they are. So, things like Christmas, Easter, and holidays can feel really difficult. You know other people are excited about events, and you want to feel how you did prior to your eating disorder, but it brings a lot of anxiety.”

Eating Disorders and Christmas Triggers

Unless you live with an eating disorder, you’re unlikely to notice the subtle but powerful societal expectations that surround food—particularly at Christmas, when family dynamics or being in an unfamiliar environment can further increase stress.

There’s an expectation that people will eat large meals, munch on chocolates and take the day off from concerns about the impact of overeating on their health. This can be very distressing for someone who feels a need to control their food intake or struggles with portion control.

It’s not unusual for people to see eating as a way to celebrate, and saying “no” to their offers of food might be seen as being “a Scrooge” or somehow rejecting the festive spirit. Well-meant but thoughtless comments like, “Go on, have some more,” or “It’s Christmas; live a little and treat yourself!” add to the challenge.

Nerissa says, “For someone with an eating disorder, food can be frightening. There’s pressure around Christmas to eat, but that fear is real, like a phobia. It’s not just a reluctance to eat. But Christmas is all about food, with this idea of throwing everything at it, eating whatever we want, then going on a diet in January. That focus on food and immediately dieting afterwards is quite unhelpful.”

“With Christmas, there’s a lot of media pressure,” Mel says. “There’s this expectation that people should just be happy and eat whatever they like. And then you’re immediately hit with ‘New Year, New You’ messaging. It’s almost like we’re told how we should feel and behave, which can be overwhelming for someone who already feels the need to control their food intake. People with eating disorders often feel this intense pressure to live up to a ‘perfect’ holiday standard, which can make them feel really isolated.”

Eating Disorders and Christmas Isolation

Some people with eating disorders dread eating in front of others or like to eat privately in an environment they can better control. But at Christmas, gathering with family and friends to eat is seen as a central part of the holiday. There is an emphasis on eating together.

Feelings of shame or guilt frequently accompany eating disorders. People often take steps to disguise the issue, fearing that others won’t understand their struggles. Anxiety that a social event might expose their difficulties can cause someone with an eating disorder to withdraw, turn down invitations, and face a lonely Christmas where they miss out on the company of family and friends.

Nerissa says, “People don’t realise how common it is for someone with an eating disorder to avoid gatherings. There’s this huge expectation to indulge, which can feel overwhelming for someone trying to manage portion control or stay within their comfort zone.”

Mel explains, “A lot of people with eating disorders may feel they can’t join in with gatherings because of the constant focus on food. The whole experience can feel like a huge pressure. For some, it’s easier to avoid these events than to face the anxiety of eating in front of others, which can lead to a very lonely time. Even if they want to be with family or friends, that fear and discomfort can keep them away.”

Triggering Christmas Conversations

Another factor that can drive someone with an eating disorder into social isolation over Christmas is the small talk we make when sitting at the table. If the heaps of food weren’t problematic enough, idle comments can be unintentionally unhelpful or downright hurtful.

Mel says, “People don’t realise that general talk about food or body image can be really challenging for someone with an eating disorder. Even casual comments like, ‘I’m being so bad with all this food,’ or ‘I’ll have to work this off later,’ can bring up a lot of anxiety. It’s easy for someone to feel under scrutiny or pressured, even if the remarks weren’t meant personally. It all just adds to that mental load.”

“People often talk about how they’ll eat whatever they want at Christmas,” Nerissa adds, “then ‘make up for it’ later. That can be triggering because it implies there’s something wrong with enjoying food, even at Christmas. Comments about eating, even if they’re not directed at someone, can still be triggering. Things like ‘I’m so full’ or ‘I’ve put on weight’… they all add to the pressure on someone already managing a lot of concerns about food.”

Casual remarks about weight, appearance, or the food we’ve eaten can trigger deeply distressful thoughts. It is a good policy to avoid personal comments, even if they are meant kindly or in jest.

Body Image and Christmas

A negative self-perception of our body and an unrealistically high standard of how we ought to look sometimes go hand in hand with eating disorders. These body image issues, unhappiness with appearance, obsessive thoughts about weight or shape, or comparing ourselves unfavourably to celebrities or sports stars can be heightened at Christmas.

“For somebody with an eating disorder, thinking about their body and how they look can become an obsession,” Nerissa says. “Other people might be able to brush off worries about weight, but for someone with an eating disorder, it’s constantly on their mind. Comments on appearance—even when positive, like ‘You look well’—can be loaded and easily taken the wrong way by someone with body image issues. They might interpret it as ‘I look bigger’ or ‘I must have put on weight,’ even if that’s not the intent.

“There’s an implication in our culture that looking a certain way—being thinner or more toned—is better, and that can be really damaging. Christmas media and events can amplify those feelings of not measuring up. The expectation that you’ll see people you don’t normally see adds a lot of pressure. They might be looking at you, commenting on how you look—it’s a huge source of anxiety.

“People with eating disorders often feel that if they gain weight, it reflects on their worth or success. At Christmas, with so much food around, that fear of their body changing can become overwhelming.”

“Around Christmas, body image concerns can really peak,” Mel adds. “Images of ‘perfect’ bodies and lifestyles are everywhere—adverts, films, social media—and that can make someone feel they don’t measure up and should look different. It’s hard to avoid comparing yourself. For someone with an eating disorder, just seeing all this can reinforce negative feelings about their own appearance. And when we’re seeing people we don’t usually see, the anxiety around body image and what others might think just intensifies.”

Eating Disorders: How to Cope at Christmas

Despite the challenges, with a bit of self-care and support, an eating disorder needn’t ruin Christmas for you or someone you love.

Tips and advice from Nerissa and Mel:

• Plan Ahead: Nerissa advises people to make a plan before Christmas to help manage anxieties, as planning provides a sense of control during gatherings. “Think about what it is that you’ve got to do. Consider who you might feel comfortable asking for help and what sort of support might be useful.”
• Focus on Non-Food Activities: To shift focus from food, Nerissa suggests creating holiday experiences that aren’t food-centric. For example, activities that bring enjoyment and connection, like spending quality time with loved ones.
• Practice Self-Compassion: Nerissa says that developing a nurturing attitude towards oneself is important and valuable. “Understand that this is a difficult thing you’re doing, and it’s reasonable you find it hard. Just acknowledging that can make a difference.” She advises being kind to yourself and recognising that it’s natural to struggle.
• Build in Breaks: Nerissa recommends scheduling breaks during get-togethers: step away, go out into the fresh air, or spend time alone. “If you’re with a big group, take moments for yourself—even if it’s just a quick walk around the block.”
• Make a Post-Holiday Recovery Plan: What activities could help you de-stress after the holiday? “Think about how you’ll soothe yourself after; what you can do to recover from the stress.”
• SWEDA Helpline and Support: Nerissa reminds people that in the run-up to Christmas, SWEDA’s helpline is available for those who need support but might not feel comfortable talking to someone they know.
• Perspective on the Holiday: Keeping the holiday in perspective, reminding yourself that it won’t last forever. “It’s just a few days; try to see it in the context of the whole year.”
• Agree a Signal with Loved Ones: For those with supportive family members, Nerissa suggests setting up a discreet signal to indicate when you’re struggling, something as simple as scratching your head. This can prompt a loved one to offer support, intervene in an awkward conversation or suggest taking a break.
• Take a Low-Key Approach: It’s helpful to take a lower-key approach to Christmas, focusing on spending time with family and keeping holiday expectations realistic.
• Prepare to Set Boundaries: Mel suggests establishing gentle boundaries to help manage potentially stressful situations. “It’s okay to say no to certain foods or to explain that you’re managing your health in your own way. Let those around you know what makes you feel comfortable.”
• Identify Supportive Allies: For social gatherings, Mel recommends identifying a friend or family member who understands your struggles and can offer subtle support. “Having one person who ‘gets it’ can make all the difference, so you’re not managing it alone.”
• Take the Pressure Off: Mel advises a realistic, gentle approach to holiday expectations. “Try to enjoy the day as it is, without pressure to make it perfect. Sometimes, just aiming for ‘good enough’ can be really freeing.”
• Have a Safe Space to Retreat: Arrange a space where you can take a breather if needed. Mel says, “Even just a few minutes alone can help you recalibrate if things start to feel overwhelming.”
• Mindfulness: “Remind yourself that it’s okay to feel how you feel and that this moment will pass,” Mel says.

How You Can Help a Loved One with an Eating Disorder at Christmas

Supporting a loved one with an eating disorder at Christmas can be challenging, but small, thoughtful actions make a big difference. Mel and Nerissa recognise the importance of open and supportive communication—ask your loved one what would make them feel more comfortable during gatherings and how you can help ease the stress. If they’re receptive, gently encourage them to discuss any specific needs, for example, plating their own food or having the freedom to step away if things become overwhelming.

Creating an environment that is less food-centric can also be beneficial. Encouraging activities that focus on enjoyment beyond food, like games, watching a movie, or taking a walk together. It’s important to recognise that the fear around food is real. “It’s a genuine fear, not just a feeling of not wanting to eat,” Nerissa explains.

Being mindful of conversation topics is equally important. Nerissa advises family members to avoid discussing weight, body shape, food, and dieting during gatherings. “Comments on what people are eating, how much, how it looks—those things can be really difficult.” Even positive comments about eating habits or appearance can be harmful; instead, focus on positive, inclusive topics that don’t involve food or body image.

“It’s about creating a safe, non-judgmental environment,” Mel says, one where the person feels accepted and supported rather than pressured to join in on everything. Eating disorders often thrive on feelings of shame and isolation; by creating a gentle, understanding atmosphere, you can help your loved one feel connected and cared for rather than alone in their struggle.