Eating Got You Anxious?

Columbia University Irving Medical Center

Tips for keeping eating behaviors healthy and finding support over the festive season

Many of us missed being with family or friends for last year’s holidays due to the COVID-19 pandemic. This year, thanks to vaccinations and booster shots, the season of big meals and parties is returning in many places. Such celebrations started on Thanksgiving and run into January, with abundant food and frequent eating.

That food-focused environment can be problematic for people with eating disorders, including anorexia nervosa, bulimia nervosa, and binge-eating disorder. It also challenges those with less-severe disordered eating behaviors, such as frequently skipping a meal to control weight or exercising exclusively in relation to dietary choices. People without eating problems also may worry about facing too many seasonal treats and holiday buffet tables-temptations that can be difficult for all.

Plus, this year, there’s an extra dollop of anxiety as we shakily step back into social settings with extended family or friend groups after pandemic isolation.

“For many people with eating concerns, holiday events involve two major stressors, the social situations and the food itself,” says Lisa Ranzenhofer, PhD, assistant professor of clinical psychology in psychiatry at Columbia. According to Ranzenhofer, studies in adults and teenagers suggest that experiencing more social stressors, such as feeling lonely or having conflict, can influence short-term eating behaviors.

At holiday gatherings, the stressors you arrive with may be compounded by comments about your weight or appearance, about how little (or much) you are eating, or other sensitive subjects. Some people will be unaffected by such remarks; others may change their eating patterns briefly. But for those Ranzenhofer calls “a vulnerable subset,” the comments add to factors that may lead to not being able to eat around others, binge eating, purging, or other problematic eating behaviors.

There are ways to counteract such effects. A 2020 study Ranzenhofer conducted with other Columbia researchers showed that connecting with someone who is in full recovery from an eating disorder and trained to give advice-known as a peer mentor-helped patients reduce binge-eating and food restriction, and lessened anxiety and depression.

“The holiday period was a time that patients were able to rely on their mentor as someone who could relate to what they were going through,” Ranzenhofer says. “Getting that support can change the impact of a stressor.”

She suggests these strategies for healthy holiday eating:

  1. Plan in advance. Are you worried about eating too much or too little at holiday gatherings? Planning for how to approach events can be more successful than trying to work out a strategy when you arrive. Before the day of the party, take a few minutes to figure out what and when you will eat. If you’re getting professional help for an eating disorder, you can develop that plan with your treatment team or therapist by talking about what would help you feel in control.
  2. Don’t fast all day to “save up” unused calories for eating later. Eating nothing at all before a party, or in the days leading up to it, can leave you feeling hungrier and more focused on food at the event. That can lead to overeating, Ranzenhofer says, “and, for some, feeling bad about it.” Some people also may experience irritability and other mood disturbances associated with fasting, as well as digestive issues – including nausea and bloating.
  3. Arrange to reach out to friends or others.

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