For thousands, Christmas means struggling to control their relationship with food. Anne Dempsey examines the issues and the help available
One in 30 people in Ireland has an eating disorder be it anorexia (fasting and starvation), bulimia (eating and vomiting) or binge eating (consuming copiously without vomiting). In addition, many thousands diet constantly, and are preoccupied if not obsessed with food, weight and shape.
Add Christmas to the equation and it's obvious that the festive season equals the frightful season for many.
Sinead (24) is an outpatient with anorexia. She's dreading Christmas.
"It's as if you are two people. There are two voices in your head, the anorexic voice, and your voice. If you don't listen to the anorexic voice, you're a slob, you're weak. You're bad and repulsive anyway, but if you go the anorexic way, you're a bit less repulsive. If you don't go the anorexic way, you're absolutely nothing, you've had it."
She is unsure how controlling food came to be linked with controlling life. "As a teenager I didn't like the way I looked, but at least I wasn't big. I began to think that the one thing I could take action on was my size. It was something I could control."
Bodywhys, the eating disorders association, is 10 years old this year, its busiest to date. "We will surpass the 2,550 helpline calls we had in 2004, and had 6,000 visitors to our website in October alone," says chief executive Jennie O'Reilly.
For Bodywhys members, Christmas is a difficult time.
"The focus is on the family dinner, but it's not just the day itself, it's the build-up, the parties, the socialising, the whole thing."
The Bodywhys website offers clients a series of tips for coping at Christmas. Planning and communication is vital, it says. Write out a list of your fears and wishes and discuss it with the family.
"Often when someone begins putting on weight, family members believe that all is well. But the person may still be struggling with what is happening, and needs to let people know how they are feeling. Making a list of wishes and needs will clarify things for them, and offer a tool to approach the family so that they understand and can help rather than the opposite.
"More people suffer from bulimia than anorexia. If the bulimia is out in the open, the person may feel they are being watched by the family, afraid they are going to disappear off to the bathroom. Again, discussing things together will help give everyone the space they need."
Keep to your own routine about meals if this is necessary for you, and/or arrange with whoever is doing the cooking that you have some control over what you eat. Be prepared for comments about food, and plan your response in a way that invites others to respect your needs.
So if Auntie Sheila remarks on your relatively small helping, you could explain that it's helpful for you to manage things at your own pace at the moment.
The subtext is to know your needs and convey them without a row.
Try not to isolate yourself, says Bodywhys, but do take time out if you need to read, walk, listen to music. You could also identify a family member to help you work out specific ways of coping.
"If I could say just one thing, it would be to share your feelings with someone in the family, don't be on your own," says O'Reilly. The Bodywhys helpline reopens on December 28th, and it has introduced an e-mail support service.
Imelda Redmond, clinical nurse specialist with St John of God's eating disorder recovery programme, echoes many of the Bodywhys points.
"Some of our patients will be home for Christmas having completed the programme here, and there could be an expectation that they will have a lovely time, while the person themselves could be hoping just to get through the day.
"Then there are comments from people which can't be totally avoided. But to tell someone in recovery 'you're looking great' or 'your cheeks have really filled out' could in fact be unhelpful.
"It could be very bad for everyone if food is locked away and the person won't want to disrupt Christmas for everyone else either. Our main advice for families and patients is that each finds a way to talk and listen to each other."
• Bodywhys, The Eating Disorders Association of Ireland, PO Box 105, Blackrock, Co Dublin. Telephone 01-2834963, LoCall Helpline 1890 200 444 www.bodywhys.ie, e-mail support alex@bodywhys.ie
• Eating Disorder Recovery Programme, St John of God Hospital, Stillorgan, Co Dublin, telephone 01-2771400, www.sjog.ie