Nine percent of Utahns will have an eating disorder in their lifetime, according to a report from Harvard University and Academy for Eating Disorders. Which makes the feast and family time of Thanksgiving an anxious and stressful event.
Because the holiday is so centered on food, there can be whirling thoughts about things like how many calories are in the meal and how they’re going to burn off what they eat, said Lehi-based therapist Aislinn Burke.
“They're oftentimes not even as engaged in the conversations or what's happening at the table,” said Burke, who specializes in eating disorders at Willow Shore Counseling. “It really just takes them out of that experience.”
So while others might be enjoying the food and conversation, people with eating disorders might be worrying, “What are other people thinking about what I’m eating?” and watching what other people are choosing to eat.
Family members can sometimes make it worse by saying things that might seem benign. “Oh, I'm so stuffed," Burke offered as an example, and "I got to go work this off" or "I'm going to pay at the gym tomorrow for what I ate today." Talking about current diet plans or ways people are trying to lose weight can also be problematic.
Those kinds of comments can be harmful to anyone, Burke said, but especially people with eating disorders since they’re already so focused on food and their bodies.
“I think [those comments] just focus us on thinking that we have to look a certain way or eat a certain way to be good,” Burke said. “I think we're a very sort of fat-phobic society, and I think that's making us as a society sicker.”
So this Thanksgiving, Burke recommended families talk less about the food.
“I think just focusing on each other, right? So rather than focusing on what we're eating or how we look. I think to focus more on what are we doing in our lives. What are we grateful for?”
This interview has been edited for length and clarity.
Ciara Hulet: How can those with an eating disorder prepare for Thanksgiving?
Aislinn Burke: It's really important to plan ahead. To identify, “What are my goals in this meal?” “What are the things that I can do to manage any emotional distress that's coming up?”
So sometimes we might in [a therapy] session practice some role play. So, ways to actually practice setting a boundary or saying it out loud. We might even do sort of visualization like, “imagine yourself sitting at the meal and so-and-so says a comment, or your fear- food is right in front of you. Imagine what's coming up for you and how you might calm yourself down in that moment.”
CH: Tell us the story of an experience a client had at Thanksgiving to help us better understand the experience.
AB: I had a client a few years ago, and for her, some of the family dynamics were also highly stressful. She had a grandma that would often talk about her own body, compare her weight to grandchildren's weight. Really talk a lot about body or food. And for this client, that created a lot of anxiety. So we talked a lot about what to do. Trying to seat herself further away from grandma. We talked to mom about ways to maybe redirect conversation and giving this client sort of fake excuses to leave the dinner table if she needed to.
CH: Is there anything that people can do before or after the meal to make it a better experience for those with an eating disorder?
AB: I think if the family is aware of the eating disorder and open to helping and supporting, I think talking through [with] them before the meals to say, “Hey, how can I best support you? Do you need me to set any boundaries at the dinner table if diet or body talk comes up?” Checking in after the meal to see how they are feeling. Even helping them identify what skills they can use. “Do you need to go for a quick walk to decompress? Do you need to take some deep breaths?”
CH: Even with the best intentions, what if it just doesn't go well at the dinner table?
AB: I think that we're human and we're all going to make mistakes and we're going to be imperfect. Right? Harmful comments can slip and without intention of harming. And so having that forgiveness and compassion for each other that we're all learning in this process, it's a learning process for everybody. And I think if families are willing to learn and loved ones are willing to learn, then giving each other grace when we mess up is super important.
