For the person:

Christmas is a time of celebration that often includes an abundance of food and treats, as well as family, friend, and office get-togethers which all involve eating. This means an increase in anxiety and pressure. 

1. Prepare for what challenges you might encounter and make a plan with helpful family members, work colleagues, or friends about how you hope to approach this. Have an alternate plan ready just in case Plan A doesn’t go accordingly. 
2. Try and be as open as you can about what you might find difficult.
3. Stick to agreed meal plans and prepare to face the fact that portion sizes may vary with new groups of food.
4. Be open to seeing this as a special period of time, with a beginning and an end, that you are going to negotiate.
5. Decide on sticking to eating with everyone and to a joint time limit, rather than the pace set by the eating disorder.
6. Keep busy to avoid having an opportunity to binge. 
7. Know who might be at various meals and be prepared for standard comments that are made about sensitive topics such as portion size or loss/gain of weight.  

For families and partners:

This time can be more stressful in terms of being mindful of the struggle the person with an eating disorder might have, whilst also creating an enjoyable time for everyone else in the family. It can also be stressful if grandparents or extended family are included in such events and they don’t know.  

1. Keep in mind how stressful it might be for the person and avoid being drawn into conflictual discussions and negotiations. 
2. Have a discussion about intentions and challenges and make a joint plan. For example, know the menu in advance, decide on who serves the meals, decide how treats can be included without causing huge anxiety, and discuss how to deal with stressful situations.
3. Be sensitive to the challenges of sit-down meals. Make a seating plan in advance, with input from the person experiencing an eating disorder. 
4. Focus on other shared activities (such as games and tv) rather than eating.
5. Seek some support for yourself—e.g., from your partner, family, or a professional.

Lent is a tricky time for anyone with an eating disorder. 

If a person has a diagnosis of anorexia nervosa, it’s no different to a period of ‘self-imposed Lent’. If a person has bulimia nervosa or binge eating disorder, the abundance of sweets and Easter treats makes managing binges even more difficult. Managing an eating disorder over this period of time can therefore mean difficult things for different people. 

For someone with anorexia nervosa:

Try to avoid using this time to restrict further. The physical impact of restriction is very significant. Fatigue, cold extremities, and a lack of essential nutrients can lead to very significant physical problems affecting dental, hair, skin, bones, blood, fertility, and many other systems. It can also lead to muscle loss and affect the smooth functioning of a person’s heart, since this is also a muscle. 

Restriction can also lead to problems with concentration and memory, which is especially hard for students who may need to be on top form for public exams, or in good physical conditions for sporting challenges. 

Instead of focusing on changing restrictive eating habits further, focus on getting better and giving up something that will benefit instead, like smoking, vaping or procrastinating.

For someone with bulimia nervosa or binge eating disorder:

Restriction doesn’t work for anyone, but is especially difficult for someone with bulimia nervosa or binge eating disorder, especially when there is easy access to a surplus of treats.

Stick to a regular eating plan, permit some variation in eating over this period, and include some treats so that they don’t become the ‘forbidden food’ that, when eaten, bring on feelings of guilt. 

Ramadan is the holiest month during which Muslims across the world fast from dawn to dusk. Fasting or restrictive eating is a feature of both anorexia nervosa and bulimia nervosa. Ramadan is therefore extremely challenging for someone with an eating disorder because fasting can trigger, maintain, or worsen an eating disorder. Iftar is a celebratory meal that follows Ramadan and for people with bulimia nervosa or binge eating disorder, this might trigger binge eating.

Some steps to manage an eating disorder over this period:

1. See a doctor for a physical check that includes blood pressure and blood tests to assess whether you are well enough to fast and, if you do fast, whether you should do less than a month and continue to be monitored over this time. 
2. Speak with an Imam who can explain that fasting is only for those in good health. They can help point out parts of the Quran that contain the fact that people with poor health cannot fast. 
3. Involve family in discussions about how to manage the challenges of not fasting over Ramadan.
4. If you do fast, then make sure at least one person knows of your eating disorder so that they can support you, as well as keep an eye out for your physical health.
5. Communal eating can be challenging for someone with an eating disorder. Stick to an agreed meal plan and try not to compare.