The holiday season is a perfect time to reflect on our blessings, however, it can also be one of the trickiest times for someone struggling with issues around food.

 End-of-the-year celebrations are supposed to be fun and festive. Yet, managing the abundance and chaos that the holidays often bring can quickly become stressful and emotional. Relatives and acquaintances that we haven’t seen in a while will comment on our looks and lifestyles, and we lose our usual routines. This can be particularly difficult for those with disordered eating.

 Signs you or someone you know is struggling with an eating disorder can include feeling stressed around food, being fearful of weight gain, experiencing guilt after eating, and skipping meals altogether. The holidays may exacerbate these feelings since they typically involve a lot of food and eating.

 While disordered eating has no simple or short-term resolution, it is critical to recognize these signs and learn strategies that can help you foster a healthier relationship with food. That way, when the next holiday gathering comes along, you know the steps to take to feel more confident.

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What is BDD?

We all sometimes worry about how we look, but body dysmorphic disorder (BDD) is serious and causes a person to be overly worried about minor or imaginary physical flaws that are usually not apparent to any else.

BDD is a mental health condition that affects 1.7% to 2.4% of the general population, about one in 50 people. It is characterized by persistent and intrusive preoccupations with one or more perceived defects or flaws in appearance. Individuals with BDD feel defined by this flaw and have excessive self-consciousness. They have a critical inner voice telling them that they are fat or disgusting or that people stare at their flaws in public.

For someone with BDD, a flaw is significant and prominent. They can dislike any part of themselves, although they often find fault with facial skin, face (size or shape of the eyes, nose, ears, and lips), size or shape of virtually any body part (buttocks, thighs, abdomen, legs, breasts, and genitals), overall size and shape of the body, and symmetry of the body or particular body parts. This can cause severe emotional distress and difficulties functioning in daily life.

BDD can lead to reduced self-esteem, feelings of anxiety, and depression, and can have a negative impact on relationships. In some extreme cases, an individual may also experience social phobia, withdrawal, and/or self-harm.

Research shows BDD equally affects men and women. It often develops in adolescents and teens.

Even though the causes of BDD are unknown, certain biological and environmental factors may contribute to its development, such as genetic predisposition, neurobiological factors like the malfunctioning of serotonin in the brain, personality traits, and life experiences (child maltreatment, sexual trauma, peer abuse).

Individuals with BDD can’t “magically cure” their thoughts or behaviors. It is a real problem that takes a while to heal, and if you’re struggling, seek out help from trained professionals and get the support you deserve.

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Symptoms of BDD

Symptoms can vary according to which body part (or parts) is targeted, but general symptoms of BDD include:

  • thinking about the perceived defect for hours every day and distressed about their preoccupation
  • worrying about their failure to match the “physical perfection” of models, celebrities, and influencers
  • constantly asking trusted loved ones for reassurance about their looks, but not believing the answer
  • constantly looking at their reflection or avoiding their reflection (for example: throwing away or covering up mirrors)
  • constant dieting and overexercising
  • taking great pains to hide or camouflage the “defect” or grooming to excess (for example: shaving the same patch of skin over and over)
  • avoiding any situation they feel will call attention to their defect and, in extreme cases, never leaving home
  • squeezing or picking at skin blemishes for hours
  • wanting medically unnecessary dermatological treatment or cosmetic surgery or repeating cosmetic surgery procedures
  • depression, anxiety, and/or suicidal thoughts

Similar conditions to BDD include:

  • Obsessive-compulsive disorder (OCD) – is characterized by recurrent unwanted thoughts and images (obsessions) and repetitive rituals (compulsions). It has also been proposed that BDD is a form of OCD
  • Social phobia – a type of anxiety disorder, characterized by fear of interaction with people
  • Agoraphobia – a type of anxiety disorder characterized by the fear of situations or places from which escape seems difficult
  • Anorexia nervosa – is characterized by the drive to control one’s weight. BDD is often misdiagnosed as anorexia nervosa because of the preoccupation with appearance, and it’s possible for a person to have anorexia nervosa and BDD at the same time
  • Hypochondriasis – the preoccupation with the development of disease
  • Trichotillomania – the irresistible urge to pluck or pull out hairs

Treatment for BDD includes cognitive behavior therapy (CBT), coping and management skills, and medication. Some people get cosmetic surgery but any medical or surgical procedure carries health risks. Unnecessary attempts to change appearance through surgery may lead to dissatisfaction with the results and could worsen a person’s BBD.


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Living with disordered eating

It is important to find coping methods when your critical voice is loud.

Some people journal, meditate or create vision boards. Other creative methods include writing a letter to your future self. Small things like this can make a huge difference in recovery, and it never hurts to try.

This Thanksgiving try to be thankful for yourself. Forget about the pressure to have the “perfect” celebration and find ways to cope.

You can start by showing self-compassion. It is completely fine to struggle and feel overwhelmed, but you do not have to struggle alone. Ask for help. Together, you can come up with a “holiday coping plan.”

Give yourself permission to eat your favorite foods and relax. If you don’t allow yourself to eat certain foods that you actually want, you can create a deprivation cycle in your mind and body that makes you feel out of control around food. Food provides nutrient value, and holiday foods especially connect us with our culture, heritage, loved ones, and traditions that bond us. It helps our social and spiritual health, subsequently improving our biological health.

I know it is hard not to feel guilt, shame, and anxiety when living with an eating disorder, but those feelings are actually more harmful than food. Learn to set healthy boundaries like choosing to not engage in diet talk or over-committing yourself. Be prepared to amp up your self-care whether it be giving more time to connect with loved ones or taking some time for yourself. Increasing your self-care around this time of year may help to manage stress.

Take it one day at a time. Making short-term goals allows you to make the most out of each gathering while long-term goals can cause worry. Try making a list of things you can predict that people might say or do which will trigger your eating disorder thoughts then write down factual, pro-recovery responses to those thoughts reminding yourself to leave the eating disorder out of the meal.

During the holiday gathering, choose to sit with people who can support you. The first hour after a meal can be extremely vulnerable for someone with an eating disorder. Choose to show up for the conversation, not the eating disorder, by listening to stories and learning about others. Give yourself the gift of enjoying your meal and remind yourself that you are more than your body.

Holidays or not, surround yourself with positive people. Spending time with people who spend their time critiquing their own appearance or the appearance of others will create an unhealthy environment for your mental health. Instead, use your time to engage in activities that excite you and that you’re passionate about.

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Try to disengage from negative social media. Social media has the capability of bringing people together, however, our beloved platforms have countless negative health effects on us. We tend to feel bad about ourselves when scrolling through social media and comparing our lives to those we see on the screen. Unfollow accounts and people who do not add to your positivity as you work towards better mental health.

Eating disorders are real conditions that require real help. They usually do not get better on their own, and if they are untreated, they can worsen over time. Working with a mental health professional can help you on your path toward recovery.

Supporting loved ones with an eating disorder


To make the holidays a little less of a battle for those you love, you can be compassionate about the struggles they are having.

You can encourage your loved one, but do not make it a “big issue” about what they are eating. Focusing too much on food may only fuel the eating disorder. Do your best to support them by being aware of what may create anxiety. When in doubt, ask questions about how the person is doing and if they need any help. Respond in an understanding and kind way.

Allow time for other activities and ways to spend time together that does not involve food, such as games. The primary focus of the holidays is to spend valued time together.

See if there is a dish you could prepare to make the person feel comfortable eating or find other agreements about how you can best help them with food. And for the love of god, please do not draw attention by commenting on when someone eats, how much they eat or praise them for eating.

Some other suggestions include:

  • Not talking about diets, weight loss, or weight gain
  • Learning enough about the illness and the triggers to help your loved one develop skills as well as strategies to defy eating disorder thoughts and urges
  • Knowing something about their struggles, triggers, and behaviors. Then, if you see those, you can approach them in private to suggest ways they might be helped in some of those behaviors and learn ways you can be helpful and supportive
  • If you see them struggling, ask them if they want to talk, but ask this in private
  • Focus on how they are feeling inside, what issues they are worried about, what their fears are, and what they need, rather than just how much they are eating or are not eating
  • Be patient and nurturing, treat them with love, and let them know that they are loved
  • Help take their mind off of food by generating a conversation
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Food for thought (no pun intended)

It is essential to appreciate what our bodies can do for us. We need to focus more on the things we love instead of over-analyzing singular parts of ourselves. Look at yourself as a whole, remembering that is how people see you. You are not defined by your mental health.