Holidays Hold a Daunting Challenge for Those with Eating Disorders

A season of dread

(December 13, 2007) -- The holiday season is stressful for just about everyone.

Kim Matarazzo of Plainville shares lessons from her struggle with anorexia by speaking to a Newton support group for people with eating disorders. (Globe Staff Photo / Bill Polo)

But for people struggling with eating disorders such as anorexia nervosa, bulimia, or bingeing, it can be positively torturous - a toxic mix of tangled family relationships, low self-esteem, and endless meals with rich, abundant foods.

Between Thanksgiving and New Year's Day, Newton-based Multi-service Eating Disorders Association sees its support group attendance and hot line calls almost double, as anxiety and depression increase among people suffering from, or vulnerable to, such disorders, said Beth Mayer, the group's chief executive. As the state's largest nonprofit organization serving people with eating disorders, the association reaches more than 5,000 clients annually.

Mayer, a therapist specializing in eating disorders, counseled several of her patients by phone on Thanksgiving to coach them through the day of family feasting.

"People dread the holidays for weeks and weeks ahead of time. They worry, 'How can I look normal?' and 'There's family coming and whether they don't know, or they do know, and what if they're watching me?' " said Mayer, 49, who said she recovered from an eating disorder as a teenager. "Whenever there is anxiety, an eating disorder can raise its ugly head."

On a recent Saturday, more than a dozen people gathered at the association's offices for a regular support group called "Hope and Inspiration," which featured a talk by Kim Matarazzo, 33, of Plainville, about her struggles with anorexia during high school and college.

She now considers herself fully recovered, and has begun volunteering as a speaker for the Newton organization.

Matarazzo said she - like many young women who become compelled to starve themselves - was obsessed with trying to please others and gain approval, even as her sense of self-worth plummeted. She graduated as valedictorian of her class at Walpole High School and in the top 10 of her class at Bentley College, even as the illness threatened her life.

At her sickest, she carried only 86 pounds on her 5-foot-4-inch frame and narrowly escaped hospitalization, she said. During those years, she dreaded holidays and visits home for weeks ahead of time, fearing scrutiny and criticism.

Relatives and friends who made well-meaning comments about her appearance or her appetite just made things worse, she said.

"It's important for family members to know that people struggling with this kind of thing aren't doing well or functioning fully," Matarazzo said.

Her audience was mostly young women, a few accompanied by a parent or a partner. It's generally an anonymous gathering - some of the attendees were getting treatment for anorexia, and others for eating disorders in which patients binge on food and sometimes purge many times a day, staffers said.

A list of guidelines for the support group adorns one wall: no food allowed (it sets people with eating disorders on edge); no discussion of specific weights, sizes, or exercise regimes (they can be competitive triggers); and no personal comments about appearance (a remark like "You look good" or "You look too thin" can send an anorexic or bulimic into an emotional tailspin).

This time of year, calls to the association have jumped from around 75 to 150 weekly, and formal assessments of prospective patients increase from five to nearly 10, said Anne Robinson, its executive director.

"The holidays bring up issues of sadness, loss, and loneliness. It's six weeks of time where all these emotions are wrapped up and spotlighted with food," Robinson said. "It's clearly a much more stressed period of time."

It is also during the holiday season that college students and young adults often return home after months away, and parents first notice issues with their child's weight loss or mood.

Association clients reflect the general population of people with eating disorders - most are girls 13 to 26 - but the agency has consulted on cases with children as young as 8 and adults in their 50s. It holds several weekly support groups for teens and adults and their family members, and is actively lobbying for the passage of a bill recently sponsored by two Newton lawmakers, state Representatives Kay Khan and Ruth Balser, that would require insurance companies to extend mental health coverage to patients with eating disorders.

Firm statistics don't exist, but specialists in the field estimate boys and men make up between 10 and 25 percent of eating disorder patients. One of the fastest-growing segments is women over 30, and in particular menopausal women, who are grappling with hormonal shifts and, in some cases, an empty nest, said Mayer.

For older women, having their grown children return for holidays can set off a whole set of anxieties. Moms struggling with food issues will often cook for their families, but avoid eating the food and camouflage their avoidance by keeping their focus on serving others.

"Some women feed their children, but manage to never sit down at the table themselves," said Mayer.

Jessica Eves, 27, of Waltham, recovered from anorexia several years ago, but vividly recalls the difficulties in battling the illness in her freshman and sophomore years at New York University.

Holidays were terrible because they fed the "spinning-out-of-control feelings" that fueled her illness. "The gaze of other people really puts you in an uncomfortable position," said Eves, an association speaker who is pursuing a master's degree at Simmons College.

Her advice for family members trying to help someone struggling with anorexia or bulimia is to resist the urge to stage a confrontation at the table.

"Set aside a separate, quiet time to talk," she said. "Don't criticize. Say, 'I've noticed changes in you. You don't seem like yourself. Can we talk about it?' "

Family members who understand the problem can be enlisted to fend off relatives who may be less sensitive, or worse, try to force or guilt them into eating more ("Why aren't you eating the pecan pie? I made it especially for you").

The group also advises clients to craft a plan for tough days - take a quick break from the table when the pressure gets too much, and get plenty of downtime between stressful get-togethers.

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When possible, families should focus on joyful and emotional connections, not the food. Create meaningful holiday traditions and rituals that don't center on eating or cooking, Mayer said.

Years ago, Matarazzo said, she could not have imagined her current lifestyle. She can eat normally, and not pay attention to what other people are saying about food or worry about her body image.

"It took a long time, but you can get there with a lot of work. That's why I am out here talking about it," she said.

By Erica Noonan
Source: Globe Newspaper Company

Last updated: 12/07

Related Information:

• Finally! Treatment Programs for Older Women with Eating Disorders
• What Parents Need to Know About Eating Disorders
• Researchers Examine 'Purging Disorder'
• 'Social Websites like MySpace Encourage Anorexia', Warn Charities
• Could You Be Fostering an Eating Disordered Child?
• Helping Your Teen with Weight Management
• How Do Mothers Contribute to Their Daughter's Eating Disorders and Weight Concerns?
• Talking to Your Teen About Eating Disorders: Mother and Daughter
• Young 'Unable to Talk' About Eating Disorders
• Worshipping 'Ana' Eating Disorders Take on a Life of Their Own
• Anorexia Nervosa - The Most Deadly Mental Illness
• What is Body Image and How Do You Improve It
• Stop Hating Your Body!
• Know When to Seek Help for Your Child
• Teen Girls Who Are Frequent Scale-Steppers Often Have more Weight Problems
• Could You Be Fostering an Eating Disordered Child?
• Helping Your Teen with Weight Management
• How Do Mothers Contribute to Their Daughter's Eating Disorders and Weight Concerns?
• Talking to Your Teen About Eating Disorders: Mother and Daughter

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