Thanksgiving can be full of difficult situations to navigate when your child has an eating disorder- from food choices, meal plans, seating arrangements and timing- there are a million things to consider to make sure the day is set up to go as smoothly as possible. Today we are going to address the logistical questions of Thanksgiving meal and talk about how to plan ahead for success when your child or teen is in eating disorder recovery. Even if you spend weeks planning every detail in order to ensure a smooth and successful holiday, it is almost inevitable that a family member will say something triggering that can turn the whole day on it’s head and upend all of your detailed preplanning. For help with how to communicate boundaries to family members and ideas about what you can discuss around the dinner table to avoid triggers for your child or teen in eating disorder treatment, check out this blog post.  

 

Now that we have made a plan for how we will communicate to family and friends about topics we’d like them to avoid (HELLO comments about bodies, calories or diet culture!), we can work on making a plan for what will actually happen on Thanksgiving day and how to set you and your family up for success!

We know that holidays in general are difficult for those in eating disorder recovery-they are emotional, surrounded by people who may or may not know what’s going on with the eating disorder and the often revolve around food that does not look like a typical meal. From my teenage clients in eating disorder treatment in Columbus, Ohio, I have heard the most difficult holiday is Thanksgiving and it is the one they dread the most. They mention that at least at Christmas or Easter there is another activity (gifts, egg hunt, etc.) to keep people distracted and move the focus from the meal, but on Thanksgiving, the main and only focus is the meal. This makes it an extremely stressful event for someone who’s biggest fear currently is eating! Imagine putting yourself in your teens shoes and build some empathy for what they are up against on this holiday.

 

The best way to help your child or teen with an eating disorder through Thanksgiving is to make a plan. We will discuss the 3 important components of your plan today:

 

1)    Meal plan

2)    Coping skills

3)    Emergency plan

4)    Table Topics

 

The 4th important component of the plan, Table topics, is discussed in the blog post here.

 

Let’s start with meal plan.

1)    Meal plan

If your child or teen is in eating disorder treatment, they are likely on a formal (calorie or exchange based) or informal (portion sizes or main & sides) meal plan, or at least have guidelines on when and how much they should be eating and who is making those decisions.

Most of the time with children or teens in early eating disorder treatment and recovery, parents or caregivers will be in charge of plating and portioning meals. This means deciding what your child will eat, when, how much, and physically making their plate for them and giving it to them at the table. If this is where you are in your journey, it is important this does not change during Thanksgiving. Parents or caregivers need to continue with plating and portioning, even at a special meal, and probably especially at Thanksgiving.

Your child or teen may give you pushback about not being able to make their own plate in front of others or share concerns about feeling embarrassed.

My advice is to assure them that people likely won’t notice, or if they do, they won’t care and to remind them this is how their treatment works right now. It can be helpful to ask them if their eating disorder would be influencing their choices if they made their own plate- their answer will likely be “yes”, reinforcing the need to have parents plating and portioning.  Make sure to discuss expectations for finishing their plate- whether that means they must finish all of it, most of it, and what that looks like.  Also discuss if desert will be included on their main plate or be expected to be completed later as a snack on their meal plan.

 

Typically, timing of Thanksgiving meals can be an issue with typical meal plan timing. Many meals are at odd times between lunch and dinner. Your child still needs to eat all of their meal plan that day, so it is important to discuss that expectation with your child and get creative with planning. You might be able to request Thanksgiving meal be closer to lunch or dinner time. If not, you may be able to give your child a large snack during their typical lunch time and have Thanksgiving meal serve as their lunch. They will still need to eat dinner later, so explore with your team the best way to get everything they need in, and communicate this plan with your child so there are not surprised on the day of. It can be helpful for immediate family members to eat with the child before the Thanksgiving meal to help them feel supported.

Having the family restrict before the Thanksgiving meal (skip breakfast, lunch, etc) can be triggering and upsetting- we want to set your child up for success on this already stressful day. While it is not necessary or recommended to always eat with your child who is on a meal plan, you may consider making an exception this day.

 

If your child is allowed to plate and portion at this point in their eating disorder treatment, discuss how you will check their plate to make sure they have enough and how you will communicate if they need more. Making a plan for code words or going behind them in the buffet line can make this more discreet and less stressful for your child.

 

Meal plan points:

-Continue following guidelines for plating and portioning set by your treatment team

-Plan the days meals and snacks out and communicate this plan clearly to your child

-Make a plan for code words or support for the day of

 

2)    Coping Skills

 

It is important to plan for how your child will tolerate distress they may experience during the meal and skills they can use to help get through it. Encourage your child to talk about this with their therapist and write down a plan for what skills they can use. This may look like:

-What skills I will use before the meal

Ex: Talking to my cousins, playing games with my brother, doing a puzzle, reading a book

-What skills I will use during the meal

Ex: Fidgets, deep breathing, grounding skills (5,4,3,2,1), playing would you rather with family

-What skills I will use afterwards

Ex: Watching football, going outside to play with supervision, listening to music

 

While making a detailed plan of coping skills may seem unnecessary, it can be very helpful during stressful moments to have a plan in place. During times of stress, it is difficult for our brain to think logically and your child may be too overwhelmed to come up with skills in the moment. It is also helpful for siblings and parents to know what skills are on the plan so they can remind their child what to do if they see them struggling.

 

3)    Emergency Plan

 

This is exactly what it sounds like- a plan for if everything else goes wrong and we need to know what to do. While we are attempting to prevent triggering comments, making a plan for meal and communicating it clearly, and writing down coping skills to use, it is still possible that life will happened and Thanksgiving might be too much for your sick child to handle. Having a plan of what your family will do in this situation will help you to remain calm and handle it in a way you will be okay with. Possible emergencies may be:

 

-your child is not able to eat or able to complete the meal

-your child is anxious and has a panic attack

-argument happens with you and your child

-many others!

 

Discuss with your child in a calm setting, what you will do if one of these situations happen.

Maybe it will be you take them in another room and help them complete their meal. Maybe it will be, you have supplementation packed and they will have it in private. Maybe it will be, you go to the backyard to help them calm down and you have a code word to initiate this. Make a plan that works for your family and write it down, so that everyone is clear. Even if you think it is not going to happen, your child has done a family meal before, I encourage you to make the plan anyway. You will never regret making a plan, but you might regret not making one.

 

Most importantly, remember this is just one day of the year and whatever happens will not make or break your child’s eating disorder recovery. You can do hard things! You got this parents!

 

If your child or teen needs help with body image or disordered eating, please schedule a free phone call to discuss teen eating disorder treatment in Ohio with Eating Disorder Therapy.

DISCLAIMER: The advice on this blog is for entertainment purposes only and is not indented to be medical or therapeutic advice.

This post has been updated in November 2024 by Heather Allen, LPCC-S of Eating Disorder Therapy Ohio. She is an adolescent and teen eating disorder therapist in Columbus, Ohio serving Dublin, Ohio, Powell, Ohio, Bexley, Ohio, Worthington, Ohio and Westerville, Ohio in person in Bridge Park Dublin. She also serves teens and adolescents with eating disorders and body image issues located throughout Ohio from Cleveland, Ohio to Cincinnati, Ohio via virtual appointments.