For those with eating disorders, Christmas can be a distinctly non-festive occasion. Nadine O'Regan outlines the acute stress points for sufferers. and their families
Her family were in the middle of planning the Christmas dinner when Sorcha burst into tears, as her family recall it. Mince pies. Turkey. Stuffing. Mashed potatoes. Christmas pudding. It shouldn't have been a list to make anyone cry, but for Sorcha, a bulimic, it represented a nightmare about to commence.
While Christmas brings increased stress for almost everyone, for people with eating disorders, that stress is of a whole different order.
On a website for anorexics and bulimics, a girl called Faye describes how the previous Christmas acted as a catalyst for her condition.
"I'm so fat," she writes. "It has always been in the back of my mind. Six months ago, I snapped after eating a lot at Christmas. I need control. This is the only way. I feel the fat all over me. It's like a disease. To me, anorexia isn't the disease, it's my drug to cure it. I love it too much to let go, even though I know it'll kill me."
This Christmas, Bodywhys, the Eating Disorders Association of Ireland, has launched a pilot scheme aimed at helping sufferers of eating disorders, and their families, cope with the festive season.
Posters have been placed in the toilets of shopping centres all over Dublin. They bear the title "Don't let an eating disorder distort your Christmas!" and contain information on how to contact the Bodywhys organisation.
The incentive for the scheme came from the realisation that Bodywhys was not always reaching the people who were directly in need of help.
"A lot of the awareness-raising work we've done has been through articles in newspapers, flyers and educational talks," explains Bodywhys chief executive Jennie O'Reilly.
"It tends to be parents who respond. We decided to try this scheme as a pilot to see what type of results we would get."
Speaking to O'Reilly, just over a week after the posters had been put up on November 25th, she has already noticed a significant positive effect, with an increased number of people accessing the Bodywhys website and treatment section.
Phone calls to the Bodywhys helpline, meanwhile, are flooding in. Many are from parents who are frightened and unsure of how to help their child.
Bodywhys suggests a multi-disciplinary approach, recommending that parents bring their son or daughter to their GP while also finding help and information for them through mediums like the Bodywhys support group and website.
For parents who suspect that their child suffers from an eating disorder, O'Reilly suggests bringing up the issue in a tactful and sensitive way.
"Try not to bring judgment into it," she says. "Rather than saying, 'You must eat your dinner', explain what you're observing. 'I'm observing you're not eating, that you're losing a lot of weight, that your clothes are big on you.'
"It's also appropriate to explain your concerns. A lot of the time, parents who contact us are afraid that if they say anything, their child might stop speaking to them.
"But often it's about saying, 'I'm concerned, I'm worried, I want to know how I can help you.'"
When Sorcha's mother contacted the helpline, she was shocked and worried. Sorcha had been bulimic for over a year, but her mother had known nothing about it until the Christmas outburst.
In this situation, when there is an awareness of the eating disorder, parents are faced with a new dilemma. Should they insist that their child eat normally or allow them to quietly starve?
Unfortunately, there is no easy answer. "It's about negotiating," says O'Reilly. "It depends on each person and where they're at in their recovery.
"If somebody has identified that they have a problem, it's about asking that person what support they need to get through the day, but also bearing in mind that there's a whole family there who need to be able to enjoy the day as well."
Families frequently find it hard to appreciate the seriousness of an eating disorder. Anorexia affects between 1 to 2 per cent of the Irish population and bulimia between 3 and 5 per cent.
Nonetheless, the public are often poorly informed about the huge psychological aspect of the illness.
"They miss the causes of it," says O'Reilly. "An eating disorder is not just about dieting. It's about coping. It's about trying to manage feelings that are just too unbearable. And the way of coping is to hold onto your eating disorder."
Healthcare professionals also sometimes experience difficulties understanding eating disorders, according to a recent report issued by Bodywhys, which surveyed 256 nutritionists, counsellors, GPs and psychiatrists working in Ireland.
"Many healthcare professionals do not have an adequate knowledge of eating disorders and do not recognise the serious nature of the illness on presentation," was the stark finding of the study.
"This can lead to a delay in treatment," it notes.
This delay has serious consequences. According to the Bodywhys report, 20 per cent of people with eating disorders die. But with early intervention that figure falls to 5 per cent.
"If treatment is accessed early, the chances of recovery are very high," says O'Reilly.
"Over 60 per cent of sufferers recover fully," she adds.
The Bodywhys poster campaign is one valuable step towards achieving this goal. But there is still much more in the future that needs to be done.
Sorcha's name has been changed.
• Bodywhys Online: www.bodywhys.ie. Lo Call Helpline: 1890 200 444