How to deal with negative body image in summer
For people who struggle with the way they look, or what they eat, Christmas can feel as booby-trapped as the 'Home Alone' house. For those with eating disorders, family support and helplines can be a big help when therapists are unavailable.
Michelle Elman, a coach and author who writes about the body positive movement, says she's well aware of the pressure. "Christmas can be a difficult time of year for some people and there is a lot of conversation around Christmas weight gain or people commenting on what you should be eating. Christmas food brings up difficulties around guilt and a lot of body insecurities."
In 2017, NICE, the clinical advisory body for the NHS, advised doctors not to use weight or BMI when deciding whether or not to admit a patient to day patient or inpatient care for eating disorders. Dr Julia Coakes is a consultant clinical psychologist at a private clinic for people with eating disorders in Leeds. Some of her patients report that if their weight falls in the 'healthy' band of the BMI, doctors cannot get them a referral.
"They have limited resources so they have to have quite strict criteria. I saw a client this week who had lost two kilos. She said, 'I won't get into an NHS service like this' - because she's a normal weight. But if you lose two kilos in a week, that's still dangerous."
Even where services are available, it can take a worryingly long time to access them. For instance, despite Leeds having a specialist NHS service for patients with eating disorders, waiting times are often still four to six months.
Earlier this year, Hope Virgo's 'Dump the Scales' campaign spoke out against 'waiting for people to hit crisis point', and was raised by MPs in parliament in February. But after years of calls and campaigns for better mental health investment, perhaps it's time for policymakers to ask why doctors have struggled to support more patients with eating disorders.
What can help
Elman says she no longer stands around listening to remarks about what she weighs or how she eats, and would advise others to head it off (or walk).
"You do not have to stand there and tolerate it," she explains. "If you don't feel comfortable telling the person to stop commenting on your body, excuse yourself to the bathroom or say you are going to get a drink. Use any excuse to get out of the conversation and if you need to, escape to the loo."
Jassy Davis, a food writer, agrees that Christmas can be a bit relentless. "It feels a little bit like everyone has developed a sort of eating disorder because there's so much food on offer, and people don't take no for an answer," she explains. Davis developed binge eating disorder six years ago and was treated for it around 18 months ago.
Have little bit of magic
For Davis, details like making an effort for a party help lift her mood when she feels self-critical about the way she looks.
"Your mind will be shouting at you, saying: 'Why are you putting on make-up? That's ridiculous. You don't deserve to wear make-up - until you're thin, toned and athletic you shouldn't even be trying.' Whereas if you allow yourself a little bit of magic that you think you're not worth having, then that's one way of bringing it to you."
Drop loaded conversations
Hope Virgo is an author and activist - her work is informed by her experience of anorexia ten years ago. She warns people, whether they struggle with eating disorders or not, to stop talking about what food is 'allowed' or has been 'earned'.
"The big one, particularly around Christmas, is to not say things like, 'I can eat Christmas lunch, because I've dieted for the last couple of weeks', or, 'I've earned this Christmas lunch'," she explains.
Ring a helpline
Ali Moore, a coach specialising in self-esteem, advises that if you're seeing a therapist, you talk worries through with them before going on leave.
"Get specific about what is bothering you and ensure you have the tools to cope," suggests Moore. "Most therapists will allow emergency appointments and Samaritans are always available. BEAT has a helpline available, with lines specifically for students and under-18s as well."
The line is open every day, including 4-8 pm on the bank holidays (Christmas Day, Boxing Day and New Year's Day).
Dr Coakes says that at her clinic, psychologists tend not to focus on body positivity - which can be another rabbit hole for perfectionism.
"'Body acceptance' fits better with our clinical way of working," she explains. "There are some things in the world we have to accept, that we may not love."
Christmas is beloved for its traditions and rituals, but recognising that it may be a difficult time for you is the first step in making it easier to cope with. And whatever happens, support is available.