Trick or Treating in Eating Disorder Recovery
~~~~~Happy Halloween ~~~~~
to everyone in the eating disorder community!
In Columbus, Ohio, we have trick-or-treating tonight and I am looking forward to a family tradition of ordering pizza and passing out candy while the kids trick-or-treat! And then stealing some of their candy when they get back of course. I know for many families in eating disorder recovery right now, Trick-or-Treat won’t be as fun or exciting as it was in years past. I wanted to write this blog post with my advice on how to handle trick-or-treating if your child or teen is in anorexia nervosa recovery or eating disorder treatment. This advice applies to Anorexia Nervosa of all types, but won’t likely be applicable to Bulimia Nervosa or ARFID. It is not intended to be clinical advise and you should reach out to your treatment team for guidance. If you are looking for anorexia nervosa treatment or eating disorder treatment in Ohio, please reach out for a free call.
Should my child in eating disorder treatment go Trick-or-Treating?
Does it interfere with eating disorder treatment?
This is a complex question without a simple yes or no answer. In eating disorder treatment, there will likely be activities and traditions your child must miss out on, whether that is due to treatment schedules or appropriateness of some activities. This can often be a very difficult part of treatment for parents- their children are struggling, distraught, upset and missing activities of daily life- it is not easy to be the one telling them they can’t do something that their peers and siblings are all doing- such as sleepovers, going to dances, or missing school. But the missing out is temporary and the benefit of recovery is lifelong. Sometimes kids have to miss activities due to treatment schedules or appointment times. If trick-or-treating is during a treatment time, I am going to tell you to skip it. Recovery is a priority and skipping treatment can be detrimental to progress. It’s not necessarily what you will miss in one night that will be detrimental, but the message you are sending to the eating disorder- “trick-or-treat (or other social activity) is more important than recovery and eating disorder treatment”. The ED hears this message loud and clear and it may set you back from progress you’ve made. The next event your child has to miss because of recovery will be even more stressful and difficult.
Are they physical stable?
Another consideration that may impact your decision to go trick or treating is physical health and stability. Often times in eating disorder treatment for teens and children, we as providers have great concern for the fragile place their bodies are in from severe calorie restriction over long periods of time. They may be lightheaded or dizzy and it would not be safe for them to go trick-or-treating and risk falling. They also may be on limited or restricted activity and trick-or-treating entails walking and expending energy. You will want to check with your child’s treatment team to see if it is safe or advisable. Some solutions to this are driving in a car or getting pulled in a wagon- if your child needs to do this and does not want to, then that is their choice if these are the parameters you and your team put in place. Recovery from Anorexia Nervosa often requires weight restoration and the research shows, the quicker we can restore weight, the better outcomes. Any activity, even walking, can slow weight restoration down and impact teen eating disorder treatment and recovery.
Are they mentally able to handle costume shopping and body comparisons?
Did your child buy a costume at their sickest and there is a possibility it won’t fit? Are you prepared to handle the impending meltdown? Are they at a place where costume shopping and trying things on in a store would be difficult? Will they work with you to chose a costume that is appropriate and won’t be triggering?
These are all things to consider. Body image is a big part of eating disorder recovery. Your child needs to be working hard in eating disorder recovery in order to go trick-or-treating- meaning: they should be working with you against the ED, not with the ED. I would not advise letting them go trick-or-treating even if they are physically stable if you do not think they are mentally stable and working towards eating disorder recovery. If they do go, I would encourage a costume that is not form fitting and that does not require trying on a lot of clothes at a store. This event might be very triggering for someone in the early stages of recovery.
I would also consider who they want to go with- are these friends supportive of treatment and kind? Or are they possibly triggering friends who will make body image or diet culture comments? I would also advise you or another caregiver be present to make sure activity level is appropriate and no eating disorder behaviors are happening (purging, trying to burn calories, hiding food, etc).
Are they able to eat candy?
Trick-or-Treat revolves around candy so this is an important consideration. Has your child or teen had candy in their eating disorder treatment? Is it a fear food? Candy and sweets are often restricted in anorexia nervosa and your child has likely avoided it for months. Have you reintroduced candy into their meal plan? Are they able to eat it without having a tantrum? Will they be able to eat candy in front of others? Will they be able to eat over their meal plan? These are questions to discuss with your child in a therapy session with their eating disorder treatment providers. If they haven’t be able to have candy yet, I would advise against trick-or-treating this year. If they have successfully had candy in their meal plan multiple times, I would consider trick-or-treating an opportunity to engage in a typical child/teen activity and build a healthy relationship with food. This would mean that if they go trick-or-treating, they must have a few pieces of candy, ideally in addition to their regular meal plan (it could replace desert or be extra- discuss with your dietician). It is NOT appropriate to have your teen or child go trick-or-treating and not eat any candy (unless due to an allergy). So please make sure you let them know the plan beforehand (i.e.; you will have 3 pieces of candy when you come home- I will pick out two and you can pick one).