Eating Disorders Don’t Take A Summer Vacation

For many, summertime means vacations, long, warm days, and a much-appreciated break from school or work. It is a season of sunshine and recreation. For the millions of people with an eating disorder, however, summer often means something much more difficult than carefree leisure and freedom.

As the school year ends and summer approaches, now is the time to plan for and address the common challenges facing people with eating disorders during the summer. In this article, we discuss some key factors that make this season difficult for those affected by these illnesses and describe how providers and loved ones can help to connect them with support.

Summer challenges for those with eating disorders

While no time of the year is easy for those with eating disorders, the summer season presents unique difficulties that can trigger and worsen symptoms if left unchecked. Changes in routine and environment, as well as additional food-related activities and body image concerns, are among the particular factors that can make the summer especially difficult.

Changes in routine

The change of the seasons often brings a change in routines, a key trigger for those with eating disorders. School breaks and more flexible work schedules may impact eating patterns, as may summer calendars full of activities or simply additional free time. Like any disruption to regular eating, these changes create an opportunity for eating disorder symptoms to take hold or worsen in those susceptible.

Changes in routine that can trigger or exacerbate an eating disorder include:

• Waking later in the mornings and then skipping or skimping on breakfast
• Working irregular shifts at a summer job, disrupting regular meal and snack times
• Increasing activity levels in warm weather but neglecting to adjust food intake accordingly
• Feeling bored by extra free time or overwhelmed by a busy summer schedule, both feelings that can trigger urges to engage in disordered behaviors

Changes in environment

Much like changes in routine, changes in physical environment can pose challenges for those with eating disorders. People often spend more time at home or on vacation during the summer months, and with this change in scenery often come changes in food availability and options. Interaction with support systems may also change, introducing stress to those who benefit from the presence of particular friends, family, or professionals during the rest of the year. 

Examples of environment-related challenges include:

• Feeling out of control around food in the house when spending more time at home
• Food insecurity in situations where someone no longer receives the meals or snacks at school or work received during non-summer months
• Exposure to more fear foods and less access to familiar foods when eating on the go and at restaurants when traveling
• Exposure to stressors of the home environment when moving home from college for the summer

More activities involving food

The season of barbeques, picnics, and backyard parties often brings an additional focus on food, a stressful situation for those with eating disorders already preoccupied with it. Triggers associated with food-centric social gatherings range from a change in structure around meals to the presence of fear foods to the pressures of eating around others.

Potentially triggering food-related activities include:

• Social gatherings that include an overwhelming amount of highly palatable food
• Summer events, such as festivals and fairs, at which all food is prepared by other people
• Parties where food is eaten while standing instead of served at a table
• Socializing with alcohol, a substance many people with eating disorders struggle with

Heightened body image concerns

As temperatures rise in the summer, feelings of body dissatisfaction often do as well. Wardrobes change to include clothing that exposes more of the body, often exacerbating body insecurity, body checking, and comparison behaviors in people whose eating disorders include a body image component. Diet culture amplifies these concerns further in the form of messaging that promotes diet and exercise as means to make ourselves “beach body” or “bikini body” ready—that is, to try to force our bodies into resembling the bikini-clad ones seen in the media.

Situations that can trigger body image concerns include:

• Trying on clothes from last season that no longer fit
• Seeing more diet-related messaging on social media
• Feeling exposed when wearing season-appropriate clothing
• Hearing comments from others about their own bodies, diets, or food

Signs that someone might be struggling

The warning signs that someone may be struggling with an eating disorder during the summer are similar to those present during the rest of the year. Look for:

• Dramatic weight gain or loss
• Rapid or persistent decline or increase in food intake
• Verbal preoccupation with food, weight, and shape
• Restricting, purging, binge eating, or compulsive exercising
• Denial of food and eating problems, despite concerns of others
• Eating in secret, hiding food, disrupting family meals, or feeling out of control with food
• Medical complications, such as amenorrhea, bradycardia, osteopenia or osteoporosis, electrolyte abnormalities, low body temperature, and orthostatic hypotension

I think my patient or loved one has an eating disorder. Now what?

If you notice signs of an eating disorder in a patient you treat or someone you love, acknowledge it. Don’t ignore the feeling you have that something might be wrong or justify disordered behaviors with an alternative explanation. Early detection and intervention are critical to a person’s recovery.

1. Ask the person about the signs you notice.

Open the conversation with your patient or loved one by expressing concern about the signs you see.

• Providers: Ask if your patient is willing to discuss their eating habits with you: “I’m concerned about your eating (or weight, body image, etc.). May we discuss how you typically eat and your relationship with food?” Then ask the following questions from our Eating Disorder Assessment Quiz: 
  • Do you worry about your weight and body shape more than other people? 
  • Do you avoid certain foods for reasons other than allergies or religious reasons? 
  • Are you often on a diet? 
  • Do you feel your weight is an important aspect of your identity? 
  • Are you fearful of gaining weight? 
  • Do you often feel out of control when you eat? 
  • Do you regularly eat what others may consider to be a large quantity of food at one time? 
  • Do you regularly eat until feeling uncomfortably full? 
  • Do you hide what you eat from others, or eat in secret? 
  • Do you often feel fat? 
  • Do you feel guilty or depressed after eating? 
  • Do you ever make yourself vomit (throw up) after eating? 
  • Do you use your insulin in ways not prescribed to manage your weight? 
  • Do you take any medication or supplement to compensate for eating or to give yourself permission to eat? 
  • Do you exercise for the sole purpose of weight control? 
  • Have people expressed concern about your relationship with food or your body? 
• Loved ones: Share your concerns, providing examples of eating habits or disordered behaviors you’ve noticed. Approach the conversation with gentle compassion and care, understanding that eating disorders are illnesses shrouded in shame.

2. Connect the person to eating disorder treatment.

If you suspect an eating disorder, connect your patient or loved one with a specialty treatment center such as The Emily Program. Eating disorders are assessed and treated most effectively by specialists who provide multidisciplinary and evidence-based support.

• Providers: To refer your patient to The Emily Program, call us at 1-888-364-5977, use our online referral form, or direct your patient to our website to request an eating disorder assessment.
• Loved ones: To find care for your child, call us at 1-888-364-5977 or complete our online form. For adult friends and family members, pass along our number or show them our website to help them get started with care.

3. Stay connected and informed.

• Providers: To stay informed of your patient’s progress throughout their eating disorder treatment, ask them to complete a Release of Information form so that we have permission to share health information with you. Learn more about eating disorders by attending one of our education or networking events.
• Loved ones: Getting support and education around your loved one’s illness can help you in understanding and supporting them. Check out our resources and support options for families and friends to learn more about eating disorders and connect with others in a similar situation.

While summer may present additional challenges for those with eating disorders, it can also be the season your patient or loved one finds help. Professional support is key to understanding and caring for these complex illnesses so that people can fully enjoy health in recovery, no matter the season.