Matthew Broberg-Moffitt, 37, remembers the first Christmas clearly. He was 16 years old and was helping his grandmother cook in the kitchen of their home in Nebraska, US. She asked him to taste the gravy she was making and tell her whether it needed seasoning. But he couldn’t bring himself to put the spoon in his mouth. Two decades later, he still has that feeling. Last year, when his mother-in-law took over a stuffing he was making, he felt so upset he had to leave the festivities for the day.
Broberg-Moffitt has had a non-specified eating disorder since late childhood and says, like many with disordered eating, that the festive period – with its intense focus on food, alcohol, treats and overindulging – is particularly difficult. In order to deal with it he tries to be involved in the preparation of food, so he can control what goes into the dishes. Pretending to snack while cooking is also an excuse he uses if he doesn’t want to eat later.
Daniela Beck, from Woking, was diagnosed with anorexia in 2017 and also makes sure she is in charge of cooking at Christmas to manage her food-related anxiety. “I find it easier that way,” she says. The 23-year-old also practices eating the components of her Christmas meal in the weeks before, and asks family not to gift her any food or clothes. But the hardest bit? The narrative of over-indulging and then dieting in January. “You have to participate and then a week later are told to go on a diet because you were ‘naughty’ at Christmas,” she says.
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There are approximately 1.25 million people in the UK with an eating disorder, according to BEAT, the UK’s largest dedicated charity. The disorders affect predominantly girls and young women between the ages of 12-20, but men also make up 25 per cent of sufferers. Recent research from the NHS information centre showed up to 6.4 per cent of the population displayed signs of an eating disorder.
Although eating disorders can be triggered at any time in the year, many with conditions like anorexia or bulimia – which the NHS says are characterised by people to try and restrict their weight – can find Christmas particularly challenging. “With such an intense focus on food and family, Christmas can be an understandably difficult time for people managing an eating disorder,” Sarah Murphy, associate director for advice at Rethink Mental Illness, tells The Independent.
Caroline Price, director of services at BEAT says she often sees people particularly struggling in December. “The Christmas period can be extremely difficult for people with all kinds of eating disorders. The pressure to eat large amounts can be triggering for people with binge eating disorder and bulimia, as well as causing anxiety for people with anorexia.”
“Christmas itself doesn’t trigger my eating disorder but the opportunity to be triggered is much more than usual because of all the things that are associated with the holiday,” says Jason Fisher from Manchester who has had binge eating disorder since he was 10. Although the 20-year-old loves Christmas – “I put my tree up on 1 November” – his coping techniques, like meal prepping, are hard to maintain with lots of spontaneous meals out and abnormal treats like advent calendars. “I find myself sneaking extra food during the holidays, and one Christmas I just spent lying on the floor night after night full of nothing but hatred for what I was,” he says. “I desperately wanted some help and support for how I was feeling.”
Some people find the period so hard they create ways to remove themselves from the festivities entirely.
Sophie Smith, 28, from London, who suffers from periodic anorexia and recurrent bulimia says she would purposefully ask for more shifts in her bar job in the weeks leading up to Christmas, so that she could avoid socialising and therefore reduce her calorie intake. She would also spend long parts of Christmas Day in bed asleep for the same reason. “It was a safe way to remove myself from these situations without being judged or questioned,” she explains.
Others find that they are unable to cope at home and are admitted to hospital or a treatment programme over the period. Rebecca Quinlan, 31, from Chelmsford in Essex, who was diagnosed with anorexia in 2008, had to spend several Christmases in hospital because of how extreme her eating disorder became around the holiday period.
Before she was admitted she remembers getting up at 5am on Christmas morning to exercise in the kitchen for two hours, before anyone woke up. She worried having one extra Brussels sprout would make her gain weight, and would even stop herself smelling the food in case she “inhaled calories”. One year she got so angry at the portion of turkey served by her mum she threw the plate across the room in front of her family.
“[Christmas] was a stark reminder that while I thought I had been doing well and my eating disorder was getting smaller, actually it was still very much there,” she says. “I was so down the whole time because I was obsessing about what I was eating and how I could burn calories.”
Similarly, Hope Virgo, 29, from London, who was diagnosed with anorexia 16 years ago, says she remembers a Christmas that really showed her how far her illness had come to taking over her life. She was so determined to avoid eating she caused a scene at the dinner table and used the distraction to hide food in her pockets.
“I would shove it in to my pockets then empty it out later on when I had the chance. It was horrid looking back there was meat and gravy in the pockets of my jacket, dripping through. But I felt like it was the only way. Up until that point it had been fairly easy to go under the radar, but my family were on eggshells around me that Christmas.”
Ms Quinlan says what triggers her eating disorder at Christmas, more than food, is the perception that it is the “most wonderful time of the year”. She says: “I feel so far removed from this so Christmas heightens my feelings of sadness and loneliness.”
Ms Price, from BEAT, says this is common among those with eating disorders. “People with eating disorders often try to hide their illness and at Christmas when eating is a social occasion – often with people who they do not see frequently – they may feel ashamed and want to isolate themselves from others,” she says.
This emotional impact cannot be underestimated. Jodie, who did not want her surname to be used, 24, from Hertfordshire, was diganosed with anorexia in 2019 and says getting ready to spend her first Christmas with the eating disorder diagnosis is “terrifying”. “This year I don’t just feel stressed. I don’t just feel anxious. I feel absolutely terrified. I feel full of dread.”
Cara Sturgess, 29, from Hampshire, who has had anorexia for 17 years, also says that one of the most misunderstood parts of eating disorders is that it cannot be “switched off” just because the social calendar requires you eat and drink. She says: “We can’t pretend that everything is okay for the sake of Christmas.”
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So how can the festive period be managed best for those managing eating disorders? Ms Price says for the sufferer themselves there are a few things they can do, including planning ahead and sharing concerns with those closest to them. “It’s important to plan ahead and openly discuss when and how food will be involved over the Christmas period.
“It can help to steer attention away from food, so once meals are over, find activities that focus on something else, such as a family walk, playing board games, or watching a funny film together.”
But more importantly, for family and friends, avoid comments such as ”don’t you look healthy?” or “haven’t you done well eating your dinner?” as these could be misinterpreted and cause more harm than good.
Ms Quinlan says people should try not to talk about over-eating. “This triggers my ED into panic mode and I [feel] I must never ever do that.”
Rebecca Lindley, 26, from Sheffield, who has had anorexia for 12 years, says: “Stop talking about the diet you’re going to go on in January and don’t use words like ‘bad’ or ‘naughty’ around food. This whole mentality makes people with ED feel that they can’t enjoy themselves around Christmas without making up for it later.”
Ms Murphy recommends that the most important thing for friends and family to do is show patience, love and understanding. “Accept that you might not understand everything that a loved one is going through. Instead positively reinforce your relationship with them as much as possible.”
If you have been affected by any of the issues mentioned in this article, you can contact the following organisations for support: the BEAT helpline on 0808 801 0677 or Mind on 0300 123 3393.
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
