Recovery from an Eating Disorder

Reviewed by Amy Baker Dennis, PhD, FAED

Recovery from an eating disorder can take months, even years. Slips, backslides, and relapse tend to be the rule, rather than the exception. Cessation of disordered eating behaviors and learning coping skills can take a long time and often requires lots of support from professionals, friends, and family. Moving forward is key, however slow it might be.

People experiencing an eating disorder must address any immediate medical concerns caused by their disorder, work on reducing or eliminating eating disordered behaviors, address co-occurring issues like depression, anxiety, or trauma, and then develop a plan to prevent relapse. Some psychologists call recovery the process of creating a life worth living. Overcoming food and eating concerns during recovery is a central goal, but it’s far from the only task of recovery.

The Three Broad Areas of Recovery


  • Physical recovery. This involves normalization of the physical effects of the eating disorder, including restoring weight to an appropriate level for the individual, normalizing electrolyte and hormone levels, resuming menstruation (if applicable), and addressing other health issues caused by the eating disorder. Those with longer-term disorders may not be able to fully reverse all health consequences but will be able to address other areas.
  • Behavioral recovery. This aspect of recovery means a cessation or dramatic reduction in eating disorder behaviors, such as food restriction, overexercising, purging, binge eating, etc.
  • Psychological recovery. Perhaps the hardest area of recovery to define, psychological recovery means addressing the cognitive and emotional aspects of the eating disorder, such as body image distress, perfectionism, and rules and beliefs around food, eating, and weight. Those with co-occurring conditions such as mood and anxiety disorders may also need to manage those disorders to sustain lasting recovery.

Support System


An active support system often plays a key role in recovery. Parents can help encourage their children to stay in therapy, eat regular meals, and use new coping skills. Partners and friends can provide support during difficult meals and help build a life outside the eating disorder. For people with long-term eating disorders, their regular social support systems have often waned, as friends and family often ‘burn out’ from providing care. For some with eating disorders, recovery involves building a support system to help when times get tough, as well as learning how to utilize it.

Maintaining Recovery


Although everyone has the potential to recover fully, not everyone will. This is not a person’s fault, but rather is caused by a complex range of issues, including lack of access to treatment at the right level and for a long-enough duration, ineffective treatments, sociocultural barriers (e.g. bias and discrimination against larger body sizes), and more. Even for those who don’t recover completely, treatment can often make dramatic improvements in level of symptoms and quality of life.

Eating disorder researchers have yet to develop a set of criteria to accurately define necessary factors for full recovery. While definitions vary, a review of the literature has identified several common features professionals use to define eating disorder recovery. These include an improvement in the physical, behavioral, psychological, and cognitive symptoms of an eating disorder as well as a person’s psychosocial functioning.1,2 Even if recovery is formally defined, each person’s recovery will look a little bit different. Some people may find the structure of a meal plan helps them stay well, while others prefer more flexibility around food. An active social life may be part of one person’s recovery while adequate time for solitude may be just as important for someone else. There’s no right or wrong way to do recovery.

Life During Recovery: Questions to Ask Yourself


What’s life supposed to be like without the eating disorder? This is a question you’ll need to consider if you are in recovery. Ask yourself: “If I woke up tomorrow morning and my eating disorder had magically disappeared, what would my life look like? What would be different? How would I know it’s different?” Knowing how your life will be different gives you a clue as to what you want from recovery. How you answer is a very personal decision.

Here are some questions to ask yourself to help you have a clearer vision of what you want and need for staying in recovery:

Let Go of the Comfort Zone:

Ask yourself: How can I keep going even when I feel uncomfortable?

Expect the recovery process to be uncomfortable. You have to live through the uncomfortable emotions and physical changes to reach your healing destination. For instance, take the objective of normalizing your behaviors with food. At first when you are asked to follow a structured food plan, it can feel overwhelming to think you have to eat several meals a day, plus snacks. With time and consistency, your body physically and emotionally adjusts to a regular eating pattern. And eventually, you’ll be more comfortable.

Lean on Support:

Ask yourself: How can I allow others to support me?

Recovery is a time to let support in, not push it away. However, many people find it difficult to reach out and accept support from others. The truth is it’s much easier to walk the road of recovery with someone walking alongside you than making the trip on your own. If you are having difficulty accepting support, think about how you feel when you are given the opportunity to provide support to others. Remember, it is a gift.

Set Small, Achievable Goals:

Ask yourself: What is one mini-goal I can set today?

No one says you must recover overnight. Most people don’t wake up one day free of the disorder when they’ve been struggling for months or even years. There are many mini-goals that you need to attain first before you can reach the ultimate goal. Your goal may be to eat out at a restaurant with friends without anxiety or guilt. To reach that goal, you may first have to practice eating meals with your family at home. Once you’ve successfully accomplished this goal, you can expand your repertoire to eating a meal with your family at a restaurant, and then move to eating a meal out with your friends. Keep in mind that your success in reaching your goals is often achieved when you break it up into smaller, more manageable pieces.

Make Peace with a Balanced Lifestyle:

Ask yourself: How will life be better when I have a more positive relationship with eating and/or my body?

While it may feel anxiety provoking, let yourself make peace with a healthier relationship with eating and body image and find ways of coping that foster a balanced lifestyle. Many people with eating disorders describe feeling conflicted about recovery- simultaneously wanting to act, feel and think like others who don’t have eating and body image issues while also feeling worried that being like them will mean losing what makes them feel special or safe. Although these feelings are typical, it’s important to recognize that these beliefs are false. The reality is that eating disorders cause both physical and emotional harm that can even be life threatening. Recovery is a journey of healing and finding a balanced lifestyle. This is not to say you can’t be unique in your own right, but recovery from an eating disorder takes you to a place of healthy functioning—and that’s a productive and life-enhancing place to be. Don’t fight it, embrace it!

Find Uniqueness the Healthy Way:

Ask yourself: What qualities make me a unique and special person?

Having an eating disorder sometimes becomes an identity. You may feel unique and special, and fear losing this identity—even if it’s destroying lives along the way. Your task in recovery is to find your identity separate and apart from the eating disorder. That person will be far stronger and more unique than any identity you could assume while being sick. Allowing the passion of who you are meant to be brings you closer to your new, healthy identity, one living without the eating disorder.

Recovery is one of the hardest things you will ever do in your lifetime, but well worth the effort.

Resources


  • Learn more about finding treatment providers in your area here.
  • Find additional free and low cost support options here.

Sources


[1] Bachner-Melman, R., Lev-Ari, L., Zohar, A. H., & Lev, S. L. (2018). Can Recovery From an Eating Disorder Be Measured? Toward a Standardized Questionnaire. Frontiers in psychology, 9, 2456. https://doi.org/10.3389/fpsyg.2018.02456

[2] Bardone-Cone, A. M., Hunt, R. A., & Watson, H. J. (2018). An Overview of Conceptualizations of Eating Disorder Recovery, Recent Findings, and Future Directions. Current psychiatry reports, 20(9), 79. https://doi.org/10.1007/s11920-018-0932-9