Are Eating Disorders Ever Cured?
The short, simple answer is "yes." Clinicians, therapists, and those who consider themselves "cured" will all say, "yes." But many who struggle with eating disorders, or who are in the midst of recovery, will find this difficult to believe. In a recent therapy session, I asked my shrink, "Will this ever go away completely?" My therapist has been practicing for nearly 30 years. He has worked with countless patients with anorexia, bulimia, binge eating disorder, body dysmorphia, or simply poor relationships with food. Some of his patients have passed away. Others have recovered well enough that they don't need him anymore. His is a job with no clear beginning or end; the work of therapy is a long, convoluted, incredibly messy process. Often, the work never ends, which is what I was afraid of when I asked, "Will this ever go away completely?"
The Rosewood Centers for Eating Disorders is one of the most innovative and respected treatment centers in the country. They write, "Eating disorders can be cured, in that people can fully recover and their eating disorder behaviors may never reoccur." But even if behaviors don't reoccur, thoughts sure as hell will. Part of recovering from any eating disorder is developing positive body image, learning effective coping skills to deal with stress or anxiety, and resolving the underlying trauma that led to the eating disorder in the first place. There is no simple, straightforward, or time-sensitive way to do this.
Alcoholics and drug users who are in recovery often say that they will always consider themselves addicts. Each day of sobriety is a day they said "no" to their chosen drug. But people with eating disorders can't simply cut out food. Our progress cannot be so easily measured when food is a daily necessity and simultaneous battle.
Perhaps the word "cure" is a poor choice when it comes to any mental illness or disorder. Mental disorders are necessarily messier than breaking a bone, or requiring a root canal. Bones can be braced, teeth pulled, repaired, or replaced. Our brains and biology are not only neurologically influenced, but constantly receive signals from our environments. The coping mechanisms that often lead to eating disorders are complex and deeply ingrained. Letting go of disordered behaviors is endlessly frightening. Letting go of disordered thoughts is nearly impossible, especially in a world that is unduly fixated on bodies, health, and food.
Eating Disorder Hope, an advocacy organization, states that eating disorders often co-exist with other diseases or disorders such as depression, trauma, or anxiety. The multifaceted and non-linear nature of co-occurring illnesses intensifies the need for comprehensive treatment. And because those with eating disorders are often extremely self-critical, perfectionism may be one of the hardest elements to overcome.
Not thinking we are "good enough" is part of anxiety and depression, too. Not thinking we are "good enough" often stems from trauma. Food is an accessible device to manage strong emotions. Deprivation of food can reinforce feelings of not being "good enough" in the most extreme, tangible way possible: you don't deserve food, and only by depriving yourself and physically shrinking can you feel "enough." The cruel joke is that the "enough-ness" never comes, and we shrink until we die.
The over consumption of food is also rooted in not feeling "good enough." Sometimes, we eat and eat and eat to numb emotional pain. Sometimes, we over-consume in the wake of extreme deprivation because we are starving to death and our bodies want us to live more than our minds want us to die. We eat and eat and eat to manage pain, resulting in more pain and self-hatred, which is ironically, exactly what we think we deserve.
Starving, bingeing, and self-criticism do not make logical sense, but they can feel damn good at times. Those brief moments of goodness, though, can never make up for a life of emotional and physical turmoil. The safety and security of an eating disorder is not worth everything that the disorder takes away: physical health, mental well-being, gratitude, joy, friendship, vibrancy, the list goes on and on. Is recovery hard? Absolutely. Is recovery worth it? Without a doubt.
P.S. If you or someone you love is struggling with an eating disorder, contact the NEDA helpline at (800) 931-2237, find a treatment center or therapist near you HERE, or find an Eating Disorders Anonymous (EDA) meeting near you HERE.