When Are You "Recovered" From An Eating Disorder?
[Listen to an audio version of this blog HERE.]
Recovery is a strange and illusive thing. Sometimes, I'll go for long stretches of time without even thinking about my eating disorder. Sometimes, especially when life is stressful, I can't help but feel it creeping back, offering itself as an easy, accessible coping mechanism. When I began treatment, my goal was to eliminate the eating disorder from my life. This involved a treatment program, a team of therapists and dietitians, cognitive behavior therapy, and a lot of leg work on my end. We talked a LOT about being "in recovery" and eventually, about being "recovered." As I worked through recovery, these phrases grew confusing. When was I "done" with my eating disorder? Unfortunately, there is no easy answer. I'm going to break down the difference between being "in recovery" and being "recovered," and yes, total recovery, I believe, is entirely possible.
Recovery is the process by which someone overcomes an eating disorder. People "recover" from sundry maladies: substance abuse, gambling, addictions of any and all sorts, and destructive behaviors like eating disorders. I underwent cognitive behavioral therapy to help me understand why my eating disorder existed and to challenge my disordered thoughts/behaviors. This was not easy, and it was highly uncomfortable. I also addressed my anxiety issues, which are closely tied to perfectionism. Finding other ways to cope with anxiety, for example, helped decrease my eating disordered behaviors exponentially. Recovery didn't end after my most intense treatment was over, though. I continue to see a therapist and a dietitian, and the process has taken a long time. I first entered treatment in 2014 and have been "in recovery" ever since. It's important to understand that everyone's timeline is different, and some might be in recovery for many years.
What Does it mean to be “Fully Recovered?”
To be “fully recovered,” means being completely free from all symptoms of an eating disorder. This means no more starving/binging/purging, but it also means no more body judgement, no more body checking, no more excessive exercise, no more skipping meals or depriving oneself, no more comparison or negative feelings associated with body shape/size. In my experience, it is simpler to eliminate the really egregious behaviors like purging than it is to eliminate the subtle behaviors like body checking or judging one's body. Accepting your natural body size, instead of trying to manipulate or change it, is an important step in the recovery process. "Full recovery" means being free from the majority of negative effects of the eating disorder. There is enough grey space here to be confusing, but I'll reiterate an earlier point: everyone's timeline is different. There is no right or wrong way or time or place to recover. The important thing is that you're on the path to recovery, wherever or however that looks for you.
Is "Full Recovery" Possible?
This is a bit of an unanswered question. While many people agree that a full recovery is possible, some people believe they will inevitably continue to deal with triggers or a desire to engage in disordered eating behaviors forever. I'm inclined to believe that full recovery is possible, which in no way diminishes the very real struggles someone went through while engaging in an eating disorder or while on the path to recovery. I learned so much about myself while in my eating disorder and while recovering, and I'm grateful for the introspection, self-harm and contiguous self-love my eating disorder brought me. I appreciate life on an entire new level, because I lived like a zombie for so many years, a slave to my eating disorder. I appreciate community differently now, because I felt ostracized for so long. And I appreciate vulnerability, because it frightened me for so long. Full recovery is possible, if you want it to be. You can live without an emotional connection to food or your body, but the work to reach full recovery doesn't end when treatment ends. You may need to seek continued counseling and self-direct corrective behaviors to make it to the "fully recovered" phase.
So what are the real differences between "recovered" and "in recovery?" I've broken it down to some handy-dandy web-friendly bullet points for your viewing pleasure.
- A history of an eating disorder: This seems obvious, but the history could be recent or years old. The important common denominator is the existence of some severity of an eating disorder.
- Recognition or acceptance of the eating disorder: Acknowledging that the eating disorder is a problem is the obvious first step. You cannot be "recovered" or "in recovery" without acknowledging the eating disorder first.
- Active pursuit of recovery: This entails a bit more than simply acknowledging that the disorder exists: you must also want to change the disordered behavior. Actively pursuing recovery might mean seeking whatever degree of treatment is necessary, whether that's an in-patient or out-patient program.
- Body image: Someone who is in recovery may still deal with a negative or distorted body image. Someone who has fully recovered will have a more positive and/or realistic view of his or her body. This is something I personally still struggle with; I always think I'm larger than I really am, which is one reason I still consider myself "in recovery."
- Enrollment in a treatment program: Someone who is in recovery is likely actively participating in some type of treatment program. Someone who is fully recovered is no longer undergoing professional eating disorder treatment.
- Disordered eating: Someone who is in recovery may occasionally engage in disordered eating behaviors or at the very least have the urge to do so. Someone who has fully recovered is no longer dealing with urges or disordered eating behaviors.
- Fear of relapse: An individual who is in recovery may have an intense fear of relapsing. However, if an individual is fully recovered, he or she will no longer fear relapse or even consider it a possibility.
Steps to Full Recovery
These are steps I am taking or have taken to reach a point of full recovery. Keep in mind that your steps might look different, and it's okay to not be there yet.
Make the decision to get better: The first step is relatively simple on its face, but deeply difficult beneath the surface. Decide you want to get better. Decide you no longer want to live chained to your eating disorder. Some people call this "rock bottom" or a "breaking point," but you can decide to get better at any time.
Enroll in a treatment program: Treatment programs are either in-patient (you live there) or out-patient (you visit a center daily, usually for meals). I went from an outpatient program to weekly therapy sessions. More than 5 years out of my treatment program, I still see a dietitian and a therapist who helps me manage anxiety and life stressors without going back to my eating disorder.
Do some self-directed study: For me, this meant reading books (like the ones in the "P.S." section below), going to Eating Disorder Anonymous (EDA) meetings, talking to people who had been through recovery, and writing in a journal to track my physical and mental progress.
Keep choosing to be better: I've heard former alcoholics say that they need to choose, each day, to not have a drink. I've heard Christians say similar things; they "choose" their faith every day, or couples say they choose each other. When you're recovering from an eating disorder, you need to make a conscious decision, every day, that you won't let the eating disorder win. This is something I've tried to do for years now, and there are absolutely days when the eating disorder wins. But when I look back on the past five years, I won a whole lot more than I lost, and that's really all I can ask for.
P.S. Read Hunger, a Memoir of (My Body) by Roxane Gay, Life Without Ed by Jenni Schaefer, Unbearable Lightness, A Story of Loss and Gain by Portia de Rossi, or the Intuitive Eating Workbook by Evelyn Tribole and Elyse Resch.