The Recovery Process
Recovery from an eating disorder is both an immense accomplishment and an ongoing process. It involves progress and setbacks, and both are normal. The pragmatics of recovery will differ for different people, such as with regard to the eating styles and treatment plans developed. Although it can take weeks, months, or even years, clinical care and social support will help achieve a lasting recovery.
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What does it mean to be in recovery?
Recovery occurs when an individual no longer meets the diagnostic criteria for their disorder. For example, in the case of anorexia that would involve not having “significantly low body weight” and an “intense fear of gaining weight or of becoming fat,” according to the DSM-5. The ICD-10 classifies full remission of anorexia as someone who was previously diagnosed who hasn’t met the criteria for “a sustained period of time.”
But the reality for those overcoming an eating disorder is that recovery is an ongoing process that doesn’t adhere to precise boundaries. There may be moments of accomplishment and gratitude, along with moments of fear and distress. One can continue improving after completing treatment; one can also endure periods of relapse.
People in recovery often need to monitor their behavior and observe changes, such as checking their weight or slipping into rigid eating patterns. They will continue to address psychological challenges, develop coping skills, and learn to navigate new settings and emotions as they arise.
How many people recover from eating disorders?
Many people recover from eating disorders and go on to lead healthy, fulfilling lives. For a smaller number, however, the disorder doesn’t abate.
Past research has found full recovery rates to be around 50 percent, but research that followed participants for a longer period of time found that two-thirds of women with anorexia and bulimia fully recovered 22 years later. After the first decade, about one-third of women with anorexia had recovered and two-thirds of women with bulimia had recovered. But by the second decade, two-thirds of women had recovered from anorexia as well.
What leads to a successful recovery?
Recovery first involves treating every aspect of the illness. Physically, the body needs to heal from the harms of the disorder, such as by maintaining a healthy weight and typical levels of hormones and electrolytes. Behaviorally, the person needs to develop healthy patterns around eating and viewing their appearance. Psychologically, the individual can address the forces that lay the foundation for the disorder to develop, such as body image, perfectionism, anxiety, or trauma.
Another crucial component is a strong support system. Successful recovery often encompasses loved ones who encourage the individual to eat, continue treatment, talk through challenges, and strive toward their larger goals.
What is the role of relapse in recovery?
The road to recovery is not one smooth process—it very often includes slips and relapses. But it’s important to continue moving forward despite those difficult setbacks.
Identifying triggers that may spark a relapse can help people with eating disorders become aware of their patterns. They can then develop a plan with their care team to target those triggers, adopt healthy coping strategies, and rely on loved ones and mental health professionals for support.
What are the warning signs of a relapse?
Recognizing when a relapse might be imminent is important so that individuals in recovery can turn to their loved ones and treatment team for support. People in recovery are at greater risk of relapse after transitions or stressful events, such as moving, starting a new job, having a child, or getting divorced. A few of the other warning signs include:
- Departing from an eating schedule, such as by skipping occasional meals.
- Developing a renewed obsession with food, weight, and appearance.
- Adopting a new restrictive diet.
- Avoiding eating with other people.
- Lying about meals, food, or other choices.
- Returning to rigid eating patterns, such as avoiding particular foods or eating only at certain times of the day.
- Checking the body continuously, such as by weighing or measuring.
- Resuming intense exercise.
- Feeling stressed, isolated, or depressed.
How can I help a loved one during the recovery process?
Continuing to love and support the person over time is the most important thing you can do to help someone with an eating disorder. It can be difficult to maintain energy and support for such a long time—over periods of disorder, treatment, relapse, and recovery—so loved ones need to take time to care for themselves as well.
In addition to providing love and support, encouraging them with specifics can be helpful, such as to eat the next meal or attend the next therapy session. It can also be valuable to reflect on the benefit of treatment and recovery in terms of the person’s life goals—such as landing a dream job, finding a partner, or simply living without anxiety—that motivate them to continue building their future.