Do people actually recover? What does full recovery look like? Is it like alcoholism that once you’ve had an eating disorder you’ll always have an eating disorder? Clients, loved ones, and even the general public have often asked me these questions repeatedly over the years that I’ve specialized in treating eating disorders. We often hear the grim statistics that eating disorders have the highest mortality rate of any mental health diagnosis and that the average length of treatment is 4-7 years. There is even a new subset of eating disorders garnering attention in the treatment world known as Severe and Enduring Eating Disorders (SEED), which are chronic forms of eating disorders lasting 10 or more years that are unresponsive to multiple attempts to treatment.
However, there is hope! An often overlooked statistic is that with treatment, 60% of patients recover from eating disorders. Early intervention improves outcomes. And thanks to mental health parity, increased advocacy efforts, and the growing need, access to treatment is more widely available.
Recovery is not one size fits all. It looks different for each individual. The latest research suggests that a full year without eating disorder behaviors is a strong indicator of recovery. There are also broad phases of recovery that have been identified: physical recovery, behavioral recovery, and psychological recovery. Physical recovery includes medical stabilization, restoring a healthy weight, and overcoming symptoms related to malnourishment. Behavioral recovery involves symptom cessation, while psychological recovery addresses underlying issues contributing to the development and maintenance of an eating disorder. Psychological recovery may include treatment for comorbid mental health problems, resolving trauma, addressing family or relationship issues, overcoming perfectionism, letting go of food rules, and developing healthier body image.
- Recovery is best achieved with a multidisciplinary team approach that includes a therapist, dietitian, medical doctor, and psychiatrist (when indicated) who specialize in eating disorder treatment.
- The involvement of loved ones is also crucial; having a strong support network of family, friends, and others in recovery improves outcomes.
- Realistic goals and patience are vitally important in the recovery process. Expect that lapses or relapses can be part of the recovery process- after all, a person with an eating disorder has to face every single day, multiple times per day, what they struggle with the most. Research has shown we make 200+ food related decisions per day. Imagine how overwhelming that can be to someone new to recovery!
- Being able to identify and minimize or handle triggers is yet another part of the recovery process. A person in recovery is vulnerable to triggers at any time, but especially during times of life stress or transition.
Part of what inspired me to write on this topic was an email I received last month from a former client. She ended treatment with me approximately 8 years ago. She’d battled a severe eating disorder for many years, compounded by a complex trauma history spanning much of her lifetime. She’d been to inpatient or residential treatment at least 5 times when I started working with her and during our time together, she did go to a higher level of care to a center that could address both her trauma and eating disorder. Today, she is a happily married mother of 3 with a thriving career in a helping profession (which even affords her the opportunity at times to work with patients with eating disorders). Here is an excerpt from what she wrote to me (shared with her permission). It speaks volumes more than any professional writing or scholarly article on recovery ever could:
“Perhaps the most humbling experience I have had over the course of the last several years was what previously seemed like a hopeless endeavor–the pursuit of true recovery. I humbly say that I know with no uncertainty whatsoever that recovery, true recovery, from an eating disorder is possible. I consider myself fully recovered and am so grateful that the eating disorder is no longer a part of my life. I share this with you because I want to encourage you to keep going. Keep doing what you’re doing because it is worth it. Your belief in me and the unconditional support that you provided helped to allow all of the amazing things above to occur, including what I hope to ultimately be the recovery of many more individuals that have never even met you, through (in part) the work that I am able to do with them at this point in time (which never would have been possible without your presence in my life).”
The final workshop I attended this year at the International Association of Eating Disorder Professionals Conference was entitled, “The Neuroscience of Hope in Eating Disorder Recovery”. In this talk, Dr. Ralph Carson spoke about the fact that humans can actually increase the density of cells in their left prefrontal cortex, the part of the brain responsible for positive emotions. He stated that hope requires continuous renewal and recommended the following: keep a gratitude journal, surround yourself with supportive people, ask for help when challenged, avoid people and media that diminish hope, and identify your personal strengths and values and use them! These are wise recommendations for anyone, but essential for everyone in the recovery process. It’s important to remember it’s just that- a process- and to have HOPE that it will happen.
Kelly Broadwater is a Certified Eating Disorders Specialist with over 15 years of experience in the field. In that time, she has proudly walked beside numerous clients in their journeys to full recovery.