Eating disorder recovery: When to seek support
If you are experiencing a crisis related to an eating disorder or would like further resources, contact the ANAD Eating Disorders Helpline at 1-888-375-7767 from Mon to Friday from 9 am to 9 pm CT.
Relationships with food can be complex. Food provides essential nutrition and energy to all living beings and can lead to a healthy lifestyle. However, many people have complex feelings about eating or may use food or restrictive habits to cope with challenging thoughts or emotions.
Those struggling with eating patterns or body dysmorphia could be living with an eating disorder and other co-occurring mental illnesses. With support, you may be able to mend your relationship with food while managing any underlying symptoms of mental illness.
Cultivating awareness around your eating disorder
In the eating disorder recovery process, developing awareness of your symptoms and the fact that you are struggling can be valuable. There are many eating disorders that people may experience. If you don't know what symptoms to look for, you may not believe you are living with a mental illness.
Below are a few common eating disorders that people experience, including their symptoms. If you relate to any of the symptoms of an eating disorder, contact a physician or mental health professional to discuss the possibility of an evaluation.
Anorexia nervosa
Anorexia nervosa is an eating disorder characterized by an obsession with weight loss. It may cause those with the condition to engage in dangerous behaviors to prevent weight gain. Symptoms of anorexia nervosa may include:
- Excessive fear of weight gain
- Limiting the number of calories eaten in a day
- Not eating for days
- Exercising obsessively
- Vomiting or using laxatives to maintain an ideal weight
- Eating non-food items to fill the stomach
- Drinking a high amount of coffee or water
- A loss of menstrual periods
- Brittle hair and nails
- A loss of calcium that affects bone strength
- Dry, yellow skin
- Anemia and muscle loss
- Constipation
- Low body temperature
- Depression
- Fatigue
- Low blood pressure, heart rate, and slowed breathing
- Medical emergencies
Note that anyone of any weight or body shape can experience anorexia nervosa. Body weight is not a defining symptom of any eating disorder.
Bulimia nervosa
Although those with bulimia may show some of the symptoms seen in anorexia nervosa, the difference between the two is that those with bulimia nervosa experience binging and purging behaviors. Symptoms of bulimia nervosa include:
- Binging on significant amounts of food
- Throwing up or using a laxative to expel food quickly from the body
- Chronic sore throat and inflammation from purging
- Swollen salivary glands
- Puffy cheeks and face
- Tooth decay and loss
- Gastroesophageal reflux disorder
- Intestinal challenges
- Kidney pain or kidney stones
- Dehydration
- A desire to lose weight
- Body dysmorphia
Binge eating disorder (BED)
While those with bulimia nervosa may expel the food they have binged on, those with binge eating disorder repeatedly binge without attempting to purge. This type of eating disorder can often result in health challenges, weight gain, diabetes, and hypertension. Symptoms of binge eating disorder can include the following:
- Eating rapidly
- Eating significant amounts of food
- Eating when you don't feel hungry
- Hiding your eating habits out of shame and embarrassment
- Feeling guilty after engaging in binge-eating behavior
- Eating many types of food or snacks at once to calm emotional distress
Along with these symptoms, a binge eating disorder diagnosis must meet certain conditions. Binge eating disorder can only be diagnosed if the affected person engages in frequent binge eating behavior for at least one day a week for three months. They must also experience at least three of the above symptoms and feel out of control of their eating habits.
Avoidant restrictive food intake disorder (ARFID)
Many people may associate restrictive eating patterns with anorexia nervosa. Although this is a symptom of anorexia, it is also a symptom of ARFID, a condition often connected to ADHD that may cause someone to struggle to eat or experience sensory difficulties with food.
ARFID is not caused by body dysmorphia or a desire to lose weight; it may go undetected because the behaviors can look like "picky eating" or difficulty eating more than one meal daily. Although these symptoms might seem "mild," they can have severe impacts, including the following:
- Brain fog
- Anemia
- Difficulty gaining weight
- Exhaustion or fatigue
- Severe malnutrition
- Anxiety and depression
If you think you might be experiencing ARFID, you're not alone. Contact a therapist or doctor experienced in this condition for further guidance.
Eating disorder recovery: Recovery process
The National Eating Disorders Association breaks down the recovery stages from an eating disorder into five sections, including the following.
The precontemplation stage
Individuals in the pre-contemplation stage may struggle to accept that they have an eating disorder. Even if they have family and friends pointing out their behavior and symptoms, they may respond by remaining in denial about their eating disorder or the need to seek recovery. This stage can often be one of the most difficult, as an individual may need to acknowledge their condition before they can begin treating it.
The contemplation stage
At the contemplation stage in the process, the individual may start to accept that they're living with an eating disorder and begin research on treatment. During the contemplation stage, people may feel anxious about seeking recovery. It can benefit individuals to have social support as they navigate looking for resources.
The preparation stage
Once someone has accepted their eating disorder, they may begin finding the resources to treat symptoms. This step can include looking for the right counseling resources, learning the proper coping mechanisms to cope with symptoms, and creating a plan of action that may allow them to move forward with fewer problems.
The action stage
Armed with knowledge and tools, individuals can begin taking action to cope with their eating disorder symptoms and manage their symptoms. In the action stage, they may have developed a solid plan with the assistance of a therapist and nutritionist and can begin working through the tools and processes they have learned. Recovery can be difficult, but this stage is a significant step in healing.
The maintenance stage
At the maintenance stage, those with an eating disorder may have worked on their treatment plan for at least six months. They may have learned how to implement the tools and start feeling self-sufficient. They could also require support as they navigate this new life phase.
Additionally, those in recovery may start to feel aware that relapse is possible. If you do engage in old habits, it doesn't make you any less worthy of recovery or change. Relapse can be a part of being human, and returning to the maintenance stage is possible.
Termination and relapse prevention
Some professionals refer to a termination and relapse prevention stage where clients believe they are no longer at risk of relapsing after some time. While this idea may be accurate, it can be beneficial to fully understand all components of your treatment plan and demonstrate that you can manage your eating disorder independently. Contact your therapist or support system to discuss these feelings if you're afraid of relapsing.
Co-morbid conditions and eating disorders
When you enter treatment, your therapist might help you devise a treatment plan for these conditions in addition to your eating disorder. This treatment plan may consist of therapy or medication. If your eating disorder has caused significant health problems, you might also be hospitalized to recover before moving forward with your treatment. Before starting, changing, or stopping any medication, consult a medical professional.
At any stage of recovery, therapy can be a helpful resource. Besides offering support when you feel dysmorphic, therapy can help you implement valuable coping mechanisms to navigate the hardships of your condition.
Counseling options
Eating disorders often accompany feelings of shame, embarrassment, or difficulty leaving home. In addition, the high rate of co-morbid depressive disorders can make it challenging to reach out for support. If you're not ready to try in-person therapy, online counseling might be more accessible.
Through an online platform like BetterHelp, you can receive affordable and accessible care through phone, video, or live chat sessions with a therapist specializing in eating disorders. Online therapy involves many of the same therapeutic modalities you may find in person. These modalities can be practiced from home, and your therapist can send you extra resources like journaling prompts, worksheets, or questionnaires to support you as you attend sessions from home.
Studies also show the effectiveness of online therapy. One 2021 study on the effectiveness of internet-based therapy for eating disorders found that online therapy increased physical and mental health, self-esteem, social functioning, and quality of life. Treatment effects were sustained over one year after therapy ended. These results show that online therapy can have effects similar to in-person options.
Takeaway
Although recovery can be challenging, it is possible. Regardless of your history of relapse or treatment, it can be valuable to keep trying and looking into the multiple resources available for recovery. An online therapist is one method that is readily available for many people living with eating disorders.
What is the recovery rate for people with eating disorders?
There is limited data regarding the recovery rate for people with eating disorders. Much of the problem is due to inconsistent definitions of recovery, remission, and relapse. Recovery is often used synonymously with “full remission,” meaning that the patient no longer has clinical eating disorder symptoms and is successfully using coping strategies to prevent disordered eating.
Partial remission is also possible, where a patient’s symptoms have reduced in severity, but they are still experiencing some impacts from their condition. Relapse is also challenging to define. A relapse occurs when a person’s disordered eating behaviors re-emerge after previously being under control. When studying the recovery process, it can be difficult to discern whether a full recovery has been accomplished. For example, if a person reports no ongoing symptoms of anorexia for over five years but relapses during the sixth year, had they recovered completely, or were they in partial remission?
Evidence from a 22-year-long study of patients with anorexia and bulimia indicated that just shy of 70% of patients fully recovered within the 22-year period. In contrast, a 30-month study of Australian citizens with eating disorders found that only 42% achieved complete remission, while 72% obtained partial remission. The disparity in the data is likely due to the chronic nature of eating disorders, many of which require months to years of treatment and life-long management to prevent relapses.
Is eating a lot good for eating disorder recovery?
Part of recovery from an eating disorder involves replacing disordered eating habits with more stable ones. For many people, especially those who restrict access to calories or avoid eating altogether, eating whenever possible can be beneficial. Many may also be recovering from low body weight and malnutrition and may need to eat a large amount of food to gain body mass. Eating disorder treatment follows a slightly different course for everybody, and a person’s treatment team or medical doctor might encourage them to eat a lot of food to aid recovery.
Treatment for other types of eating disorders, such as binge eating disorder, places a greater focus on reducing calorie consumption. However, dieting or weight loss are typically lower priorities than establishing good eating habits. Evidence suggests that calorie restriction may make binge eating worse, and a person who struggles to control binge episodes may be encouraged to eat a lot of healthy, nutritious food throughout the day to prevent hunger from exacerbating binge cravings.
How can nutrition help eating disorder recovery?
For those with avoidant eating disorders - meaning they restrict calories or avoid food, nutritional counseling can help them gain weight while reducing the psychological burden of eating, which can often cause those patients significant distress. Those who consume too much food may benefit from nutritional guidance as they learn to maintain regular eating habits throughout the day, an important part of avoiding episodes of bingeing or excessive calorie consumption.
Does eating more mean recovering from an eating disorder faster?
Eating more doesn’t necessarily mean recovering from an eating disorder faster, and for those whose eating disorder causes them to consume too many calories, eating more may be counterproductive. Many people who are recovering from restrictive eating disorders where they don’t get enough calories are encouraged to eat whenever and however they can. However, eating disorders are complex, and each person will follow a path to recovery that is unique to them. For example, someone with anorexia may experience significant psychological distress at the prospect of eating and may need to take slow, gradual steps toward eating a healthy diet.
How to recover from stress?
Stress is a common trigger in eating disorders, and reducing stress is an important part of managing eating disorders and other mental health conditions. It is difficult or impossible to avoid all of life’s stressors, but taking some proactive steps can significantly reduce their impact.
Some common strategies to handle stress are summarized below:
- Decide if stressors can be avoided. While it's not possible to avoid every stressor you encounter, it is likely possible to avoid some of them. Think about your sources of stress, and consider permitting yourself to let non-essential responsibilities go, at least until you build more stress-management skills.
- Lean on others. Positive social interactions significantly improve stress resilience, meaning that seeking validation and guidance from others may make many stressors easier to handle.
- Adopt an exercise routine. Regular exercise is associated with higher stress resilience and improved overall well-being. In fact, evidence suggests that getting at least 90 minutes of moderate-intensity exercise per week may be one of the most effective interventions for stress available today.
- Get enough sleep. Sleep disturbances significantly exacerbate stress, anxiety, and worry. Try to maintain a regular sleep schedule and sleep long enough to feel rested.
- Get into nature. Evidence suggests that green spaces, such as parks, nature preserves, and hiking trails, significantly reduce stress and will likely improve your mood.
- Seek professional help. Stress can sometimes be overwhelming, especially if it is related to mental health conditions. A therapist or other professional can discuss treatment options and evaluate how you can tackle your stress best. Individual therapy, group therapy, and family therapy may all be viable options.
How do you heal yourself mentally and emotionally after an eating disorder?
One of the most important things to do when healing yourself mentally and emotionally is to maintain good mental and physical self-care. At its most basic, self-care requires regular physical activity, adequate sleep, and a healthy diet. If you’re recovering from an eating disorder, be sure to follow your treatment team’s recommendations regarding your recovery path. They will discuss the importance of self-care, as well as managing underlying mental processes that may have contributed to your eating disorder.
You may want to consider working with a therapist or other mental health professional after your treatment concludes. They will likely be able to help you continue your growth and prevent a relapse. They can help you continue to develop a healthy body image, conquer negative self-talk, increase self-acceptance, and bolster your self-worth. Mental and emotional healing may require focusing on the positive aspects of everyday life and noting which positive qualities you already possess that can help you stay in a good mental place.
How does the body heal itself after an eating disorder?
Eating disorders have three distinct areas of recovery: physical, behavioral, and psychological. Bodily healing refers to physical recovery and often means achieving a healthy weight, normalizing electrolyte and hormone levels, and addressing other health issues that may have been caused by the eating disorder. For example, those recovering from bulimia nervosa may need to heal from damage caused by vomiting or excessive laxative use.
Although there are several serious - sometimes fatal - complications that arise when eating disorders are left untreated, treatment typically involves managing many of those complications, which reduces overall health risks. Despite this, eating disorders can be long-lasting, and it may take months or years before symptoms are completely under control. It is difficult for the body to heal while symptoms are still present, which may lead to permanent issues that persist after treatment. Most notably, trouble maintaining a healthy weight, reduced bone strength, and neurological issues.
- Previous Article
- Next Article