Eating Disorder Recovery Doesn’t Happen All at Once
As a regular contributor to Still Stoked, I’ve written openly about my battle with an eating disorder and my eating disorder recovery. The more I share, the more I hear from other athletes who confided that they have similar stories. It is my hope that my experience can bring strength and hope to others who suffer.
Even people who have not suffered an eating disorder but have spent years dieting, restricting calories, over-exercising, or doing other disordered behaviors will have to go through a similar process of recovery.
Disordered eating doesn’t just go away at the moment you stop doing the disordered behaviors. For most, recovery takes years. In the alcoholism recovery community, they call it being “a dry drunk.” In other words, even though you might not be actively doing disordered eating behaviors, your thinking is still disordered. Some sufferers have found it beneficial to complete a treatment program over the course of a few months. This is generally just the beginning of recovery.
These are the stages of eating disorder recovery as I have experienced them personally.
As with any sort of behavior modification, admitting that you are unhappy with your relationship to food and your body is the first step. If you are the sufferer, rest assured you have already reached this step or else you would not be reading this. If someone you love suffers from an eating disorder and has not yet admitted that there is a problem then there is not much you can do, except love them. Things will certainly have to get worse before they can get better. The good and bad news is, they will.
#2 Willingness to do whatever it takes, including gaining weight
Circumstances must be bad enough that you are willing to gain weight, or do anything at all, if it means you will no longer be controlled by this awful disease. If you’ve reached this stage then hope has a chance! Unfortunately, it takes a whole lot of misery to get to this stage since gaining weight is the thing most feared by those who chronically diet or have an eating disorder.
But living as if you truly believe them [these words], takes bravery.
This is a tricky stage. You may put your trust in a treatment program, a dietician, or a therapist. This is part of stage three. But ultimately you are learning to trust life in general. This may be the most important stage because this is where real change happens, not just behavior modification. As you pass through this stage your beliefs change from, “Life is hard and I must fight for survival,” to “all of life is here to support me. I can trust my body and the people who love me.” This is where you switch from a poverty mentality, “There is never enough love, affection, money or food,” to an abundance mentality, “All my needs are provided for before I even have to ask. I am worthy of love without having to earn it.”
This mindset does not change overnight. If you are reading this and those words resonate with you, this is a very good thing. But living as if you truly believe them takes bravery. This is a very difficult transition for people who were raised in homes where love had to be earned. This might be especially difficult for people who were taught they were sinful from birth.
If you are in this stage, you will want to seek professional counseling. Suggested books are Women Food and God by Geneen Roth or You Can Heal Your Life by Louise Hay. The reason this stage is critical is that you must learn that your body is good and can be trusted. Lasting change will not happen unless you can move away from fear and into trust.
#4 Listening to your body
Once you’ve learned to trust life, and have learned that your body is your friend, you will naturally want to start listening to the cues of your body. This especially includes listening to your body’s need for nutrition. If you have dieted or restricted calories for a long time your body will most likely need to go through a period of refeeding.
Once your body understands that you are willing to listen to its hunger, it will likely go into feast mode, after so many years of famine. You might feel ravenous all the time. In this stage, you will be tempted to fight your body. It might not seem “normal” the amount of food you want to eat. For example, in my case I had to eat breakfast three times and lunch twice before I felt satisfied. This went on for months.
Keeping in mind the body can be trusted, it is critical that you give in to your hunger and allow the body to be satisfied. Most people will still find themselves fighting this for a while. Yes, weight gain is likely, but excessive weight gain is only temporary as long as you continue to progress through the stages. Remember your body can be trusted. It will not allow you to stay at an unhealthy weight for longer than it needs to be there. If you are trusting your hunger then whatever weight you are at, is a healthy weight for you.
Think of it this way. Would you ever say, “I feel like I need to use the toilet but I don’t deserve to. I haven’t drunk enough water today so I shouldn’t have to go. I’ll just force myself to hold it until I’ve earned it.” What?! No way! The body has natural signals telling us what it needs and it is our job to trust that the body knows what’s best for itself.
#5 Ditching food rules
This might happen at the same time as stage four, or slightly after. In stage four, many people will allow themselves to eat enough to be satisfied but will continue to stick to foods they consider “safe” or “healthy”. In stage five you allow all foods. Foods are no longer healthy or unhealthy, food is just food. Again, overeating and weight gain may happen, but they are a necessary part of recovery and you will not become “unhealthy”. This is all a part of the journey to getting healthy! This is the hardest stage. This is where most people who fail at recovery slip up and go back into disordered eating behaviors.
Returning to trusting the body is incredibly important. If the body can be trusted and the body says it wants three cheeseburgers to be full, then that is what it wants. If the body wants 9 chocolate chip cookies for dinner then that is the healthiest thing you can give it. This will NOT last forever but you must pass through this stage. Remember the body will never ask for something that is unhealthy. This is just a step on the journey to health.
I remember loathing my body more than ever during this stage and falling off the wagon more than once. I remember trying on everything in my closet and then falling on my bed in tears because nothing fit. But the big payoff is right around the corner in step 6.
#6 Hunger levels begin to normalize
At last! You wake up in the morning and you aren’t really all that hungry. It’s the strangest sensation. You get most of the way through your lunch and don’t feel like finishing it. You wonder if there is an alien living in your body. It starts slowly. It comes as a shock at first, “Wow, it’s been four hours and I haven’t even thought about food.” At first, it happens only now and then and you may continue having many days where you are still famished, especially around your cycle. It is critical to listen to your hunger at this stage. If you are hungry, eat. Stop when you are full. Do not eat if you are not hungry.
#7 Cravings begin to normalize
Even after your appetite slows down a bit you will likely still suffer from cravings. These cravings also begin to taper off as you become adept at listening to your body. This stage takes dedication. Yoga and meditation is a wonderful way to practice listening to your body’s more subtle signals. You will start to notice that you feel better when you avoid large amounts of certain foods. Before you may have labeled these foods “bad” but now you simply don’t want them because they don’t make you feel good. It will take no willpower to avoid them as it used to. Your body simply will not want to overindulge in something that will make it feel sick or slow. This will happen naturally if you’ve already progressed through the earlier stages.
#8 Weight stabilizes
By the time you reach this stage, you will be eating only what the body needs. The body gives you clear signals when it is hungry, what it is hungry for, and when it is full. You enjoy listening to these signals. As a result, your body reaches its optimum weight. It may be more or less then what you weighed when your eating disorder was active. But either way, you will have what you wanted all along: happiness. You will be happier with the shape and functioning of your body than you ever knew was possible when you were in the grips of your disease.
#9 Slips and relapses
No one person progresses through all of these stages neatly. You may bounce back and forth between a few stages for a while. You may be doing very well and then something sets you off and you are back on a diet. You may get stuck in one stage for a very long time. There is no timeline here. A general rule of thumb therapist use is that the number of years you were in your eating disorder is double the number of years it will take to recover. I struggled for ten years. I now have four years of recovery and I am in the weight stabilizing stage. If I gain a few pounds then my hunger will shut off and I will easily lose them. If I lose a few pounds then I will get very hungry and put them back on. But sometimes, although very rarely now, I still have the urge to binge and occasionally I do.
Sometimes I still feel fat and subconsciously restrict my calories for a few days. But I always end up feeling physically awful whenever I do. Little by little my body is steering me away from caloric restriction. The important thing to keep in mind is that this is not a process you “do” so much as allow. If you have made it to step three (trust), then all the rest of the process will follow if you just allow it. Your body wants to be healthy, and it will be. If you stop trying to control it and simply support it.
I hope this guide is helpful. I am not a physician and you should always follow the advice of your doctor first. If you have recovered from an eating disorder or have progressed through some or all of these stages please share your experience in the comments below. If you are in the middle of these stages please reach out for help.