There’s very little consensus about the definition of recovery in the eating disorder field. As eating disorder expert Sarah Ravin, Ph.D, told me in an interview here on Weightless:
Some research studies loosely define recovery as no longer meeting full criteria for the eating disorder. For example, recovery from AN could involve restoring weight to the point that the person is above 85% of IBW (Ideal Body Weight) and menstruating. Other research studies define recovery from AN as being at 95% of IBW or 100% of IBW and getting regular periods. Bulimia nervosa (BN) recovery is typically defined as abstinence from bingeing and purging, or infrequent bingeing and purging (e.g. once a month).
One of the problems with this definition is that it dismisses the cognitive and emotional parts of recovery. As Ravin said:
Many research studies fail to consider the cognitive and emotional aspects of recovery, which usually persist for at least a few months after weight restoration and cause a tremendous amount of distress for the sufferer. In addition, many behavioral symptoms may persist (e.g. avoidance of fats, food rituals, rigid or excessive exercise regimens) long after the person is weight restored and no longer bingeing or purging.
Ravin defines full recovery as someone who:
…is weight-restored, does not engage in any ED behaviors, has realistic thoughts and behaviors surrounding food, has a realistic body image and accepts her body (even though she may not like it), practices good self-care, engages in proactive relapse prevention, and does not struggle with ED cognitions or emotions. She is cognizant of her underlying predisposition and thus must avoid dieting, fasting, high-stress environments, etc. She may have a better body image, better eating habits, and better psychological functioning than her peers as a result of her treatment.
Recently, I read the book 8 Keys to Recovery from an Eating Disorder: Effective Strategies from Therapeutic Practice and Personal Experience by clinicians Carolyn Costin and Gwen Schubert Grabb. (It’s a valuable resource!)
Both Costin and Grabb struggled with eating disorders and achieved full recovery. In fact, Grabb was Costin’s client. And both women believe strongly that full recovery is possible.
In their book, Costin and Grabb describe full recovery. They write:
Being recovered is when the person can accept his or her natural body size and shape and no longer has a self-destructive relationship with food or exercise. When you are recovered, food and weight take a proper perspective in your life, and what you weigh is not more important than who you are; in fact, actual numbers are of little or no importance at all. When recovered, you will not compromise your health or betray your soul to look a certain way, wear a certain size, or reach a certain number on the scale. When you are recovered, you do not use eating disorder behaviors to deal with, distract from, or cope with other problems.
This chapter also features inspiring quotes from individuals who had an especially difficult time recovering from their ED. They struggled with an eating disorder for 10 years and also experienced many relapses.
As Costin and Grabb write: “All of these individuals had loved ones who had lost their patience and given up on them. These are individuals who at one point had given up hope as well. The point is, all of them are well today! They offer words of encouragement that no matter how long it takes or how hard it is, it is possible.”
Below, I’ve included some of these quotes. If it helps, print them out or write your favorite one down.
“I would read stories of people who were in recovery or people who had got past the demeaning and controlling voice inside their head, but I did not and would not accept that I could be one of those people who survived and lived to tell the story. Don’t let that voice tell you the same lie. Life is so good and if I had known how good it could be and that full recovery was possible I would have changed a long time ago. I won’t paint a pretty picture; going through the process is torturous at times. However, it is also the most rewarding and most insightful ex- perience you will ever have. I feel lucky to have gone through it because I am a stronger, wiser, and healthier person now, and I feel I have skills to navigate this world that are far greater than those who have not had my experiences. I believe in my- self now, and because of that I know I can continue into being fully recovered.” ~ JW
“People often wonder how I got better after so many years and so many slips and lapses. There are a few things that stand out and I offer them as hope because if someone like me who suffered for 15 years can get better, I think anyone can. I had thought my eating disorder showed my strength and willpower, but I realized that the harder thing to do was not engage in behaviors and notice how much stronger I felt each time I dis- obeyed my disorder. When I noticed how much more people genuinely enjoyed my company when I was not using my eating disorder behaviors and how much more love I got when I was doing the harder thing it was extremely motivating. I finally realized that I wanted to live and have relationships more than I wanted my eating disorder.” ~ MP
“Feeling hopeless didn’t mean I was hopeless. The only differ- ence between someone who gets better and someone who doesn’t is whether or not that person gives up and stops trying. I had many opportunities to give up since I had multiple treatments that did not work. My parents stopped talking to me and I felt sure I would not recover, but I did not give up trying. After years of thinking I would never get better and looking for an answer outside myself, I finally realized it was up to me. I learned how to use my healthy self to fight off my eating disorder self and internalize the process, which I had needed all along. This helped me see that it was possible. Knowing that it was hard, and that hard times didn’t mean I wasn’t getting better, was also really helpful. People do get better. There’s a point when you just have to start believing you can get better. I learned at Monte Nido that energy follows thought. When I thought I could do it and I started to see results, no matter how small, I gained more faith in myself and more strength to keep going.” ~ PK
A Visualization Activity for ED Recovery
In their book, Costin and Grabb also include a helpful activity on recovery. (They include many valuable exercises for readers.) They suggest readers imagine what a day looks like once they’re fully recovered.
They write: “Visualize in as much detail as possible what you are doing, what you are wearing, who you are with, how you feel about life, how you feel in your body, what profession you are in, what hobby or activities you enjoy, or whatever else you would like to be true for you. (Remember, sometimes we are afraid of the very same things that we want. Even if you are afraid of the recovered life, try to do this assignment anyway.)”
When you’re having an incredibly hard time, these are the images you can go to. As Costin and Grabb say: “Having a clear picture in your mind where you see yourself successful, happy, and doing something you love, such as having a child, hanging out with friends or even just feeling comfortable, can provide helpful visuals and reminders when things feel tough.”
You might write this activity down and keep the piece of paper in a visible place. Let it remind you of what you’re fighting for and why you’ll win.
Recovering from an eating disorder is a difficult road, and for most, filled with roll-coaster ups and downs. But with treatment and hard work, recovery is always possible, and there is always hope!
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Last reviewed: 31 Aug 2011