Updated: Feb 8
When you or a loved one is in recovery from an eating disorder, it can feel like living in survival mode. During the time of my initial recovery, in my late teens, I was so focused on my waist, on my weight, what I was eating, and how much I was exercising, that I couldn't care less to ask what are the things I should know about starting recovery?
Bear in mind recovery is a mode, not a destination. Just like beauty is a myth and an ever-moving target.
To catch you up if you haven't read Ana, Mia & Me: An Eating Disorder Recovery Memoir, I didn't begin counseling for my eating disorder until I had already stopped restricting and was struggling with eating in a dangerous, out of control, not enjoyable way (binging) and gaining weight back. I went to counseling to find out why I was "so good" before and how I was "out of control," and didn't even know the recovery process had started until I was in it!
Unfortunately, though, my recovery plan fell short of being complete, especially given the severity of physical health symptoms and concerns. As such, there are some things I didn't get to learn, and things I had no idea about until years later (hat I would have liked to know back then) I hope by sharing this now it can save you or someone you love some pain and grief and help ensure the best recovery process possible.
Recovery mode is a team process. Recovering requires a combination approach that should ideally include a family doctor, a trained mental health professional, and a registered dietician or nutritionist who is equipped in treating patients with eating disorders. The recovery process should include lab work from your doctor, checking for any underlying illnesses or nutritional deficiencies caused by having the eating disorder; checking for and/or watching hormonal deficiencies, heart problems, and digestive tract problems; cognitive behavioral therapy (CBT) sessions and homework to help you change your thinking, and a nutritional program to help you in learning how to eat again (including how to grocery shop, plan meals, meal prep, attend events, etc.). Ideally, there will also be access to someone trained to ask the right questions (ie., a counselor, social worker, or psychiatrist) about any traumatic origins or contributions to the etiology of the eating disorder. Access to physical therapy options to regain muscle or heal from exercise injuries is also on the "wish list" of things to include if you can, but it's understandable that these are all limited by finances.
Relapses may or may not look the same as the first episode, and they don't erase progress. Although I had recovered from the initial episode of anorexia nervosa (orthorexia or healthy eating obsessed subtype) in my teens, also I struggled with binge eating junk food while studying and exercise-type purging while studying in university, pretty much living in oversized sweats and hoodies (university swag, no doubt). As I approached my wedding dress shopping day years later, I found myself skin and bones in the mirror with the dress consultant saying it was easy trying the dresses on with me because I was the "perfect size." Pretty sure my spine was showing. The pressure I felt to maintain that look for that day was ridiculous. Somehow, I didn't see the disorder part. I masked it with veganism, raw food eating, the fact I took the bus so there was more walking involved in my day (exercise I 'had' to do and there was the dog to walk), I had started a new job...in a new city...in a new home... Plus, who doesn't want to maintain the "perfect" bridal bit until the big day? While I was able to use the skills I learned in CBT to enter recovery mode, it's the fact of the matter that sometimes relapses happen before we, ourselves, even realize! Getting back on track with what you've learned in recovery mode is most important.
Stick with treatment longer: Eating disorders, especially ones that go untreated, can do lasting damage and can kill you. Your body needs a base level of calories to pump blood, feed your heart and brain, and keep you alive. You don't need to wait until you're in rough shape to start recovering from an eating disorder or disordered eating. You can ask for more help if you feel you need more, too. People at all stages of their eating disorder can die from health complications associated with overeating and/or chronic malnutrition and more including damage from laxative overuse, purging as in self-induced vomiting or excessively exercising with the intent of ridding the body of calories and foods eaten - ie., undoing the eating). Getting as much help as you can afford is and commit to is advised (this is coming from a survivor's perspective-I am not a licensed medical professional).