Eating Disorder Recovery is NOT Linear

Disclaimer: This content is for informational purposes only and should not be taken as professional medical advice.

Eating disorders are complex and treatable mental and physical illnesses. Eating disorder recovery is equally complex and often requires an interdisciplinary treatment team to address the different concerns present. Due to the complexities of eating disorder recovery, the saying “recovery is not linear” is heard in countless appointments. But what does this really mean?

Let’s start by defining eating disorder recovery.

Eating disorder recovery has two stages of healing. The first is physical healing, which often includes:

• Reaching your individualized target weight range for your body to function optimally

• Stopping eating disorder behaviors

• Healing physical symptoms that were related to eating disorder behaviors

Physical healing is often specific and measurable, which is why many people think of this as eating disorder recovery. However, many of the people I work with reach their physical recovery and still feel that something is missing.

The second stage of healing is psychological healing. Since eating disorders are both physical and mental illnesses, it makes sense that there would need to be full psychological recovery as well – right?

Psychological healing often includes:

• Replacing your old thought patterns about food, exercise, body and self with new adaptive thought patterns

• Learning emotion identification and adaptive coping skills for those emotions

• Understanding your underlying concerns (anxiety, depression, trauma, obsessive-compulsive disorder, etc) and receiving support around these concerns

• Finding purpose in recovery

Psychological healing is not as easily quantified and often takes a longer. However, this stage is so vital to helping build a lasting, sustainable recovery.

So why isn’t recovery linear?

Because… eating disorder recovery is HARD!

If you don’t have first-hand experience with an eating disorder, I want you to think of your worst fear. What comes to mind?? Are you scared of heights? Snakes? Spiders? Sharks?

Whatever your biggest fear is, I want you to think about how you would feel if I asked you to sit with your biggest fear for 30 minutes, 6 times per day. You probably wouldn’t want to do that and you probably wouldn’t want to see me ever again. For a person with an eating disorder, food is often one of those fears and it makes it very hard to do the things that are asked of them to do.

So that’s reason number 1 that recovery isn’t linear.

The second reason is that once you start making steps forward in recovery, things often get worse before they get better. You see, the eating disorder, while a very real physical and mental illness, is also a coping skill used to try and cope with an underlying issue. So even though, it is objectively speaking dangerous, it can seemingly help you feel better by allowing you to numb out or shift your focus to something you have control over. So, when you stop using your eating disorder behaviors it often leaves you feeling more raw and vulnerable because the underlying things you were trying to run away from start to come to the surface. Part of eating disorder recovery is learning to sit in the discomfort of this raw and vulnerable place without using eating disorder behaviors. This takes time!

The third reason is that no one is perfect. Behavior change is possible and it’s also incredibly challenging. Eating disorder recovery, at least in the early stages, requires daily decisions about eating each meal, finding other ways to cope with strong emotions, and rewiring your brain to new ways of thinking. It’s exhausting work.

What do I do if I use an eating disorder behavior in my recovery process?

In talking with my clients, we talk about a fixed mindset versus a growth mindset.

A fixed mindset is more likely to see things in black and white terms – success or failure, good or bad, etc. A growth mindset is more likely to see things in shades and can view each experience (positive, negative, or neutral) as a learning opportunity.

When a client talks to me about using eating disorder behaviors, I am not critical. I become a detective. I spend time acknowledging that they may wish that this behavior didn’t happen and just because it did happen doesn’t make them a failure. Then I start asking my detective questions to understand the mindset, setting, and potential triggers at that time to problem-solve for the future.

Questions it is helpful to consider after using a behavior are:

What was going on at the time you used this behavior?

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How did it feel physically and psychologically to do that behavior?

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What did you do after this behavior?

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What did you learn from this experience?

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With hindsight being 20/20, what would you do differently? How would that have looked?

The answers to these questions are crucial in helping us learn from an experience to prevent the use of an eating disorder behavior in a similar situation.

In Summary

Eating disorders are complex and treatable mental and physical illnesses. Eating disorder recovery is equally complex and is a product of physical and psychological healing. The phrase “recovery isn’t linear” is a common statement made by eating disorder professionals as there are many challenges you face in recovery. You can use a growth mindset to any of the successes and challenges you face in recovery to create a more resilient and sustainable eating disorder recovery.