How can anyone not just overcome an eating disorder but finally learn to eat normally again? Researchers who have looked at hundreds of reports from doctors who have treated millions of patients generally have these recommendations:
- It's almost never enough to prescribe antidepressants and enforce either eating enough or not eating too much. Recovery from an eating disorder is a psychological process, not just a physical process. Counseling is usually helpful.
- Family-based approaches like the Maudsley Method (and the New Maudsley Method) are important for stabilizing eating habits. Hospitalization takes care of life-threatening health issues, but the home has to take over part of the role of the hospital when the eating disorder patient is released. Newly released patients need help to stay on track, and sometimes whole families have to change their behaviors to avoid pulling them off track. Bullying is a frequent issue.
- Individual psychotherapy helps people struggling with eating disorders to make the transition from being not sick enough to be hospitalized to actual healthy eating. Cognitive behavioral therapy (changing behavior by changing thought patterns) and psychodynamic psychotherapy (the process of discovering the emotional issues underneath dysfunctional choices) are often helpful in preventing gain for people who live with bulimia or binge-eating disorder.
The most important thing to realize about eating and exercise habits that the alternative to achieving all of your goals isn't giving up on all of your goals. Improvement isn't all-or-nothing. It's OK to incorporate a certain amount of fun into cooking, eating, and play. Of course, one of your issues may be that you don't enjoy activities other people find to be fun. You may just need to find other people to share your time, or you may benefit from speaking with a counselor about that issue, or both.
Another important consideration in organizing your daily life as you recover is the need for balance. You need to have healthy eating habits regardless of the food that is available to you. Healthy people find enough calories, enough macronutrients, and enough micronutrients in a variety of foods. That doesn't mean that if you have a food avoidance disorder you have buy foods that make you go "eww." That doesn't mean that if you have a binge-eating disorder you need to start visiting all-you-can-eat buffets. That doesn't mean that if you have anorexia your family has to hover over you to make sure you eat.
Balance simply means doing healthy things without feeling guilty about not doing enough or doing too much. Most people recovering from an eating disorder don't stay balanced all the time. Most people in recovery need some additional help from time to time. Keep communications with potential sources of help open, and seek help when:
- You feel guilty about something you are doing or not doing.
- You are losing weight that isn't your treatment plan to lose, or you're gaining weight that isn't in your treatment plan to gain. You don't have live on top your scales, but numbers offer objective feedback on whether your program is working. There's no shame in being off target, but failure to seek help you when you need it is a major issue in itself.
- You feel addicted to food, exercise, or thinness. Or you feel obsessed about some aspect of your appearance, whether or not it is weight-related. A mole or a scar or losing your hair or popping out hairy all over can all interfere with self-image in ways that affect your eating habits. You may need to see a counselor, or, if you can afford them, a tailor, dressmaker, or aesthetician. Or you may benefit from lower-cost makeovers that make you feel good about the way you look. It's not unusual to discover in recovery that you weren't just upset about your weight.
One aspect of recovery from eating disorders that is frequently overlooked is that other members in the family usually need support, too. This is a particular problem for siblings. Brothers and sisters of the member of the family who is being treated for the eating disorder often feel deprived of attention. The eating disorder goes on and on, so the resentment builds and builds. If it isn't addressed, it can last a lifetime. The problem isn't that the parents are doing something wrong. The problem is that eating disorders require a lot of help.
Spouses of people who have eating disorders also need support. Marital issues around eating disorders usually involve one spouse's assumption that the truth won't come out, and then the truth inevitably does. But in the meantime the spouse who is keeping the secret may harbor the idea that their partner doesn't care when the issue is that the partner doesn't know for sure, at least not yet.