Can You Fully Recover From an Eating Disorder?
YES.
Yes! You can.
(say it louder for the people in the back)
You can fully recover from an eating disorder.
I feel a lot of dismay when someone says to me; “You know how you never really recover from an eating disorder?” as if it’s a known fact. I actually hear this statement with surprising frequency, and the person is usually pretty surprised to hear that I don’t agree.
While recovery is often a slow process, full recovery is absolutely possible.
The Foundation of Eating Disorder Recovery: Your Body
Before I dive into how to obtain a full recovery psychologically, I want to address the foundation of recovery— the physical body.
The Key Principles of Physical Recovery
Nothing a therapist says can do as much for your mind as full weight restoration
Nothing a therapist says can do as much for your mind as regular eating and adequate nutrition
A body that is living in a semi starved state- and yes, you can be in a malnourished, even in a larger body- cannot feel safe enough to recover. Full stop.
So if you’re reading this article to find out the magic formula for recovery, but are suppressing your natural weight and shape through restrictive eating, you will not recover.
Restriction Keeps the Eating Disorder Alive
I have seen this over and over again in my clients— they are so terrified of feeding themselves an adequately and regularly that they decide they will wait for the eating disorder thoughts to get quieter and then they will nourish themselves.
But it never works in that direction (Boring, 2020).
The preoccupation with body size and shape will continue as long as food is restricted (Accurso et al., 2014).
The only way to break through that anxiety is to face it head on and nourish your body adequately, despite your fears. Support with this process should come from a dietitian who specializes in eating disorders and works best alongside therapy for eating disorders.
This Applies to Anorexia— as well as Bulimia and Binge Eating Disorder
This is true for people with restrictive eating disorders like anorexia nervosa (AN), but it is equally true for those struggling with binge eating disorder (BED) and bulimia nervosa (BN).
Generally people with BN and BED identify their binging as the main problem, and feel if they could only stop binge eating, they would be ok.
But in order to stop binge eating, you have to focus on regular, adequate nutrition so that the physiological impulse to binge is removed.
Clients with BN and BED are often unaware that they too are living in a state of semi-starvation in between binge eating episodes, but when we look at their food intake we can see that their chronic undereating sets them up to binge because their body is in a state of chronic stress and deprivation.
For more on the physiological and psychological impacts of semi-starvation, I encourage clients to learn more about the Minnesota Starvation Experiment (Gil, 2023). What’s striking about this study is that these were psychologically healthy men (in the 1940s), who, when semi-starved, became preoccupied with food, anxious, depressed, and obsessive.
In other words, many of the thoughts and behaviors people attribute to “having an eating disorder” can actually be the direct result of not eating enough.
This should be shocking news to everyone reading this; it certainly was for me when I first learned it.
Many of the “symptoms” of an eating disorder are, at least in part, the result of being undernourished. When the body is adequately nourished, body image distress and anxious, preoccupied thoughts tend to soften, usually far more than people expect.
How Eating Disorders “Help” Emotionally
Adequate nutrition is just the first step, but a critical one . Once that is firmly in place, we can explore what in the person's inner emotional world has made disordered eating such a compelling experience. This is the core of depth-oriented eating disorder therapy.
People don’t do things without good reason.
From the outside we can all agree that eating disorders are tragic and destructive, but they don’t feel that way from the inside.
To a person with an eating disorder, disordered behaviors are the solution to emotional problems beyond their capacity to cope.
They are helping you avoid pain.
They are helping you cope with vulnerable emotions.
There are a myriad of reasons the eating disorder persists, but the underlying commonality is that the behaviors (yes, even the ones you hate) are serving you.
Some people describe their eating disorder as being like a friend. A comforting hug. A feeling that everything is going to be okay when the world feels out of control. A way to lower anxiety. A way to feel confident. A way to make your inner pain visible on the outside. A way to hide your pain from the world.
They serve many emotional purposes, some of them seemingly contradictory, but the intention behind them is always protective.
After all, don’t we all want to feel comfortable?
Meeting Your Needs Without the Eating Disorder
If we can find another way to meet your needs, the eating disorder loses its power.
If you can learn to prioritize listening to your body's signals and trusting those messages above all external messages, you can recover.
This comes back to how you respond to your body's hunger and fullness cues, but also how you respond to your body's emotional cues.
There are few means more effective to blotting out emotions than a distorted relationship with food.
When emotions can be experienced fully, the drive behind the eating disorder is satiated, and the symptoms can fade away. This process, of understanding what the eating disorder is actually doing for you, is where real, lasting change begins in therapy.
What is “Normal Eating”?
You can return to normal eating. Or perhaps discover it for the first time.
Normal eating is:
Overeating at a birthday party because you were distracted by a good conversation and the cake was amazing.
Losing your appetite when you're anxious or sad.
Eating when you’re physically hungry, and also when you’re sad, bored or happy.
Cultural celebrations and tradition.
Eating to be polite.
Not eating enough and wishing you had eaten more.
Eating too much and wishing you had eaten less.
Normal eating fluctuates and isn’t perfect.
Normal eating means trusting your body to correct its mistakes.
Healing Your Relationship with Food
Normal eating should be as emotionally charged as doing the laundry.
Yes, it is nice to have clean clothes. But getting behind on laundry doesn’t alter your value as a person. And if you over or under-load the washing machine, you don’t beat yourself up— you just try again next time.
If you are brand new to recovery, all of this may sound so far away.
You may have lost your own hunger and fullness cues.
You may have no idea what you're feeling emotionally.
You may feel guilty for having an eating disorder.
You may feel like you don’t deserve help, because having an eating disorder is all your fault. (It’s not— more about the causes of eating disorders here).
Full recovery from an eating disorder is possible. No matter where you are in your journey, honoring and respecting your body starting right now can improve your quality of life.
Eating Disorder Therapy in San Francisco
If you want freedom from an eating disorder and you live in San Francisco or anywhere in California, you can learn more about my eating disorder therapy services here.
If you have no hope, but believe you could feeljust 1% freer around food and your body, reach out to me.
I know how to get you there.
I would love to help you.
References
Accurso, E. C., Ciao, A. C., Fitzsimmons-Craft, E. E., Lock, J., & Le Grange, D. (2014). Is weight gain really a catalyst for broader recovery? The impact of weight gain on psychological symptoms in the treatment of adolescent anorexia nervosa. Behaviour Research and Therapy, 56, 1–6. https://doi.org/10.1016/j.brat.2014.02.006
Boring, E. (2020, September 16). When in doubt, aim higher: What I wish I’d known about target weights in recovery. F.E.A.S.T. https://feast-ed.org/when-in-doubt-aim-higher-what-i-wish-id-known-about-target-weights-in-recovery/
Gil, C. (2023, May 9). The starvation experiment. Duke Department of Psychiatry & Behavioral Sciences. https://psychiatry.duke.edu/blog/starvation-experiment
The contents of this blog are for informational purposes only. This blog is not intended to be a substitute for professional advice, diagnosis, or treatment that can be provided by your own mental health practitioner. If you have any specific concerns about your mental health, you should consult your doctor and you should not delay seeking medical advice, or treatment for your mental health, because of information on this blog.
Megan Bruce
Megan Bruce is a licensed therapist specializing in eating disorders, anxiety and ADHD. She is based in downtown San Francisco and sees clients in-person and virtually in the greater California area.
