Eating Disorders: Exploring Recovery – What Is It? What Does It Feel Like?

“Recovery may be when life replaces the eating disorder.”  Dr. James Lock, director of the Stanford Child and Adolescent Eating Disorder Program.¹

Eating disorders are potentially life-threatening disorders that cause significant impairment and distress. Treatment works and recovery is possible, but recovery often takes time.

But what is recovery, exactly? Are you recovered as soon as you eliminate maladaptive eating behaviors, or is there more to it than this – does recovery ever end?…What is recovery and how do you know when you find it?!?

Well unfortunately, experts haven't yet agreed on a standardized recovery definition - which makes starting treatment a little akin to starting a journey without knowing your final destination.²

But maybe it doesn’t matter. At best, though you get expert support and treatment, recovery is a self-directed and self-defined process of building the life you want for yourself – and no one else can or should tell you what that life looks like.

What do you want for your recovery – where is your recovery journey leading to? These are tough questions. To help you in your thinking, read on for an exploration of eating disorder recovery from different points of view, such as:

• What recovery isn’t.
• Recovery models.
• Components of successful recovery journeys.
• Traits of successful recoveries.
• Recovery as defined by those in recovery.

What Recovery Isn’t!

In order to develop a good understanding of eating disorder recovery, it’s useful to first talk about what recovery isn’t like.³

• Recovery is not the same for every person.
• Recovery does not happen over a set period of time.
• Recovery progress is not always steady – it’s normal to make progress and then have progress slow, or even reverse, before restarting again.
• Recovery isn’t always forever – relapses are a common part of recovery. You can use them as learning and growing experiences.
• Recovery is not something you can put off for later – the longer you wait, the harder it gets.

Physical Signs of Recovery

• Within 85% of normal weight.
• Restoration of normal menstruation.
• No signs of malnutrition.
• No longer binging or purging.

However, though medical normalization/stabilization is easier to measure than mental outlook (obsession, perfectionism, self-criticism, etc.) most would agree that solving just the physical aspects of your eating disorder does not constitute full recovery.

5 Criteria for Complete Eating Disorder Recovery

Where are you in your recovery?

Well, ceasing maladaptive eating behaviors doesn’t mean full recovery. According to eating disorder researcher Dr. Bardone-Cone, recovery actually occurs across 5 distinct areas and you are in full recovery when you satisfy each of the following 5 criteria:⁴

1. Diagnosis – You no longer meet the diagnostic criteria for an eating disorder.
2. Maladaptive behaviors – you no longer engage in eating disorder behaviors (for example, no binging or purging).
3. Physical health – you are at an appropriate healthy weight.
4. Mental health – You have a generally positive outlook about yourself and your body, about food, about your emotions and your social interaction abilities.
5. Quality of life – you have a reasonable quality of life across social, vocation and occupational domains.

Full vs. Partial recovery

One way to view recovery is that when your physical health, eating behaviors and food related cognition are indistinguishable from a control group of people without eating disorders – then you have achieved full recovery. 

Partial recovery is a very common step on a hopeful path to full recovery. In partial recovery, your weight and eating behaviors are normalized, but you still have maladaptive thinking on food, body image and eating.

5 Traits of People with Successful Recoveries

Normal eating is being able to eat when you are hungry and continue eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it… In short, normal eating is flexible. It varies in response to your emotions, your schedule, your hunger, and your proximity to food.” Ellyn Satter, R.D.⁵

Researchers have identified the following 5 traits/factors as important for long-term success:

1. Accepting yourself as you are.
2. Accepting your body as it is.
3. Feeling relaxed about food.
4. Having a healthy social life.
5. Feeling and being able to express your emotions.

The SAMHSA Components of Recovery

For another take on recovery, consider the Substance Abuse and Mental Health Administration’s 10 essential components of recovery:^{. 6}

1. Self directed – you decide that you want to get better and you take active steps to make that happen.
2. Individualized – you choose a recovery pathway that makes sense to you, given your strengths, preferences, cultural background and history.
3. Responsibility – you feel a sense of personal responsibility to meet your recovery goals. You are ready to learn from your experiences and use new skills to achieve your goals.
4. Holistic – Recovery can’t hyper focus on just one aspect, such as disordered eating; recovery happens across all domains of life: mind, body, spirit and community. You may need to address, housing and living situations, education, spirituality, social relationships, family relationships and more.
5. Non-linear – You won’t always move forward. Sometimes it’s steady progress but sometimes it’s two steps forward one step back.
6. Based on your strengths – You have many strengths. Recovery happens best when you build on existing strengths and use your growing self-worth as the basis for new or improved relationships.
7. Peer-supported – You can find encouragement, support and knowledge from others facing similar challenges.
8. You feel respected – you feel respected in your treatment process.
9. Empowerment – you feel able to speak-up and influence your treatment, recovery and future.
10. Hope – you believe in the possibility of a better life.

Survivors Describe Recovery

According to Harriet Brown, author of ‘Brave Girl Eating’ recovery is “absolutely ordinary relations with food…you’re able to live life in a way that’s not completely organized around food and eating.”⁷

What does recovery feel like?

To answer this question, researchers at the University of Missouri recruited and interviewed a sample of women in long term recovery

• The women had all been treated in a primary care facility.
• Most women had 4 or more years of recovery.

Here is what these women described lasting recovery as ‘feeling’ like.⁸

Psychological Recovery

• Not having to fight every day. No longer wasting mental energy obsessing about food, exercise, calories, food weights, etc.
• No longer having eating disordered thoughts – or, feeling confident in your ability to stop negative thoughts and choose a better outlook.
• No longer feeling guilty about eating.
• No longer using food to ease stress.

Behavioral Recovery

• No longer restricting or counting calories.
• No binging or purging.
• Eating normal meals every day.
• Eating out whenever you want to.
• Eating without picking food apart.
• Exercising normally (not trying to burn every calorie you take in.)

Social Recovery

• Feeling able to eat in front of others.
• Feeling able to focus on yourself, not just on your eating disorder.
• No more social withdrawal.

Treatment Works: Early Intervention Helps

Treatment works, but for best odds of enduring recovery, early intervention is helpful (before thoughts and behaviors triggering destructive behaviors become too entrenched). Early identification and early treatment initiation, both at the outset and with recurring episodes, reduces the severity, duration and consequences of the disease.⁹

What Is Recovery To You?

Since experts haven't yet reached consensus on a comprehensive definition for long-term recovery, for now, it's up to you and to all the other men, women and teens out there battling every day (and winning these battles) to decide for yourself what your true recovery looks and feels like.

If possible, as a way to help others, please leave a comment below discussing what lasting recovery from eating disorders looks and feels like to you.