The concept of recovery from an eating disorder is vast and at times, controversial. It ranges from the idea of learning to manage the eating disorder, all the way to ‘complete recovery.’ Learning to manage an eating disorder sounds a bit like trying to nail jello to the wall. How exactly does one learn to manage the very thing that is out of one’s control in the first place? If you can ‘manage’ the eating disorder do you actually have one? In my experience, having worked both inpatient and outpatient for almost 20 years, I have come to believe in and embrace ‘full recovery.’ Not every patient or client walks into full recovery but I have been privileged to witness the transformation in many women and men. So basically, as Popeye would say, ‘I believes it because I sees it!’
In a recent research article “Predictors of long-term recovery in anorexia nervosa and bulimia nervosa: data from a 22-year longitudinal study. Journal of Psychiatric Research, 96, 183-188,” there are more facts to help us understand more about recovery. The research study which spanned 22 years, pointed to two predictors of not reaching and maintaining recovery. They were: an initial assessment where major depression and anorexia were comorbid (co-occurring) and secondly, the lower the BMI, the lower the chances of recovery being maintained 22 years later. In other words, if major depression was also present — it needs to be treated successfully, along with the anorexia. It also points to the complicating factors if the BMI/low weight is extreme. It is uncertain if this is because of how lower BMI/weights impact physical, mental and emotional health and a person’s ability to do the work of recovery. We do know that a client/patient needs to recover a certain amount of their brain functioning/cognitive abilities and physical wellness in order to do the psychological work of recovery. With regard to bulimia, the study noted that the only predictor of not being in/maintaining recovery was based on those who continued to have “more weeks of active diagnosable bulimic symptoms during the study.” There are some points that require further investigation to fully comprehend and apply this research but it does give us some positive information.
Treating the co-morbid issues like depression (and anxiety) is essential. Using CBT and DBT is proven to be effective for both of these issues. This will help to address the compounding issues of perfectionism, all or nothing thinking, and inflexibility (found in eating disorders and depression).
This study also points to the importance of treating the whole person with the eating disorder. We cannot do weight restoration for an anorexic and expect them to become well. Nor can we expect that a bulimic who stops purging will be healthy. The intervention must include psychological/clinical intervention (counselling, psycho-education, assessments where appropriate) and medical treatment. The whole person is impacted by an eating disorder — their body, mind, soul and spirit. Therefore the treatment must reach into all those aspects. Weight restoration might need to be done more effectively and then ensure that medical doctors are requiring their patients to do the psychological work of recovery, not to just relieve symptoms or manage them.
In conclusion, when there are has been holistic clinical and medical intervention (including nutritional support through an eating disorder specialist dietician), there is hope! There is a way to find healing and for a person to walk in full recovery from their eating disorder. Every time I get the joy of seeing someone secure this journey, I get pumped! In fact, it’s the very thing that keeps me working with eating disorders. I believe in full recover because I’ve seen it — many, many, many times!
If you are struggling with an eating disorder — don’t give up! Please, reach out and let us help you start on the pathway to recovery. It is worth doing. It’s time for you to get your life back — or possibly ‘get your life’ moving ahead for the first time. Recovery does exist (and you’re not the one person that it won’t work for!)