Recovery from an eating disorder means different things to different people.
For many people, recovery from an eating disorder signifies an end to eating disorder thoughts, feelings and behaviours and improved physical and psychological wellbeing. This may mean engaging or re-engaging with social activities, hobbies, and daily life. For others, recovery may be an ongoing process.
No set pace
There is no set time for recovery and it is common for the recovery process to slow or stop at times, or for a person to experience lapses or relapses in their eating disorder behaviours and/or thoughts. Recovery is rarely a linear process. While setbacks can be incredibly frustrating, it can help to remember that they are common to the recovery experience and often provide valuable information to assist in continuing towards recovery. Setbacks can enable a person and their care team to identify new recovery areas and skills to work on. Developing new skills can enhance confidence and strengthen recovery.
Viewing recovery as a process rather than an end goal may be helpful. Focusing on recovery as a finite end point may make recovery seem continually ‘out of reach’ and opportunities to recognise and celebrate progress may be missed.
The pace and nature of each person’s recovery will depend on their individual circumstances, including the treatments and the support they receive. Recovery can also be impacted by systemic or societal factors, such as affordability of treatment and support services, cultural safety and responsiveness of services, and the presence and compounding impacts of stigma and inequality.
Key components of recovery
While definitions of recovery are often deeply personal and by nature highly individual and varied, in general, recovery includes nutritional, physical, psychological, functional and social elements.
Nutritional recovery involves eating a variety of foods from all food groups, eating an appropriate quantity of food to meet individual health, development and activity requirements, and responding to the body’s hunger and satiety cues. For some people who experience difficulties with perception of the body’s internal state (such as level of hunger or satiety), a focus on regularity of eating may be more helpful than a focus on hunger and satiety. Nutritional recovery also involves eating with flexibility, eating socially, and for enjoyment and pleasure.
Physical recovery is typically associated with improvement of the physical complications associated with an eating disorder, and restoration or stabilisation of weight where relevant. Physical recovery may also be defined by improvements in physical observations such as heart rate and blood pressure, body temperature, gastrointestinal function, and hormonal function.
As someone experiencing an eating disorder begins to recover psychologically, they may describe experiencing less distress or anxiety associated with their body, food or exercise, or a reduction in how much their feelings of self-worth might be impacted/influenced by their eating, weight or body shape. For some people, improvements in their eating disorder thoughts, feelings and behaviours can temporarily exacerbate co-occurring conditions such as depression, anxiety or substance misuse. While this may be frustrating to experience, it provides valuable information for the person and their care team about new recovery areas and skills to focus on. Assessing psychological recovery may include measures of quality of life, or a reduction in co-occurring conditions such as depression and anxiety, as well as the person’s own reflections about how they feel.
People will often experience functional improvements in their life as they recover from an eating disorder, including higher energy levels, improved sleep, improved concentration and memory, and an ability to be more engaged with study, work and social activities.
As a person experiencing an eating disorder moves through recovery, they may notice many improvements in the social domain of their life. This can include being able to engage in more social activities with friends in a flexible and spontaneous way, such as choosing to eat out or go to see a film, which may have previously been impeded by a strict exercise regime, food rules or body-related distress. People may also begin to experience improvements in their relationships, and increased feelings of belonging and social connectedness.
Early treatment leads to better outcomes
Evidence suggests that the sooner a person starts treatment for an eating disorder, the shorter the recovery process will likely be. Early and targeted care will improve the likelihood of positive treatment outcomes for people experiencing an eating disorder. However, it is possible to recover from an eating disorder, regardless of how long the person has experienced their eating disorder.
Lived experience perspectives on key components of the recovery process
People who have recovered from an eating disorder have identified the following themes as being key components of their recovery process:
Support: support, advice, and encouragement from others can provide a valuable sense of connection and decrease feelings of isolation
Hope: having a sense of hope can support motivation to seek help and to persist in the face of challenge in recovery
Self-compassion: practising self-compassion, self-acceptance, and connecting to and expressing emotions – positive or negative – can support recovery
Identity: spending time reconnecting with prior interests, or developing new interests, can help to build or rediscover a sense of meaning and identity outside of the eating disorder
Meaning and purpose: developing a sense of purpose and meaning outside of the eating disorder can help to shift focus towards and build these important areas
Empowerment: developing a sense of independence and autonomy can build confidence to make important changes and engage in the recovery process.
Adapted from: Wetzler S, Hackmann C, Peryer G, Clayman K, Friedman D, Saffran K, Silver J, Swarbrick M, Magill E, van Furth EF, Pike KM. A framework to conceptualize personal recovery from eating disorders: A systematic review and qualitative meta‐synthesis of perspectives from individuals with lived experience. International Journal of Eating Disorders. 2020;53(8):1188-203.
If you think that you or someone you know may be experiencing an eating disorder, it is important to seek help immediately. The earlier you seek help the closer you are to recovery. Your GP is a good ‘first base’ to seek support and access eating disorder treatment.
To find help in your local area go to NEDC Support and Services.