What Makes Anorexia Recovery Different

At this point in my eating disorder recovery, I often find myself consulting a friend who has been sober for five years. She gets it. She’s experienced addiction. It tore her life apart. She worked hard, and now, she is on the other side. Her insights have been invaluable, and I owe her more recognition than words.

As a special educator, I study human behavior at length. The cyclical patterns of behavior present in anorexia have been a long-standing interest of mine. It’s exciting to see research is beginning to focus on new methods to change the thought patterns and behaviors of individuals living with anorexia.

Psychology Today defines an addiction as a condition that results when a person ingests a substance or engages in an activity that can be pleasurable, but the continued use or act (of the substance or activity) becomes compulsive and interferes with ordinary life responsibilities. While anorexia is not clinically recognized as an addictive disorder, one could argue the symptomology and the level of impairment of people with anorexia equate to a clinically significant obsession or addiction.

The behavioral change process is a growing phenomenon in our society. A common misconception is all behavior change is aimed at decreasing or eliminating a behavior. Cutting out foods, spending less money and reducing bad habits are all examples of decreasing behaviors. Unsurprisingly, the behaviors of people with addictions, alcoholism and bulimia all fall into this category. With each of these addictions, one must eliminate or reduce a targeted behavior.

This is what separates anorexia recovery from recovery of similar illnesses. For individuals with anorexia, rather than focus on the elimination of a behavior, an individual must significantly increase his or her energy. This not only includes consuming a greater quantity, but also a larger variety of foods and nutrients. Herein lies the dichotomy of this mental illness. No other addiction-based illness requires an individual to actively increase a single aversive behavior.

One could argue individuals with anxiety and depressive disorders must engage in non-preferred behaviors to manage their illnesses, too. For example, someone with depression may need to increase his amount of time out of bed, while someone with an anxiety disorder must increase her socialization. While these disorders require the individuals affected to engage in new behaviors, symptomologies associated with these disorders present in various ways with no single solution. No other mental illness requires those in recovery to increase a single, specific behavior without alternative options.

So, what does all this mean? Why does this matter? The treatment of anorexia is different. Individuals impacted must constantly come in contact with their addiction every day. While people recovering from alcoholism, drug use and bulimia can go “cold-turkey” and avoid their addiction, someone with anorexia must actively engage in a non-preferred behavior to cure their illness. This is not to say treating anorexia is easier or more challenging than treating substance abuse or other mental illnesses. It is just different.

In my opinion, this makes anorexia recovery exhausting. Every day, several times a day, I must make an active choice to eat. I must engage in a behavior I despise. I cannot avoid my fear or numb it; I must face it head on. I must learn to tolerate and then accept eating meals and gaining weight.

While it can become easier, the demand never fully goes away. This is an unbelievably terrifying realization. There are no days off or breaks. There is no finish line. I must continue to eat three meals a day for the rest of my life. In these moments when doubt and uncertainty creep in, I look to my sober friend and think: If you can eliminate liquor completely, I can choose to keep eating completely, too.

If you or a loved one is affected by addiction and need help, you can call SAMHSA‘s hotline at 1-800-662-4357.

 If you or someone you know is struggling with an eating disorder, you can call the National Eating Disorders Association Helpline at 1-800-931-2237.

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