What to Know About the ‘Early Stages’ of Eating Disorder Recovery

A month after being discharged from the hospital, I’m sitting across from my therapist. I am in a much better position than I was just a few weeks ago. The room no longer spins when I stand, my hair finally stopped falling out, and I don’t rely on a tube to get adequate nutrition and hydration. I have picked up shifts at work and have returned to being a full-time doctoral student. In many ways, I am “better.” But I am not “OK.”

My therapist looks at me with a face of concern and sternness.

“I’m worried that you’re backsliding.”

My response isn’t verbal. I am the type of person whose face reveals all and my face reveals that I completely disagree with what she is saying. I am not argumentative or defensive. I just don’t see what she sees, and that is a central part of the problem. She lists off the reasons she is expressing her concern for a possible relapse: I’ve missed several meals; I’ve returned to the gym without my dietician’s consent; I’ve made food choices out of fear rather than hunger. I hear what she is saying but it’s hard to take in. When you are early in eating disorder recovery, any comment on your progress or choices can feel like an attack. Here I am, getting up every day and functioning. I am not in a hospital. I am not monitored 24/7 by medical and mental health professionals. I am, in many ways, free and fine. In my brain, the brain that I’m still trying to reclaim, that should be enough. But as I’m learning, it’s not.

When I leave my session, I have an hour commute to my internship which gives me plenty of time to think and reflect. I feel a little sad but also very frustrated. I text my friend (hands-free, of course, because safety is number one) and tell her my session was “meh.” I tell her why. I share that my therapist says I am in “dangerous territory” and I am very close to slipping into a full-blown relapse. I say I don’t agree and don’t see the big deal. My friend takes the courageous plunge and asks, “What if, hypothetically, she is 100% correct? Can you entertain that for just a minute?” I reluctantly sigh as my Honda Civic cruises up 95 North toward Boston. I agree to entertain this idea. I try my best to look at the situation objectively and without judgment.

My eating disorder kicks in before I can really analyze the situation and I hear myself say out loud, “I’m eating, I’m fine.” My friend, who God bless her soul has been so patient and supportive through my many ups and downs of recovery, hits me with the facts: “It’s not all about eating. You know that. Your exercise, your habits, your thinking, your openness, your perspective.” She explains to me how, as unfair as it may seem, I do not have the luxury of missing a meal or just going to the gym without it potentially turning into me diving headfirst into the rabbit hole. I have to be intentional. Always.

As I take this in and realize metabolize it, I notice something: I’m upset. I’m scared. I’m sad. I’m annoyed. I’m angry. I admit I have no idea how I’m supposed to do it all. I do not, for the life of me, know how to prioritize recovery when I have so many other responsibilities. My friend is right. Recovery is not just about eating. It is about everything. Yes, eating is the priority because, without nutrition, everything else falls to the wayside. But when you’re in recovery and really trying to make it work, you have to be aware. You have to notice your thoughts and challenge those thoughts. You have to talk yourself off of the ledge (sometimes multiple times per day). You have to admit when you’re struggling and allow yourself to feel pride when you overcome a challenge. You have to retrain your brain and try to make peace with your body. You have to plan your meals and make sure you are meeting all of your meal plan requirements. You have to balance your coffee consumption with water consumption because dehydration is a giant part of your eating disorder. You have to force yourself to be social when the eating disorder tells you that going out will lead to a total loss of control. You have to tell the truth when someone asks how you’re doing.

I’ve found that most people don’t talk about the early stages of eating disorder recovery. More specifically, they don’t talk about the anger that comes up when you accept just how diligent and committed you have to be. It is very easy to live in denial and allow yourself little slips: a missed meal here, an extra run there. Living in denial is your prerogative; it’s mine as well. But following that path has led me to two treatment stays in six months, my family’s lack of trust in me and an indescribable feeling of exhaustion toward life. Nobody told me that recovery was going to be a full-time job. Nobody told me it was normal to be angry about that. Each day I have to wake up with the intention of fighting this disorder at every snack, every meal, every negative and insidious thought that pops into my recovering brain. I have to take ownership of the choices I make while asking for help and support when it all feels like too much. I hope people find comfort in this: the fact that recovery is really goddam hard and exhausting. It is OK to hate this process, especially at first. For me, hating it means I am in it and working it and accepting it, and that’s where true recovery starts to happen.