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Why Full Eating Disorder Recovery Is Worth Aiming For

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Many people recovering from anorexia might try to achieve the “best of both worlds.” To have challenged some of the behaviors and progressed from a “dangerous zone” where one’s life is compromised, but still be thin, manage to hold down a job and have some semblance of a social life. It seems like an enviable place to be, especially in a culture craving thinness.

But I think this is delusion. It’s actually the worst of both worlds. Your mind is still battling eating disorder thoughts, your body is still being physically compromised and many of the symptoms of your illness remain. And when this happens, you also might not receive the support you need.

So is partial recovery good enough?

The rate of recovery is estimated to be around one-third. But what recovery is seems to remain unclear. Some people believe that you can never fully recover from an eating disorder and that the best you can hope for is “management” of it. While it is true that no “wonder” cure exists, the idea of settling for management is one that encourages partial recovery, and that’s a dangerous place to be in my opinion. Recovery is not something easily defined, and everyone – those struggling and experts – have different opinions.

The blog Your Eatopia suggests three facets that can be used to measure recovery: weight restoration, repair of physical damage and developing new non-restrictive neural patterns in response to usual anxiety triggers. Recovery requires a “healthy” body weight, internal damage to be fixed and more “normal” behaviors around food and better psychological responses to difficult situations. Weight restoration comes first – both in importance and time. The second two might not happen without weight restoration.

Emily T. Troscianko, Ph.D., a Knowledge Exchange Fellow at the University of Oxford, has written extensively about her experience of, and recovery from, anorexia. Her blog, A Hunger Artist, is an inspiring and fascinating source of personal understanding and scientific research. She takes issue with the idea that recovery is not possible, as “there’s no clear evidence for irreversible neurological or cognitive damage post-recovery,” but believes that reaching a minimum BMI acceptable for leaving treatment is not a sign of recovery. She encourages people to “overshoot” before settling on a weight range that works for them. Very few people’s set point is exactly a BMI that is still considered on the “low” side, and constantly measuring your intake and living a life defined by a number is still considered disordered behavior, regardless of whether that number is considered an underweight one. As she says, “Dieting is incompatible with recovery from anorexia, both physically and psychologically.” Gaining weight is challenging, but it is necessary for the brain and body to begin to function once again. If recovery comes with a fully working body, then the fuel needs to be there for it.

One medical study over a six year period found patients were being discharged from the hospital at a BMI that was lower than it should have been, which was leading to a higher readmission rate. Basically, the lower the BMI when exiting support, the greater the chance of relapse, and severe enough relapse to require hospitalization. This demonstrates how reaching this “middle ground” is not really recovery, because there is always such a high chance of slipping back again.

Each relapse can become more difficult to fight back from. The longer the eating disorder remains in place, the more impact it has. The body adapts to being malnourished and ceases body functions that are not “vital” causing amenorrhea, osteoporosis, organ deficiency and endocrine imbalance. Relationships break down, social engagements are difficult, holding down a job or going to school becomes harder and mood is impaired. All this makes life seem tough – and the eating disorder more attractive. The longer an eating disorder goes on, the more entrenched it becomes, and staying in a semi-recovered state is only perpetuating that process of entrenchment.

I would also urge you to find an eating disorder specialist nearby that can help support you throughout your entire recovery journey. That way, “partial recovery” is less likely to happen.

Another study found that those who reached a stage of partial recovery continued to have poor body image, feelings of anxiety and exhibited some eating disorder behaviors. In this research three groups were compared – those who were deemed “fully recovered” (physiologically, psychologically and behaviorally), those partially recovered and those still struggling with their eating disorder. The findings suggested that while “scars” of eating disorders remained in all groups, they were far less in the fully recovered group. 12 percent of the fully recovered group reported that aspects of the eating disorder interfered with psycho-social functioning in the past three months. However, this percentage changes to 40 percent for the partially recovered group and 73 percent for the active eating disorder group.

For people who fall into the category of having a “severe and enduring rating disorder” (generally defined as over five years and over age 26), chances of recovery are lowered. New guidelines suggest that the focus should be on quality of life and social integration rather than weight restoration and regaining a healthy body.

The eating disorder will always be present if it is allowed to be and it can sneak back in the door if it’s left ajar, because that is what partial recovery is. It’s better than dying, sure, but it’s never committing. It’s never letting yourself be free of the illness. It’s trying to reach the wall on one side of the room without letting go of the other.

If your quality of life is impaired because of the presence of eating disorder behaviors in your life, you might not be fully recovered. In my opinion, partial recovery is stopping just before the finish line. Imagine what lies beyond it. It’s hard — really bloody hard. But that doesn’t mean there is no hope. It just means you have to keep pushing forward. Don’t just settle. Live the life you were made for.

This piece was originally published on Recovery Warriors

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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Thinkstock photo via Archv

Originally published: October 23, 2017
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