Eating Disorder Recovery Is Not as Simple as 'Wanting It Enough’

“You just have to want it more, Rachel.”

If I had a penny for every time someone has said those words to me, Bill Gates would be in some serious competition. One of the most frustrating misunderstandings about eating disorders is the idea that someone who is struggling simply needs to “want to get better.” There’s this idea that if they “wanted it enough,” they could stop using behaviors, the urges would dissipate and they’d be able to move on with life. While I understand how, to someone who has not personally experienced an eating disorder, it would be easy to see it this way, I know for myself and for some of my closest friends who have also struggled, it definitely hasn’t worked this way.

While there is definitely an element of choice in recovery (and in the eating disorder itself), at a certain point, when someone is very sick, they lose the ability to make those choices. The eating disorder literally becomes paralyzing. As much as you might want to “get better,” you can’t bring yourself to do the things you know intellectually you need to do, even if you want to.

Three years ago, when things were at their worst for me, my mom asked me almost daily to, “Please, try. Please, don’t give up. Please, eat something.” I remember thinking, I wish I could. I didn’t know how to explain because I really couldn’t understand it myself. How could I hate my eating disorder so much, want recovery so badly and still be stuck? How could I be terrified of dying and simultaneously not able to break my calorie per day limit? It didn’t make sense.

When I would try to tell my mom, I couldn’t. I’d tell her I was just going to die and to please give up on me. She would tell me it didn’t have to be like this. She would tell me this wasn’t cancer. I had a choice! I could choose to fight! I understand how technically, yes, she is right. I mean, I was starving to death in a house well-stocked with food. But I really just couldn’t eat. I wanted to, but I just couldn’t.

I think one of the hardest things for me and for most people to understand and accept is, really and truly, nothing about an eating disorder makes sense. Nothing about an eating disorder is logical. People forget these aren’t choices or lifestyles. An eating disorder is a crippling mental illness. I don’t think anyone with schizophrenia really wants to hear or see things, but wanting not to isn’t enough to make the voices or images go away. You can’t want a mental illness away. You can want recovery and still be too stuck or sick to make the choices needed to achieve recovery.

I think a lot of it can be chalked up to the biological effect of starvation on the brain. I know for me personally, the lower my weight got and the longer I went without eating, the more paralyzing the eating disorder felt. Yes, I wanted things to be different, but I was still too afraid to leave my bedroom because I thought I’d inhale calories from my family’s food. I felt like my brain was broken, and in some ways it really was.

I couldn’t think. I was afraid of everything. The fear felt too real and too paralyzing for me to even consider trying to move past it. Also, I know with each year I continued to struggle, the eating disorder continued to become stronger. Things that wouldn’t have been a big deal for me at the onset of my illness felt impossible to me a year later. Then, those things felt impossible the next year and so on. As the eating disorder grew, my world shrank. My ability to choose recovery shrank, until I really just felt powerless and out of control.

When I did make it to treatment, my doctor had to put me on a certification for involuntary treatment and involuntary tube feedings. Even though I wanted to be there, wanted to get better and even though I was trying, I had continued to lose weight during my first week. I was still restricting several times a day. I remember sitting in her office crying hysterically, begging her not to do it and promising I would eat everything from there on out. I remember asking her to please give me one more chance. She just shook her head and said, “Rachel, I really believe you want to be able to do this. I do. Right now, you’re just too sick, and I need to step in and help you.”

Looking back, I literally owe that woman my life. As much as I wanted to do it, I really just couldn’t at that point. As I began eating and restoring weight, I did become more and more able to make those decisions for myself (and eventually she dropped the certification and I became a voluntary patient). At this point in my recovery, I do feel I have to make a conscious choice at each meal and snack. What do I really want to do right now? Do I want to do what is comfortable or what will move me toward what I value? That ability has come in little bits over a lot of time, a lot of work (and a lot of weight) and through people initially taking the “choice” away from me.

There have been many times in previous treatments when I had been written off as “non-compliant,” “difficult,” “chronic,” or “doesn’t want recovery.” I was told if I didn’t want help, then I wasn’t going to get better. I was told I was just wasting everyone’s time. Looking back, it makes me so sad, because all I needed at the time was for someone to recognize I was just really scared and sick, that I wasn’t “playing games” or “being manipulative.”

No one was able to do that. I understand it would be difficult for someone who hasn’t struggled, because as I said before there is truly nothing about an eating disorder that makes any sort of logical sense. The truth of the matter is the girl who is draining her tube feeds at night and hiding sandwiches in her sweatshirt pockets may really want to get better. She could probably list you off numerous things she wants more than the eating disorder — school, friends and good relationships within her family. She probably really hates the eating disorder and how it keeps her from those things, but she’s sick. So she’ll still do those things anyways.

I’ve followed a handful of treatment centers and eating disorder organizations on both Facebook and Twitter. I feel like when they aren’t posting about being brave enough to wear a bikini or on the evils of the media, they’re posting content to be “motivating.” I suppose these are meant to empower the reader. However, when someone is really sick, it just doesn’t work that way. You can’t “motivate” someone out of it.

Asking someone who is starving to death if they’ll be proud of the choices they made today a year from now isn’t going to help. I remember seeing a quote like this in December. “Make a choice today that your future self will thank you for!” I still couldn’t bring myself to eat.

Given that eating disorders manifest differently from other mental illnesses, I think it’s often easy for people to forget they are still mental illnesses, and not something the person has full control of. The men and women I’ve known who have struggled with eating disorders have been incredibly thoughtful, intelligent, talented and high-achieving people. I think it’s harder for people to understand how a person can have so much insight into other areas of their life, and possess “so much potential,” and yet simultaneously be struggling so much.

I think a lot of people don’t understand you can want recovery and still be terrified of it. This might be something that, if you haven’t struggled personally, could be difficult to understand. (Honestly, it is still difficult for me to understand) There is nothing wrong with you if you still want certain aspects of the eating disorder or if you don’t feel like you’re able to “make yourself want recovery more.” I have really, really struggled with that. In reality, that’s just not how this disease works. There is no such thing as “wanting it enough” to make it happen.

I know it is no small feat, but try to give yourself some compassion for wherever you are in your journey. Try to extend that compassion to others too. I know it can be really hard to see someone sick and struggling and to not see it as a choice they’re making. I know it can be hard to not want to shake them and somehow “make them want recovery enough.” Try to remember the person struggling is undoubtedly already in a lot of pain, and most likely feels a lot of shame around their struggle. They need patience, understanding, and again, compassion, not judgment.

Image via Thinkstock.

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.