Food for Recovery Thought

A recent article in the New York Times today gives an important overview of the many different definitions of recovery from anorexia. Also, the article is sure to spark debate among ED veterans, professionals, and families about just how elusive recovery really is.

I was quoted in the piece with some of the perspective I've gained while working on my new book Restoring Our Bodies, Reclaiming Our Lives. Although it's not clear from the quotes, I'm actually a true believer in FULL recovery, both physical and psychological. I applaud Ellin for highlighting the cognitive, emotional and other psychological aspects of recovery, in addition to the gains of weight stabilization and healthy eating behavior.

She and I talked at some length about the role of the insurance industry in "restricting" the definition of recovery in order to deny coverage for extended treatment. Space constraints prevented her from examining this critical issue, but I hope the Times will pursue it in another article.

I am a little concerned, though, that readers may view this article as bad news for those in recovery. To brighten the picture, I'd just like to stress a few important points that did not make it into the piece:

• 1. The sooner you begin treatment with a professional eating disorder specialist, and the more you yourself genuinely want to recover, the greater your chances will be for full recovery.
• 2. No one can agree on a single timeline or pattern for recovery, because every case is different. The time it takes to recover will necessarily depend on age, physical condition, the degree of severity and duration of the illness, the quality and duration of treatment, and the strength and health of relationships and support networks -- among other factors.
• 3. This article focuses on anorexia nervosa -- implicitly, restricting anorexia -- which has the highest level of genetic vulnerability of all the EDs, and is the most difficult to treat. That said, restricting anorexia nervosa also represents the smallest piece of the eating disorder "pie." Vastly more people wrestle with binge eating, bulimia, and EDNOS. It's unfortunate that the article did not have a broader focus, since the prognosis for full physical and psychological recovery is much more encouraging for these other eating disorders.

Personally, I absolutely consider myself fully recovered. The key for me lay in recognizing that the half-life of eating disorders -- free of food obsessions and compulsions but still mired in self-criticism and perfectionistic thinking -- is far from a full life of health. As long as I remained stuck in the half-life, I remained vulnerable to relapse. Writing my last book, "Gaining," and working with an extremely gifted therapist on my whole life's health helped me reach full recovery at last.

Fortunately, more and more ED therapists now take a much more holistic view of treatment and of health. As a result, many of the contributors to my new book also consider themselves fully recovered. I hope you will find wisdom and inspiration in their words. Recovery really is within reach.

 

 

 

Comments

[NotEve]

04:48 PM on 05/04/2011

Ms. Liu, thank you for your perspective and the link to the TIMES article. We just had a series of lectures (I'm in med sch) covering eating disorders, and anorexia nervosa specifically. It's very interesting to hear your personal perspective and I'm pleased that it jived so well with what I'm being taught.

I don't have much time for personal reading, but I'll be adding your book to my list.

[nohtaram247]

11:11 PM on 05/01/2011

I have struggled with eating disorders for the past 16 years and I am not convinced that full recovery is possible. When I was 15 I became severely anorexic and, at 5'9" and 65 pounds, I was literally days away from death. I am still not certain where the will to live came from, but I had a deeply spiritual experience that helped me to regain some of my health, but never a full recovery. I do wonder, however, if I had experienced a more holistic treatment if things would have turned out differently. At the time that I was undergoing in-patient treatment, the focus was on my weight (which was understandable considering how malnourished I was). I never learned about nutrition or received the psychological help that equipped with coping mechanisms that did not involve starving, purging, overexercising, etc.

Today I am among the silent sufferers. My weight is stable so I do not "look" anorexic, but my head is wedged in a dark hell of disorder and chaos . . . after many attempts, I cannot slay the eating disorder. I seriously do hope that people experience a full recovery. But I do wonder if eating disorders are more akin to alcoholism - once an alcoholic, in a sense, always an alcoholic. I view my eating disorder as sometimes hibernating and sometimes violently active. But because I do not "wear" it like I did when I was 65 pounds, no one knows how crushing it is.

[William Anderson LMHC]

08:42 AM on 04/29/2011

While I too consider myself fully recovered, I think that the time it takes for full recovery is the rest of our lives. Living well is a matter of intentionally living well each day. We're never done. I have always been at odds with many other eating disorders experts and it is important to consider that those experts were always oriented to Anorexia Nervosa and Bulimia Nervosa. What they proclaimed as factual about disordered eating and recovery never jibed with my experience. My eating disorder was overeating, compulsive overeating, Binge Eating Disorder, and the resultant chronic obesity and diet craziness, EDNOS. All eating disorders are not the same, all recovery truths are not the same, and most eating disorders specialists fail to recognize this. Keep up the good work. While I do not agree that other eating disorders have a more encouraging prognosis of full recovery, I know that Anorexia Nervosa is more immediately lethal, and most needful of and emergency medical treatment and follow up. Other eating disorders may present the illusion of more recovery because we have accepted that relapse and disorder is the norm. We do not look upon the unhappy obese people, which we have an epidemic of, with the same sense of treatment failure as the Anorexic patient who we have failed. But simply being alive and suffering quietly with disorder, not complaining and not in the ER, is not the same as recovered.

William Anderson, LMHC, author of 'The Anderson Method', www.TheAndersonMethod.com