I think lots of people have their own way to define eating disorder recovery. Today I’m going to do my best to share my view of recovery. As someone who has personally navigated eating disorder recovery and a coach who helps parents get their kids through recovery, my view may help you visualize what recovery might look like for your family.
As you may imagine, the answer varies for each person, so what I’m doing here is giving you some concepts to consider that can help you visualize what recovery may look like for your child.
My daughter has been in treatment for her eating disorder for a few months, and it’s taking a big toll on my family. We’re all scared to trigger her, and we’ve had to make so many changes to our lives for her eating disorder treatment. I’m struggling to work, and my younger son is starting to have angry outbursts because of all the stress in our home.
So I’m wondering: how long will it take for her to recover from this? When will we know that she’s recovered? Do people really recover, or is this a lifelong thing?
Oh, Pat. I totally understand how challenging it is to manage eating disorder recovery, and I can understand your eagerness to move on from this chapter in your life. Having a way to define eating disorder recovery may help you navigate this process.
That said, recovery is unique for each person, so I can’t say what your child’s recovery will look like, but I am going to discuss the three main questions here:
- What is recovery?
- How do you know when your child is recovered?
- How long does it take?
What is recovery?
So first, what is recovery from an eating disorder?
I think of eating disorders as icebergs. We have the area that is above the surface and the area that is below.
At the top of the iceberg we have the disordered behaviors. These may include restricting food, binge eating food, purging food, and over-exercising. You can also put weighing, measuring, and any form of obsessing about, counting or checking of both the body and food in this category.
Next, we have the disordered beliefs about food and body. These may include believing that restriction is healthy and good, that there’s something wrong with their body, that being thin is worth it at any cost, that restriction is healthy and superior, and that more exercise is better.
Then we have disordered thoughts about food and body. These may be thoughts like:
- I need to eat less
- I ate too much today
- I’m going to plan exactly what I will eat each day
- I need to track my food, exercise, and weight constantly
- I can’t eat that
So we have disordered behaviors, beliefs, and thoughts about food and body at the top of the iceberg. This is usually what we are talking about when we talk about eating disorder recovery. We’re looking for a reduction or elimination of these things.
But we can’t forget the elements that lie beneath the surface.
The visible aspects of the eating disorder – behaviors, beliefs, and thoughts – would not exist if there weren’t something beneath the surface. And often the portion of the iceberg that is under the surface is much larger.
So while your child may technically no longer have a diagnosable eating disorder because their behavior, beliefs, and thoughts are in remission, they likely still have something going on under the surface that was supporting the eating disorder.
This may include an anxiety disorder, depression, complex trauma, OCD, PTSD, ADHD, Autism Spectrum Disorder, or other condition that really needs to be treated.
Your child’s providers will likely focus on the behaviors, beliefs, and thoughts that define eating disorders. But treatment will be incomplete if there isn’t also treatment of the underlying factors.
Mental health is a lifetime process. The fact that your child has an eating disorder means that they will likely need ongoing mental health support throughout their life.
We wouldn’t think twice if I said that about physical health – after all, most of us see doctors regularly, both for check ups and when we have a specific problem. We brush our teeth twice per day and see the dentist every six months for a check up.
But we think quite differently about mental health.
I’d like you to consider that your child’s mental health is just like their physical health, and while this intensive recovery from an eating disorder will pass, they should still take care of their mental health at least as frequently as they monitor their physical health.
How do you know when your child is recovered?
Next, how do you know when your child is recovered?
Well, based on the iceberg analogy I just gave, your child’s active eating disorder will be in remission once their behaviors, beliefs, and thoughts are no longer compulsive. What this means is that they may still have occasional urges and thoughts, but they aren’t compulsive and they aren’t impacting daily life.
Your child’s treatment team should be able to tell you when they believe the eating disorder is in remission. But you should also be able to feel it intuitively.
What does this look like? Well, eating will no longer feel like an issue. They won’t hide their bodies or seem upset about their clothes and appearance. They will likely be easier to get along with, more open to you, and more flexible in multiple areas of their lives.
You may distrust your instincts if you didn’t see the eating disorder coming on. Maybe you, like many parents, were surprised by the eating disorder and feel guilty about that.
That’s pretty normal. But it doesn’t mean you can’t trust your instincts. It just means you need to develop a new instinct for whether things are OK with your child.
This is a skill that you can learn. And over time you will be able to trust your intuition about whether something might be up, and you can respond by scheduling a check-in with someone.
Just like you don’t think twice about scheduling regular dental cleanings, you don’t need to think twice about scheduling regular mental health check-ins.
How long does it take?
The million-dollar question is how long does it take? Even when you can define eating disorder recovery, most of us want a timeline for when the worst of it will be over.
And I wish I had an answer for you. I do know that there are a few things that help.
1. Get help for yourself
You can make adjustments to your behavior, beliefs, and thoughts that can really help create a healthy environment for recovery.
You don’t need to do this alone. Parents aren’t responsible for a child’s eating disorder, and we have tremendous opportunities to speed up recovery. I recommend therapy, coaching, or both to help you navigate the knowledge and skills that will help create a pro-recovery environment for your child.
2. Keep your child in treatment
In the beginning, you need a psychotherapist, dietitian, and physician watching your child’s health.
Over time, you may reduce that down to the psychotherapist only. But I don’t recommend ceasing all mental healthcare when the team says the eating disorder is in remission. Because remember the iceberg … we need to keep seeking to understand what is beneath the surface. Create an ongoing mental healthcare plan for your child. This is essential.
3. Release the idea that recovery is black or white
Recovery is not binary, because health is not a binary state.
Our health fluctuates. We don’t expect one dental cleaning to keep our teeth clean for decades. We brush our teeth twice per day and see a dentist every six months. Mental health is similar. We should practice emotional hygiene and seek emotional support regularly. No, it’s not as simple as going to the dentist, but it is actually far more important.
Pat, I realize that so much of what parents learn during their child’s eating disorder is different from what we have learned about health and wellness.
Eating disorders are a wake up call for our families and our society. They combine mental, emotional, and physical health. And when parents use them as opportunities to learn and grow, the whole family can become healthier in every way.
I hope that being able to define what eating disorder recovery might look like for your family is helpful, and I wish you and your family all the best.
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