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Eating Disorder Treatment and Recovery

How to Overcome Anorexia or Bulimia and Gain True Self-Confidence

Woman in bathroom eying scale

The inner voices of anorexia and bulimia whisper that you'll never be happy until you lose weight, that your worth is measured by how you look. But the truth is that happiness and self-esteem come from loving yourself for who you truly are—and that's only possible with recovery. And while it may seem like there's no escape from your eating disorder, recovery is within your reach. With treatment, support, and these self-help strategies, you can find healthier ways to cope with negative feelings, overcome your eating disorder, and gain true self-confidence.

How do I begin recovery from an eating disorder?

The road to recovery from an eating disorder starts with admitting you have a problem. This admission can be tough, especially if you’re still clinging to the belief—even in the back of your mind—that weight loss is the key to your happiness, confidence, and success. Even when you finally understand this isn’t true, old habits are still hard to break.

The good news is that the behaviors you’ve learned can also be unlearned. Just as anyone can develop an eating disorder, so too, anyone can get better. However, overcoming an eating disorder is about more than giving up unhealthy eating behaviors. It’s also about learning new ways to cope with emotional pain and rediscovering who you are beyond your eating habits, weight, and body image.

True recovery from an eating disorder involves learning to:

  • Listen to your feelings.
  • Listen to your body.
  • Accept yourself.
  • Love yourself.

This may seem like a lot to tackle, but just remember that you’re not alone. Help is out there and with the right support and guidance, you can break free from your eating disorder’s destructive pattern, regain your health, and find the joy in life again.

Reach out for support

Once you’ve decided to make a change, opening up about the problem is an important step on the road to recovery. It can feel scary or embarrassing to seek help for an eating disorder, so it’s important to choose someone who will be supportive and truly listen without judging you or rejecting you. This could be a close friend or family member or a youth leader, teacher, or school counselor you trust. Or you may be more comfortable confiding in a therapist or doctor.

Choose the right time and place. There are no hard and fast rules for telling someone about your eating disorder. But be mindful about choosing the right time and place—ideally somewhere private where you won’t be rushed or interrupted.

Starting the conversation. This can be the hardest part. One way to start is by simply saying, “I’ve got something important to tell you. It’s difficult for me to talk about this, so it would mean a lot if you’d be patient and hear me out.” From there, you may want to talk about when your eating disorder started, the feelings, thoughts, and behaviors involved, and how the disorder has impacted you.

Be patient. Your friend or family member will have their own emotional reaction to learning about your eating disorder. They may feel shocked, helpless, confused, sad, or even angry. They may not know how to respond or help you. Give them time to digest what you’re telling them. It’s also important to educate them about your specific eating disorder.

Be specific about how the person can best support you. For example, you may want them to help you find treatment, accompany you to see a doctor, check in with you regularly about how you’re feeling, or find some other way of supporting your recovery (without turning into the food police).

Eating disorder support groups

While family and friends can be a huge help in providing support, you may also want to join an eating disorder support group. They provide a safe environment where you can talk freely about your eating disorder and get advice and support from people who know what you’re going through.

There are many types of eating disorder support groups. Some are led by professional therapists, while others are moderated by trained volunteers or people who have recovered from an eating disorder. You can find online anorexia and bulimia support groups, chat rooms, and forums. These can be particularly helpful if you’re not ready to seek face-to-face help or you don’t have a support group in your area.

For help finding an eating disorder support group:

  • Ask your doctor or therapist for a referral
  • Call local hospitals and universities
  • Call local eating disorder centers and clinics
  • Visit your school's counseling center
  • Call a helpline listed in the Resources section below

Getting treatment for an eating disorder

While there are a variety of different treatment options available for those struggling with eating disorders, it is important to find the treatment, or combination of treatments, that works best for you.

Effective treatment should address more than just your symptoms and destructive eating habits. It should also address the root causes of the problem—the emotional triggers that lead to disordered eating and your difficulty coping with stress, anxiety, fear, sadness, or other uncomfortable emotions.

Step 1: Assemble your treatment team

Because eating disorders have serious emotional, medical, and nutritional consequences, it’s important to have a team of professionals that can address every aspect of your problem. As you search, focus on finding the right fit—professionals who make you feel comfortable, accepted, and safe.

To find an eating disorder treatment specialist in your area:

  • Ask your primary care doctor for a referral
  • Check with your local hospitals or medical centers
  • Ask your school counselor or nurse
  • Call a helpline listed in the Resources section below

Step 2: Address health problems

Eating disorders can be deadly—and not just if you’re drastically underweight. Your health may be in danger, even if you only occasionally fast, binge, or purge, so it’s important to get a full medical evaluation. If the evaluation reveals health problems, they should take priority. Nothing is more important than your well-being. If you’re suffering from any life-threatening problem, you may need to be hospitalized in order to keep you safe.

Step 3: Make a long-term treatment plan

Once your health problems are under control, you and your treatment team can work on a long-term recovery plan. Your treatment plan may include:

Individual or group therapy. Therapy can help you explore the issues underlying your eating disorder, improve your self-esteem, and learn healthy ways of responding to stress and emotional pain. Different therapists have different methods, so it is important to discuss with them your goals in working towards recovery.

Family therapy. Family therapy can help you and your family members explore how the eating disorder is affecting your relationships—and how various family dynamics may be contributing to the problem or impeding recovery. Together, you’ll work to improve communication, respect, and support.

Nutritional counseling. The goal of a nutritionist or dietician is to help you incorporate healthy eating behaviors into your everyday life. A nutritionist can’t change your habits overnight, but over a period of time you can learn to develop a healthier relationship with food.

Medical monitoring. Often, treatment will include regular monitoring by a medical doctor to make sure your health is not in danger. This may include regular weigh-ins, blood tests, and other health screenings.

Residential treatment. In rare cases, you may need more support than can be provided on an outpatient basis. Residential treatment programs offer around-the-clock care and monitoring to get you back on track. The goal is to get you stable enough to continue treatment at home.

Step 4: Learn self-help strategies

While seeking professional help is important, don't underestimate your own role in recovery. The more motivated you are to understand while you developed an eating disorder, and to learn healthier coping skills, the quicker you will see change and healing. The following tips can help:

Self-help tip 1: Learn healthier ways to cope with emotional pain

It may seem like eating disorders are all about food—after all, your rules and fears about dieting and weight have taken over your life. But food itself isn’t the real problem. Disordered eating is a coping mechanism for stress or other unpleasant emotions. You may refuse food to feel in control, binge for comfort, or purge to punish yourself, for example. But whatever need your eating disorder fulfills in your life, you can learn healthier ways to cope with negative emotions and deal with life’s challenges.

The first step is figuring out what’s really going on inside. Are you upset about something? Depressed? Stressed out? Lonely? Is there an intense feeling you’re trying to avoid? Are you eating to calm down, comfort yourself, or to relieve boredom? Once you identify the emotion you’re experiencing, you can choose a positive alternative to starving or stuffing yourself.

Here are a few suggestions to get you started:

  • Call a friend
  • Listen to music
  • Play with a pet
  • Read a good book
  • Take a walk
  • Write in a journal
  • Go to the movies
  • Get out into nature
  • Play a favorite game
  • Do something helpful for someone else
Coping with anorexia and bulimia: Emotional Do's and Don'ts
Do...
  • allow yourself to be vulnerable with people you trust
  • fully experience every emotion
  • be open and accepting of all your emotions
  • use people to comfort you when you feel bad, instead of focusing on food
  • let your emotions come and go as they please, without fear
Don't...
  • pretend you don’t feel anything when you do
  • let people shame or humiliate you for having or expressing feelings
  • avoid feelings because they make you uncomfortable
  • worry about your feelings making you fall apart
  • focus on food when you're experiencing a painful emotion

Adapted from: The Food and Feelings Workbook, by Karin R. Koeing, Gurze Books

Tip 2: Develop a balanced relationship with food

Even though food itself is not the problem, developing a healthier relationship with it is essential to your recovery. Most people with eating disorders struggle with issues of control when it comes to food—often fluctuating between strict rules and chaos. The goal is to find a balance.

Let go of rigid eating rules. Strict rules about food and eating fuel eating disorders, so it’s important to replace them with healthier ones. For example, if you have a rule forbidding all desserts, change it into a less rigid guideline such as, “I won’t eat dessert every day.” You won’t gain weight by enjoying an occasional ice cream or cookie.

Don’t diet. The more you restrict food, the more likely it is that you’ll become preoccupied, and even obsessed, with it. So instead of focusing on what you “shouldn’t” eat, focus on nutritious foods that will energize you and make your body strong. Think of food as fuel for your body. Your body knows when the tank is low, so listen to it. Eat when you’re truly hungry, then stop when you’re full.

Stick to a regular eating schedule. You may be used to skipping meals or fasting for long stretches. But when you starve yourself, food becomes all you think about. To avoid this preoccupation, try to eat every three hours. Plan ahead for meals and snacks, and don’t skip!

Learn to listen to your body. If you have an eating disorder, you’ve learned to ignore your body’s hunger and fullness signals. You may not even recognize them anymore. The goal is to get back in touch with these internal cues, so you can eat based on your physiological needs, not your emotions.

Tip 3: Learn to accept and love yourself as you are

When you base your self-worth on physical appearance alone, you’re ignoring all the other qualities, accomplishments, and abilities that make you beautiful. Think about your friends and family members. Do they love you for the way you look or who you are? Chances are, your appearance ranks low on the list of what they love about you—and you probably feel the same about them. So why does it top your own list?

Placing too much importance on how you look leads to low self-esteem and insecurity. But you can learn to see yourself in a positive, balanced way:

Make a list of your positive qualities. Think of all the things you like about yourself. Are you smart? Kind? Creative? Loyal? Funny? What would others say are your good qualities? Include your talents, skills, and achievements. Also, think about negative qualities you DON’T have.

Stop body checking. Pinching for fatness, continually weighing yourself, or trying on too-small clothes only magnifies a negative self-view and gives you a distorted image of what you really look like. We are all very bad at detecting visual changes in ourselves. Your goal right now is to learn to accept yourself—and that shouldn't depend on a number on the scale or a perceived flaw you think you see in the mirror.

Avoid “fat talk.” It’s something many of us take part in without even noticing. Perhaps we make self-deprecating jokes about our appearance, criticize a celebrity for gaining a few pounds, or when we greet friends, we focus on how they look—their new outfit or newly toned physique, for example. But focusing on appearance—our own or others—only leads to feelings of body dissatisfaction. Instead of telling others, “You look great!” try focusing on something other than appearance, such as “You seem really happy!” And avoid spending time with people intent on judging others by their looks.

Challenge negative self-talk. We all have negative thoughts about our appearance from time to time. The important thing is not to base your self-worth on these thoughts. Instead, when you catch yourself being self-critical or pessimistic, stop and challenge the negative thought. Ask yourself what evidence you have to support the idea. What is the evidence against it? Just because you believe something, doesn’t mean it’s true.

Tips to improve your body image

Dress for yourself, not others. You should feel good in what you wear. Pick clothes that express your personality and make you feel comfortable and confident.

Stop comparing yourself to others. Even people without an eating disorder experience feelings of anxiety and inferiority when they compare themselves to others on social media. People exaggerate the positive aspects of their lives on Facebook, Instagram and the like, brushing over their flaws and the doubts and disappointments that we all experience. If necessary, take a break from social media—and toss the fashion magazines. Even when you realize that the images are pure Photoshopped fantasy, they can still trigger feelings of insecurity. Stay away until you're confident they won't undermine your self-acceptance.

Pamper your body. Instead of treating your body like the enemy, look at it as something precious. Pamper yourself with a massage, manicure, facial, a candlelight bath, or a scented lotion or perfume that makes you happy.

Stay active. While it's important not to overdo it with exercise, staying active is good for both your mental and physical well-being. The key is to differentiate between compulsive exercise—which is rule-driven, weight-focused, and rigid—and healthy exercise that is rule-free, fun, and flexible. Focus on activities you enjoy and do them because they improve your mood, not because they might change how you look. Outdoor activities can be especially good at boosting your sense of well-being.

Tip 4: Avoid relapse

The work of eating disorder recovery doesn’t end once you’ve adopted healthier habits. It’s important to take steps to maintain your progress and prevent relapse.

Develop a solid support system. Surround yourself with people who support you and want to see you healthy and happy. Avoid people who drain your energy, encourage disordered eating behaviors, or make you feel bad about yourself.

Identify your "triggers." Are you more likely to revert to your old, destructive behaviors during the holidays, exam week, or swimsuit season? Or are difficulties at work or in your relationship likely to trigger your disordered eating habits? Know what your early warning signs are, and have a plan for dealing with them, such as going to therapy more often or asking for extra support from family and friends.

Avoid pro-ana and pro-mia websites. Don't visit websites that promote or glorify anorexia and bulimia. These sites are run by people who want excuses to continue down their destructive path. The "support" they offer is dangerous and will only get in the way of your recovery.

Keep a journal. Writing in a daily journal can help you keep tabs on your thoughts, emotions, and behaviors. If you notice that you're slipping back into negative patterns, take action immediately.

Stick with your eating disorder treatment plan. Don't neglect therapy or other components of your treatment, even if you're doing better. Follow the recommendations of your treatment team.

Fill your life with positive activities. Make time for activities that bring you joy and fulfillment. Try something you've always wanted to do, develop a new skill, pick up a fun hobby, or volunteer in your community. The more rewarding your life, the less desire you'll have to focus on food and weight.

If you do lapse, don’t beat yourself up. Recovery is a process—and that often involves setbacks. Don’t let feelings of guilt or shame derail your recovery, but think about how you’ll handle the same situation next time. Remember: One brief lapse doesn’t have to turn into a full-blown relapse.

Recommended reading

Almost Anorexic – Harvard Health Books

Treatment – National Eating Disorders Association

Eating Disorder Treatment: Know Your Options – Mayo Clinic

Helplines for eating disorders

U.S.: National Eating Disorders Association, 1-800-931-2237

UK: Beat Eating Disorders, 0345 643 1414

Australia: Butterfly Foundation for Eating Disorders, 1800 33 4673

Canada: National Eating Disorder Information Centre, 1-866-633-4220

Authors: Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D. Last updated: September 2018.

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