The Importance of Full Recovery in Eating Disorder Treatment - Dr. Ashley Solomon
“I'd made it this far and refused to give up because all my life I had always finished the race.”
― Louis Zamperini, Olympian, WWII Prisoner of War, and the subject of the film Unbroken
A few months ago I visited a funhouse at a local entertainment center. It had everything that you’d expect: optical illusions that made things appear larger or smaller than they were, creepy photos hanging on walls that made it look like eyes were following you, paths that turned out to be walls and walls that turned out to be paths. And something struck me as I was navigating my way through the funhouse (which really is a term better suited for other visitors who particularly liked being turned around in circles and utterly confused!):
The road to eating disorder recovery can feel a bit like a funhouse; it can be a disorienting maze where you question whether an end really exists. And if there is an end, can you ever really find your way there?
When you are deep in the maze of recovery, the idea of taking a shortcut or giving up entirely can seem overwhelmingly attractive. I understand why some people look at the long road to full recovery and say, “You know what? I think I’m good right here.”
Many fight eating disorder illnesses for years. By the time they are able to access treatment, energy, motivation, support and resources can be limited.
I’ve worked with many patients who make initial progress in treatment, and then struggle to keep going. They begin to restore their weight or decrease their binge eating, and then they start to panic. They recognized that the recovery maze was longer than their initial estimation. There were obstacles that they didn’t anticipate, and they started to doubt their own ability to make it through. My job was to help them see that there was a way out of the maze. My job was to help them see that the strength, creativity and tenacity to make it through was within them and also within the people that loved them.
Finishing the work of eating disorder treatment and achieving full recovery is not only possible, it is imperative.
People with eating disorders have the best chances for positive outcomes when they achieve full recovery. This means achieving full remission of symptoms and restoration of body weight and physical function. In fact, research dating back all the way to the 1940s, and that has been built upon since, tells us that the body, after being in a malnourished state, requires full refeeding to achieve an optimal state of functioning. The body – and mind – also require practice to create the new neural pathways that will foster new ways of eating and living.
A colleague of mine often uses the example of writing with our non-dominant hand. If we are asked to do this after being given a pen for a day or a week, we’d feel it was impossible. But if given the opportunity to practice, to create muscle memory, it might not be comfortable – or even our preference, but we’d get better and better.
It can be tempting to think that a reduction in symptoms or restoring some weight is enough. We may say, “I’m better than I was before, right?”
But the reality is that full recovery takes time. It takes dedication – on the part of the individual in treatment, the family, and the treatment team. And it takes everyone seeing it through to completion.
Barriers to eating disorder treatment
Sadly, there are sometimes serious barriers in seeing eating disorder recovery through to completion. Insurance carriers may stop authorizing treatment or people may lack sick/medical leave from their jobs. These stressors come up against the challenges in motivation and insight of the illness itself, and can make for a deadly combination.
So what do we do?
We advocate for our loved ones and for ourselves to get the best care by making our voices heard. We support the work of important foundations that help individuals access care. And we can cheer ourselves and our loved ones on. We cheer on those who are doing the hard, brave work of making their way through this difficult maze of recovery.
And last, for those of us not in the trenches of the eating disorder, we hold hope for all of those individuals who are just starting their journey, those who are just entering the funhouse, confused and afraid, and not believing that there’s really a way out.
We know that there is a way out. From where we stand, we can see the exit and have the chance to be a voice guiding them to it.
Ashley Solomon, PsyD, CEDS, Executive Clinical Director at Eating Recovery Center, Ohio, emphasizes the importance of finishing the work of eating disorder treatment — and why full recovery is necessary.