Defining Recovery

Reviewed by Millie Plotkin, MLS

Bardone-Cone, A. M., Hunt, R. A., & Watson, H. J. (2018). An overview of conceptualizations of eating disorder recovery, recent findings, and future directions. Current Psychiatry Reports, 20(9), 79.

https://doi.org/10.1007/s11920-018-0932-9

This article reviews the literature on concepts and operationalization of eating disorder recovery, focusing on publications since 2016. The authors discuss the varied measures used to quantify research on recovery, which may include BMI, abstinence from behaviors, improvement of body image disturbances, and/or psychiatric status. They identify the conflicts in defining recovery, such as minimum duration of abstinence, lack of diversity in samples, predictors of successful recovery, and neurobiological markers. Lastly, the authors propose future directions for bringing the field together to create a consensus on defining recovery.

Why is This Important?

Despite the fact that the end goal of treatment for eating disorders is full recovery, the field has not come agreement on how to define what “recovery” is. Attempts to create meaningful measures have often not included patient perspectives in the discussions. This has led to definitions focusing more on the physical and behavioral aspects of recovery, while minimizing or leaving out the role of psychological/cognitive recovery. Patients identified as recovered by these measures while still retaining disordered cognitions are more likely to relapse. Attempts to determine treatment effectiveness lose meaning when different studies do not have consistency in criteria.

It is notable that this article does not include the controversy about whether weight loss should be included in defining recovery from binge eating disorder. However, the authors point out that the vast majority of studies on recovery are only looking at patients with anorexia nervosa. More research on BED will help with identifying key factors in recovery.