Working towards recovery

‘You can be extremely ill and you can come through it and it can be fine. Because if I can do it, really anybody can do it.’ -Steph

Most of the young people we spoke with considered themselves to be recovered or ‘on the road to recovery’. Getting better was often a slow process and not ‘a straight line’; it could involve relapses. For some people, recovery meant being ‘completely recovered’ in body and mind. For others recovery was about learning to control thoughts and behaviours associated with an eating disorder in a way that didn’t limit their lives.

Why get better?

‘The best thing to do if you want to get better is to admit that you’re ill.’ -Eva

Often people with an eating disorder don’t want to get better or didn’t know how. People didn’t always feel they were ill. Over months or years, people had developed thoughts and behaviours which had become very important to their lives and who they were and letting go was described as ‘scary’. . . Not feeling ‘ready’ to get better could mean being treated for a long time without success. Often people described the decision to want to get better as sudden; Felicity had ‘a light bulb moment’, Hannah Z said, ‘Something switched,’ in her mind and Steph ‘woke up one morning’ and decided to eat some breakfast.

At first, Laura felt that recovery was scary because she had to relearn what normal was.

Age at interview 18

Gender Female

Age at diagnosis 18

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The key to recovery was finding a reason to want to get better. When people realised they weren’t ‘getting anything’ from the eating disorder anymore, or how much of their lives was taken over, they could feel able to start getting better.
Sometimes a health scare, or just gradually realising the long term health damages could help people want to get better. Annabelle described how she took her health for granted without realising the possible harm an eating disorder could cause. Some women wanted to get better because they wanted to have children in future and were worried that their eating disorder could damage their ability to get pregnant. People also said they didn’t want to pass on their unhealthy attitude to food to their children in the future.

Annabelle realised if she carried on with anorexia nervosa she might jeopardise her chances of…

Age at interview 22

Gender Female

Age at diagnosis 14

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For some, the decision to get better was made when seeing the effect of their condition on others. Chloe wanted to get better when she realised how much it had upset her family. David said that the compliments about weight loss stopped and his mum and friends started telling him how ill and ‘gaunt’ he looked, at that point he realised he’d ‘gone too far’. For Charlotte, a concern voiced by her teacher, an outsider, helped her realise she needed help.
Sometimes people had simply had enough of living with an eating disorder. Laura described her life as ‘a mess’ and that ‘something had to change’. Steph said she had ‘nothing left in life’. Some people had become so ill that they thought they wouldn’t survive. Nikki got to 21, and thought about her life. She said she made ‘the choice to live’. Rachel describes the decision to recover as a choice between life and anorexia nervosa.
Very often people gradually realised that their eating disorder was ‘incompatible with life’. Physical symptoms, exhaustion, the overwhelming and time-consuming nature of eating disorder behaviour was preventing them from achieving things in life; schooling, getting to a university, getting a job, having friends. People saw how their friends were moving on in life, finishing school and getting a degree while they had ‘nothing to show for life’. Being accepted to a top university gave Elene a sense of worth and for the first time she had ‘something to lose’ to bulimia. People often described an eating disorder as something that they could be ‘good at’ and which gave them self-worth. Once they wanted to do other things in life, the eating disorder could get in the way. Fiona-Grace said she wanted to ‘achieve things unrelated to anorexia’.

Elizabeth had ambitions to become a journalist and realised that she couldn’t be both good at her…

Age at interview 20

Gender Female

Age at diagnosis 12

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Realising that being ‘skinny’ didn’t make people happy could also help in making the decision to try to get better. Sometimes people realised this through therapy. Eva felt for years felt that anorexia was her ‘best friend’ and that it made her feel good about herself. She described it as a ‘mental trick’ which made her feel that she was never good enough.
Sometimes a change of environment made all the difference. For example, when bullying in school or a difficult home life had triggered the eating disorder, simply getting out of that environment could help. Georgia said that once she moved to university she simply didn’t have as much time to think about food.

Going away to university helped Katie break old eating habits. It helped her to see what was…

Age at interview 21

Gender Female

Age at diagnosis 13

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How to get better?

Where the decision to want to get better could be very sudden, the process of recovery was often slow and gradual. It was common to experience relapses. Rob believes that as anorexia nervosa took years to develop it would also take him years to get better. People said slow recovery was important so that they could feel in control of it and not ‘freak out’ by weight gain.

People often had a lot of support with recovery from family, hospital care, talking therapy or doctors. However some managed their recovery without any help. Maria refused any professional help and said that it was ‘a ginormous risk doing it alone’ despite her having recovered. She wouldn’t recommend it to others.

Gaining weight was a part of recovery for Maria. She had lost a big part of her identity and had…

Age at interview 18

Gender Female

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Ewan’s mum used the contract method with the help of the doctors. He was set weekly challenges…

Age at interview 18

Gender Male

Age at diagnosis 15

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Recovery involved taking “risks”. For many, ‘trying to forget’ or unlearn their old thought patterns was the biggest challenge. Jasmin said she had to learn ‘how to not have an eating disorder’. Lauren compared recovery to learning how to drive a car; over time you don’t have to think about eating healthily anymore because it becomes automatic.
In terms of eating, often small changes worked better; increasing a food item at a time (with anorexia nervosa) or halving portion sizes (with bingeing/overeating).

It’s important to realise that, when eating again, having small portions is not giving into…

Age at interview 23

Gender Female

Age at diagnosis 20

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When on holiday in a different environment, Katherine experienced new freedom. When she decided…

Age at interview 19

Gender Female

Age at diagnosis 11

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When Sara was in hospital, visitors brought her grapes. She started to relearn how to eat with…

Age at interview 20

Gender Female

Age at diagnosis 16

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Some said that during their illness they had become experts in calorie counting or weight loss and now they could use the knowledge to put weight on. For many, developing new daily eating routines helped to replace the old habits. Many followed a meal plan and set themselves targets. Making progress contributed to a positive cycle; achieving even small targets was rewarding and encouraged people to carry on.
‘It was very small steps each day but they’ve just added up to a massive journey in the end.’ -Steph

In hospital, Zoe felt that a doctor made her have a high calorie drink. At the time she felt…

Age at interview 23

Gender Female

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When people realised that getting better opened up new opportunities, recovery started to become more rewarding than being ill. It was sometimes difficult to notice progress at the time, it was only when people looked back that they found it ‘exhilarating’ to see how far they’d come.

Letting go of the eating disorder was liberating. Rob realised everything he had missed out on…

Age at interview 17

Gender Male

Age at diagnosis 14

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Gaining some weight helped people to think more clearly, providing a further reason to continue recovering. Chloe described how ‘having some sugar in the brain’ helped her think more clearly and Felicity said that after initial weight gain her ‘cognitions became clearer’ and she was more able to think about, and take steps towards, recovery.

What does ‘recovery’ mean?

‘Recovery is beginning to enjoy being you a bit more.’ -Nikki

‘There might always be a little bit of it there but I think I’ll be strong enough to tell it to go away.’ -Eva
Some people believed in ‘complete recovery’ but some thought an eating disorder would always be a part of them. For them recovery meant learning to control their thoughts and behaviours. Nikki compared eating disorders to addictions in the sense that it ‘never leaves you’. Felicity commented that, although she is currently recovered, she felt that she would always be at a higher risk.
Some still struggled to eat certain foods or had to stick to particular meal times and routines but said that overall they felt more comfortable about eating, exercise and weight. Elene still had issues and bad days but said that she now ‘wouldn’t act on it’. Hannah O said that it was nice to not have to do exercise, but to have ‘the option to’. Even after a long time in recovery, a lot of people said they still struggled with body issues and self-confidence. (For more see ‘The body and body-image‘).

Emily still struggles, but recovery to her means not being consumed by trying to be a different…

Age at interview 21

Gender Female

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There eventually came a point when people believed they could recover. Eva always used to think ‘I’ll be like this forever’ and to Emily recovery always seemed like an ‘insurmountable mountain’. People were often so taken over by the eating disorder in their everyday life that they weren’t able to look forward to the future. In hindsight, it was difficult to see what they had been so afraid of and why letting go of the eating disorder had been so hard. People who were recovered described their past as ‘a different life’ and that they were like ‘a different person’. Jasmin said she was ‘happiest I’ve ever been’ and Annabelle said she would ‘never go back for any amount of money’. Lauren said she had no regrets about her past because her experiences ‘moulded’ her life into what it is now;

‘My life’s just great. When I look back and think two years ago when my life was just horrible, it’s such a difference and I just feel so alive and I’m just so busy and doing so many wonderful things and so many opportunities are happening‚Äö√Ѭ∂I love every minute of it. I thank God for every minute of it because there was a time when I thought it was gonna end and that I couldn’t get through. There’s bad days but everybody has a bad day but it’s now realising the difference between just having a normal bad day and a sort of an anorexic bad day.’ -Lauren

Peer support

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Eating disorders and thought patterns

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