Gina battled bulimia for seven years—struggling on her own in secret—before she finally opened up to her mother. Gina wrote her a long letter explaining her shame and embarrassment, and gave her mother a book about how to deal with someone with an eating disorder. Her mother was so relieved that Gina had finally opened up, and together they sought professional help.
Gina’s road to recovery was still rocky and she had plenty of slip-ups, but she also had the support of her family. Gina chose to use relationships to replace her bulimia. She saw a therapist and joined a support group of fellow eating disorder sufferers. In time, she went back to graduate school, got married and had children. Like everyone else, she still had difficult experiences in life. Her mother developed cancer and Gina lost her job. But she no longer used her eating disorder to cope.
The road to eating disorder recovery 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 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 eating disorder behaviors you’ve learned can be unlearned if you’re motivated to change and willing to ask for help. However, overcoming an eating disorder is about more than giving up unhealthy eating behaviors. It is also about rediscovering who you are beyond your eating habits, weight, and body image.
True recovery from anorexia and bulimia involves learning to:
- Listen to your body.
- Listen to your feelings.
- Trust yourself.
- Accept yourself.
- Love yourself.
- Enjoy life again.
The exact treatment needs of someone struggling with an eating disorder will vary according to the individual. It is, therefore, important that a health professional coordinate any treatment plan.
Eating disorder treatment step #1: Ask for help
It can be scary and embarrassing to seek help for an eating disorder but gaining support from a trusted friend, family member, religious leader, school counselor, or work colleague is for many people the first step on the road to recovery. Alternately, some people find it less threatening to confide in a treatment specialist, such as an eating disorder counselor or nutritionist.
Whoever you select as a confidant, set aside a specific time to discuss your situation with them, ideally in a quiet, comfortable place away from other people and distractions. Remember, your friend or family member may be shocked when you disclose details of your eating disorder. They may even be angry or confused, unsure of how to respond or the best way to help you. It’s important to remain patient. Take time to educate them about your specific eating disorder and the ways you’d like them to support you during the recovery process.
How to talk to someone about your eating disorder
The more specific the information you offer, the better the person you’re speaking with will understand and be able to help. Answer the following questions and include the answers you are comfortable revealing:
- When did you begin having different thoughts regarding food, weight, or exercise? What were the thoughts?
- When did the different behaviors start? What was the behavior and did you hope to accomplish something specific (lose weight, gain control of something, get someone’s attention)?
- Have you noticed any physical health effects (fatigue, loss of hair, digestive problems, loss of menstrual cycle, heart palpitations, etc.)? Or any emotional effects?
- How are you currently feeling physically? Emotionally? Do you feel ready to stop the disordered eating behaviors?
- How can the people in your life best support you? Do you want them to monitor your behavior?
- Do you want them to ask you how you are doing with your recovery or would you rather tell them?
Source: National Eating Disorders Association
Eating disorder treatment step #2: Find a specialist
Eating disorder recovery is much easier when you have experienced, caring health professionals in your corner. It’s important to find a professional counselor or nutritionist who specializes in anorexia or bulimia. As you search, focus on finding the right fit, someone who makes 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 local hospitals or medical centers.
- Ask your school counselor or nurse.
- Call the National Eating Disorders Association’s toll-free hotline at 1-800-931-2237 (Mon–Fri, 8:30 a.m. to 4:30 p.m. PST).
Eating disorder treatment step #3: Address health problems
Anorexia and bulimia 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 top treatment priority. Nothing is more important than your physical well-being. If you’re suffering from any life-threatening problem, you may need to be hospitalized in order to keep you safe.
Eating disorder treatment step #4: Make a long-term treatment plan
Once your health problems are under control, you and your doctor or therapist can work on a long-term recovery plan. First, you’ll need to assemble a complete eating disorder treatment team. Your team might include a family doctor, a psychologist, a nutritionist, a social worker, and a psychiatrist. Then you and your team will develop a treatment plan that’s individualized to meet your needs.
Your eating disorder treatment plan may include:
An effective treatment program for eating disorders 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, and other uncomfortable emotions.
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.
Therapy for eating disorders
Therapy is crucial to treating anorexia and bulimia. There are many ways a therapist can work with you, including addressing any feelings of shame and isolation caused by your eating disorder. Different therapists have different methods, so it is important to discuss with a therapist your goals in working towards recovery.
The most common therapy for eating disorders is cognitive-behavioral therapy. This targets the unhealthy eating behaviors of anorexia and bulimia and the unrealistic, negative thoughts that fuel them. One of the main goals is for you to become more self-aware of how you use food to deal with emotions. The therapist will help you recognize your emotional triggers and learn how to avoid or combat them. Cognitive-behavioral therapy for eating disorders also involves education about nutrition, healthy weight management, and relaxation techniques.
Nutritional counseling for eating disorders
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 the food you consume.
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.
Online support for eating disorders
You can find online help for anorexia and bulimia at Internet support groups, chat rooms, and forums. Online resources are particularly helpful if you’re not ready to seek face-to-face help or you don’t have an eating disorder support group in your area. See the Resources & References section below.
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.
To find an eating disorder support group in your area:
- 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
- Search the National Eating Disorders Association’s. See the Resources & References section below.
Anorexia and bulimia aren’t about food. They’re about using food to cope with painful emotions such as anger, self-loathing, vulnerability, and fear. Disordered eating is a coping mechanism—whether you refuse food to feel in control, binge for comfort, or purge to punish yourself. But you can learn healthier ways to cope with negative emotions.
The first step is figuring out what’s really eating you up inside. Remember, “fat” is not a feeling, so if you feel overweight and unattractive, stop and ask yourself what’s really going on. Are you upset about something? Depressed? Stressed out? Lonely? 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:
Coping with anorexia and bulimia: Emotional Do and Don't lists
- 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
- 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. Koenig, Gurze Books
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 bad qualities you DON’T have.
- Focus on what you like about your body. Instead of searching for flaws when you look in the mirror, appreciate the things you like about your appearance. If you’re distracted by “imperfections,” remind yourself that nobody’s perfect. Even supermodels get airbrushed.
- Challenge negative self-talk. 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|
Wear clothes you feel comfortable in
Dress to express yourself, not to impress others. You should feel good in what you wear.
Stay away from the scale
If your weight needs to be monitored, leave that up to the doctors. How much you weigh should never affect your self-esteem.
Stay away from fashion magazines
Unless you can look through these magazines knowing they are purely fantasy, it's just better to stay away from them.
Do nice things for your body
Get a massage, a manicure, or a facial. Pamper yourself with a candlelight bath, scented lotion, or a new perfume.
Movement therapy helps improve your sense of wellbeing. Take up Yoga or Tai' Chi, play volleyball with the kids, or bike ride with friends. Make angels in the snow or sandcastles at the beach. Be active and enjoy life!
Adapted from: The Something Fishy Website on Eating Disorders
|Tips to Improve your Body Image|
Wear clothes you feel comfortable in - Dress to express yourself, not to impress others. You should feel good in what you wear.
Stay away from the scale - If your weight needs to be monitored, leave that up to the doctors. How much you weigh should never affect your self-esteem.
Stay away from fashion magazines - Unless you can look through these magazines knowing they are purely fantasy, it's just better to stay away from them.
Do nice things for your body - Get a massage, a manicure, or a facial. Pamper yourself with a candlelight bath, scented lotion, or a new perfume.
Stay active - Movement therapy helps improve your sense of wellbeing. Take up Yoga or Tai' Chi, play volleyball with the kids, or bike ride with friends. Make angels in the snow or sandcastles at the beach. Be active and enjoy life!
Adapted from: The Something Fishy Website on Eating Disorders
Developing a plan for healthy eating
In order to make a healthy eating plan, you need to know the basics about nutrition. Once you learn what a well-balanced diet looks like, you’ll be able to make healthier choices for yourself. Learn more
Learning and establishing healthy eating habits is an essential step in recovery from anorexia and bulimia.
- 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, make sure to eat every three hours. Plan ahead for meals and snacks, and don’t skip!
- Challenge your strict eating rules. Strict rules about food and eating fuel anorexia and bulimia, 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. Healthy eating—not dieting—is the key to avoiding weight gain. 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.
Relapse prevention for anorexia and bulimia
The work of eating disorder recovery doesn’t end once you’ve adopted healthy 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 that drain your energy, encourage disordered eating behaviors, or make you feel bad about yourself.
- 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.
- 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.
- Identify your “triggers.” Are you more likely to revert to your old, destructive behaviors during the holidays, exam week, or swimsuit season? Know what your triggers 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.
Resources & References
Eating disorder recovery and self-help
Overcoming Disordered Eating - Part A – Series of self-help worksheets designed to help you understand and recover from an eating disorder. (Centre for Clinical Interventions, Western Australia Department of Health)
Overcoming Disordered Eating - Part B – Second set of worksheets on eating disorder recovery, covering topics such as self-esteem, body image, and relapse prevention. (Centre for Clinical Interventions, Western Australia Department of Health)
Eating disorder treatment
Types of Treatment – Overview of the types of eating disorder treatment available for anorexia and bulimia. (The Something Fishy Website on Eating Disorders)
Eating Disorders Treatment – A residential treatment center describes their eating disorder treatment approach. While the article promotes the center’s own program, it also provides a solid overview of what a good treatment program for anorexia or bulimia should include. (Timberline Knolls Residential Treatment Center)
Finding help and support for eating disorders
Eating Disorder Treatment Finder – Directory of eating disorder treatment providers, including doctors, therapists, nutritionists, and support groups. (The Something Fishy Website on Eating Disorders)
EDReferral.com – Comprehensive, easy-to-search database of eating disorder treatment providers, including specialists for anorexia and bulimia. (The Eating Disorder Referral and Information Center)
Information & Referral Helpline – Eating disorders helpline offers advice and referrals. Includes an online directory of treatment providers and support groups. (National Eating Disorders Association)
HelpFinder – Searchable database of treatment and help for anorexia and bulimia in the United Kingdom and abroad. (beat, UK)