Challenges of Eating Disorder Recovery

In the past 6 years of being what I refer to as “fully recovered” from an eating disorder, I have been fortunate. My thoughts about my body and my eating habits have been positive – more positive than I ever thought possible. Recovery for everyone looks different, but my final phase of being “fully recovered” vs. being in "recovery" was defined by my view of exercise. I began to finally understand exercise as a means to move, celebrate, and strengthen my body rather than a way to control it.

My husband made a comment tonight during dinner that briefly caused me to question all of this and scared the hell out of me to be perfectly honest…not because of the specific content of his message, but because of the way my mind twisted this information into something unhealthy. Our brains become wired a certain way as a result of things that we think over and over again…oftentimes triggered by a combination of our environments (society’s influence/family influence) and genetics (perfectionistic, rigid traits). I, personally, thought I had effectively re-wired every last connection…maybe that was naïve…but truly I did.

As an individual recovered from an eating disorder, I refuse to consider dieting or rigidly monitoring my food intake ever again. For individuals who have struggled with eating disorders in the past, my personal belief is that our issues with food are similar to an alcoholic’s issues with alcohol…only we have to keep eating in order to survive. Eating, however, is not the enemy…it’s the addiction to rigidly controlling one’s eating habits that’s problematic. For me personally, the concept of dieting or closely monitoring food intake would be similar to a person with alcoholism attempting to drink in moderation. It’s a truly slippery slope and something I’m not willing to risk.

This is why I speak out so adamantly against the concept of dieting. Eating disorders are not a lifestyle choice. Eating disorders are serious psychiatric disorders, which we understand to result from a diathesis stress model. Although, I cannot say this in absolute terms...what we are discovering in the field of eating disorder treatment is that there is oftentimes a genetic predisposition, but environment serves as the trigger...and unfortunately, dieting is all too often the environmental trigger for disordered eating. Some people can diet (although dieting is not an effective means of weight loss) without developing eating disorders...but for individuals with a genetic predisposition toward disordered eating, this is very dangerous.   

Exercise is also something that I have to really be thoughtful about. Similar to eating, it is necessary for my health (both mentally and physically), but I have to be clear about the intention behind my exercise. In my relationship with both food and exercise, I have to utilize the approach of opposite to emotion action (Dialectical Behavior Therapy) in order to sustain my recovery. If a fear about food comes up, I find it most helpful to eat what I formerly called a “challenge” food (a once scary, high calorie food), which I now call “fun food.” Similarly, if the desire to exercise for the purpose of changing/maintaining/controlling my body should arise, I have to abstain or choose a less intense type of aerobic exercise where the intention behind it is congruent with my recovery.

What my husband said during dinner is not important because he did not mean it in the way that my mind chose to interpret it. This is where we, as recovered individuals or individuals in recovery, also have to take responsibility for what we identify as “triggers.” A trigger is not an excuse for relapse – it’s an opportunity to reevaluate and strengthen one’s recovery. Hearing that others may evaluate individuals based on societal standards of what is preferable can easily trigger competitiveness, self-judgment, and a myriad of other negative thoughts and preoccupations. This does not have to challenge my beliefs that:

1.       Individuals are so much more than our external appearances

2.       We have very little control over our genetic set point range of weight/size

3.       People of various sizes are indeed attractive

While Cognitive Behavioral Therapy is crucial in establishing some positive new self-statements and connections in the brain, the old connections will occasionally resurface as mine did this evening (though this becomes rather few and far between as one advances in recovery). This is why I find Acceptance and Commitment Therapy to be highly effective in the treatment of eating disorders. I can Accept and make room for these feelings of discomfort without judging myself for having such thoughts, and I can Commit to my values which today will include:

1)      Having a large glass of chocolate whole milk and a delightful breakfast

2)      Refraining from the morning cycling class and instead taking the time to play with my daughter (we've had a gym membership for a few months, and I've only made it to walk the track a few times...this happens when playing with a toddler becomes more appealing)
 

**As I’ve mentioned before, there is a lot of controversy within the field of psychology regarding psychologist self-disclosure. This is a personal rather than professional blog, so I feel that sharing my meandering thoughts” should be authentic. I also feel that as psychologists, we are “fellow travelers” as Yalom described us…not immune from the inevitable struggles of life.