Whether you’ve been recovering from an eating disorder for ten minutes or ten years, it’s inevitable: you’re going to face obstacles at one point or another. But eating disorder recovery isn’t about never slipping up. After all, for many of us, that need for perfection is the reason we are here in the first place!

Instead, eating disorder recovery is about how you deal with the setbacks. Do you decide to give up on recovery altogether, or do you choose to move forward despite a momentary lapse? The choice is entirely up to you.

During NEDAwareness Week 2020, we hope you will choose to move forward! This is a week honoring you and the challenges you have faced (and overcome) to get to where you are today. Whether you’re new to the eating disorder recovery community or well into your journey by now, this week celebrates the triumphs over setbacks you’ve already faced, as well as the celebrations of victory that await you in your future.

This blog post details some of the setbacks you may face (or might have already faced) in eating disorder recovery and how you can cope with them when you’re feeling uncertain of your next steps.

Setbacks You May Face in Eating Disorder Recovery

During your eating disorder recovery, you may face setbacks that threaten to disturb your recovery or throw you off track. These setbacks may challenge you physically, mentally and emotionally, presenting an obstacle to your eating disorder recovery.

What matters isn’t that you get through recovery without obstacles, however, but how you deal with those obstacles! Later, we’ll talk about how to cope with the challenges of eating disorder recovery — but first, here are some of the setbacks you may face as you progress through your recovery journey.

Unintentional Weight Loss

Even if you feel great — as in, you’re free from disordered thoughts and behaviors and no longer obsessing about what you eat or weigh — you might still lose weight when you’re supposed to be gaining or maintaining it. This can come out of nowhere and come as a huge surprise to you and your treatment team, especially if you’re feeling positive about your eating disorder recovery.

As recovering patients have noted in their own experiences, sometimes the problem can stem from your hunger cues. If you are following your hunger cues to the letter, you still may not be eating enough food to sustain a healthy weight, as years of struggling with an eating disorder can distort your hunger cues and put you out of touch with your body.

The solution, then (which we’ll talk more about later), is not only eating more but also relearning how to listen to your body and its cues. If you’ve spent years ignoring your body’s hunger cues, then you may not even realize when it is time to eat, potentially leading you to eat less than you probably should.

Neglecting Self-Care

Neglecting self-care as one of five important signs that you might need a higher level of care for your eating disorder — and for good reason: being unable to maintain regular hygiene, move your body appropriately, feed yourself as you should or stay current with your doctor’s and therapy appointments may suggest depression.

In studies of women with eating disorders, 92% of respondents reported also struggling with a mood disorder like Major Depressive Disorder (MDD) or bipolar disorder. Even if your eating disorder goes into remission, you may still be likelier than most to develop depression due to a general genetic vulnerability to psychiatric disorders.

Neglecting self-care is an important sign of depression that should never be ignored and warrants a visit to your primary care provider (PCP), psychiatrist or other medical professional. But don’t panic! It can also just be a sign that you are going through a rocky time in your eating disorder recovery and need a little extra love and support from your community.

Extreme Hunger

In recovery from disorders characterized by self-starvation, such as anorexia nervosa, a phenomenon referred to in the eating disorder recovery community as “extreme hunger” is a common setback that can take you by surprise. Even when your stomach feels full, you might feel what one patient describes as “an innate calling to keep eating.”

Extreme hunger might feel anything but logical, but it actually occurs for a sane reason: say you owed someone $1 million and paid them back $1,000. Would you be surprised if they started to demand more money after that first check? Your body functions the same way.

After being in an energy deficit for so long, your body begins to ask for more food, even when it’s already gotten what you might consider being a “normal” quantity of food. That’s why you might need larger portions than you think to feel full, especially in the early days of eating disorder recovery.

Still, extreme hunger can be frightening and uncomfortable when you first experience it — especially because there’s no telling how long it will last once it occurs. That’s why it can be a major setback for someone in eating disorder recovery, who may not want to give their body the food it is demanding for fear of “excessive” weight gain.

Our team warns against stopping at this “partial recovery:” you need to eat however much your body asks for, and regain however much weight your body wants to, rather than stopping halfway. Otherwise, you may never achieve true eating disorder recovery, which is obviously not the goal we are striving for!

Relapse

Eating disorder recovery is a long, difficult process that can’t be achieved without at least a few setbacks. For many of us, those setbacks will include at least one episode of relapse, or readopting eating disorder behaviors and thoughts after a period of letting them go. In fact, relapse is much more common than you might think: the relapse rates for anorexia nervosa and bulimia nervosa are 36% and 35% respectively.

It’s important to understand some of the signs of relapse so you know how to recognize them in yourself — and when to seek help. Relapses rarely occur out of the blue, and they usually come with at least a couple of warning signs that signify it may be time to seek additional support for your eating disorder again.

As you navigate your own recovery from an eating disorder, you should keep an eye out for the following signs of relapse:

• Skipping meals or snacks; reducing the size of meals or snacks
• Eliminating individual food items or groups of foods
• Less openness to discussing recovery
• An attitude of “I’m fine, don’t worry about me”
• Making excuses for not eating
• Changes in weight
• Eating alone or avoiding mealtimes with others, including not going out to eat

We will talk about how to prevent and cope with relapse and other setbacks later in this blog post. However, recognizing a relapse is the first step in stopping it — and in preventing future relapses from threatening to derail your eating disorder recovery.

How to Prevent and Bounce Back from Setbacks in Eating Disorder Recovery

Setbacks in eating disorder recovery are inevitable, but that doesn’t mean that your recovery efforts are doomed to fail. If you want to prevent and bounce back from setbacks in eating disorder recovery, try taking some of the following actions to solidify your dedication to recovery:

1. Create a relapse prevention plan. Make a list of different triggers that are personal to you and might cause you to slip up in your eating disorder recovery. Then, create a plan for coping with each of these triggers in a constructive way to reduce the chances of relapse.
2. Reduce negative influences. Do you have people in your life who make negative comments about yours or their own weight and/or bodies? Try to reduce the amount of time you spend around people like this to reduce the influence they have on you in your eating disorder recovery.
3. Make a meal plan. If you are finding it difficult to stick to eating regular meals and snacks, it may be time to create a plan or keep a food diary of what you are eating to hold yourself accountable. You can do this on paper or using an app like Ate to track your meals without tracking nutrition information. Your therapist or registered dietician may be able to help if you are stuck.
4. Throw away your scale. If you haven’t already: stop weighing yourself altogether. Granted, weighing yourself may be unavoidable in certain situations, such as visiting your doctor’s office to ensure you are keeping up with your recovery. But you do not need to keep a scale at home and weigh yourself obsessively — so if you’re still doing this, it’s time to toss the scale! (Additionally, you can ask your doctors not to tell you your weight directly and talk to you in terms of moving closer or farther away from your target!)
5. Understand that challenges are unavoidable. Nearly everybody experiences a setback at some point in their eating disorder recovery. There is no use blaming yourself or making yourself feel guilty for facing a challenge in eating disorder recovery. It happens to everybody, so rather than blame yourself, show yourself some compassion and make room to roll with the flow.

Finding Help for Setbacks in Eating Disorder Recovery

Sometimes, in your eating disorder recovery, it may be necessary to seek professional help for setbacks, even if you haven’t needed to go to a therapist for years now. Our professional counselors here at The Meadowglade can help support you through setbacks to get you back on track toward recovery. The most important thing is not that you avoid setbacks altogether, but that you don’t give up — so reach out to us today if you suspect you may need additional support on the road to eating disorder recovery.