Each year, the National Eating Disorders Association acknowledges Eating Disorders Awareness Week as an opportunity to raise awareness and reduce stigma. This year, we’re honoring the week of February 27-March 5 to share “Strength Through Experience and Knowledge” and recognize “It’s Time for Change.” In the spirit of awareness and change, these efforts will elevate voices of individuals with lived experiences and educate the general public about the realities of eating disorders.
As a therapist with personal and professional experience with disordered eating, I’ve encountered individuals from all walks of life who come to treatment at various stages in the recovery process. Whether you are new to recovery, recovered, or know someone recovering, there are several different ways that you can gain awareness and be the change in your community.
If you are new to recovery...
Eating Disorders are mental health conditions that can also result in potential medical consequences. Eating disorders develop from the inside out, whereas the treatment process often occurs in the opposite direction. That is, disordered eating results first from internal psychological distress that later manifests externally as behavioral symptoms, which can go unnoticed until they begin to affect one’s physical health.
However, it is difficult to treat the underlying distress without first addressing medical stabilization. Therefore, a treatment team should include a physician, a therapist, and a registered dietitian — ideally all of whom have received additional specialized training to effectively assess and diagnose eating disorder symptoms — to address both the internal and external factors.
If you suspect you may be experiencing an eating disorder and have not yet started the treatment process, it is recommended that you contact your primary care doctor and receive a physical exam to evaluate your current vitals and recent changes in your weight or appetite. Depending on the severity of your symptoms, you may be referred for different levels of care anywhere from inpatient or residential to outpatient services. If you are already in therapy, it is important to be honest about your eating patterns in order to identify the "what” and the “why” when it comes to underlying psychological causes, which then determine the appropriate therapeutic interventions. Your doctor or therapist may then refer you to a registered dietitian who can identify the “how” and fill in the missing pieces when it comes to dietary intake.
Because the topics of weight and food can be triggering and the treatment process can be overwhelming for many people, it’s important to be aware of the different ways to make the transition to recovery a little bit easier. First, you may request to receive “blind weights” during your appointments by stepping backwards onto the scale so that your providers can document the necessary information without you having to worry about the numbers involved. Second, recognize that eating disorder recovery is different from other forms of recovery because food is such a necessary part of our survival so it is impossible to completely avoid triggers and “relapse” is very common. Trusting the process is a must when you begin your journey. Third, there are many free and low-cost resources available, including online support groups and smartphone apps, to supplement treatment and receive additional support.
If you are recovered...
If you’ve already been through the treatment process and have maintained your progress for a while, congratulate yourself for getting this far. While many argue that we are always in recovery, it’s certainly important to recognize the small and big successes along the way.
At the same time, it’s also important to recognize that long-term recovery for eating disorders is achieved by managing not only the physical symptoms, but the behavioral and psychological symptoms involved as well. This means learning to cope with the underlying stressors long after weight, health, and nutrition are stabilized. More specifically, you and your therapist may continue to work on behavioral recovery by identifying triggers and positive alternative coping mechanisms for disordered eating urges. Your therapist may also help you work on psychological recovery by reframing the deep-seated rules and distortions you may have around food, weight, and body image.
Lastly, mobilizing your support system is critical for long-term success in eating disorder recovery. For many individuals with eating disorders, being in recovery requires setting necessary boundaries in their relationships in order to manage triggers and receive adequate support. Part of relapse prevention and safety planning is identifying those people in your life whom you will contact based on your needs and the level of intervention they can provide. For example, it’s a good idea to be aware of friends and family you can call when you need to distract yourself versus those you can call in the event of a relapse. If you experience an emergency and are in need of immediate help, there are several crisis resources available on our website.
If you know someone in recovery...
Watching a loved one struggle with an eating disorder can feel like a powerless situation, but there are many ways that you can take action and show your support. First, you may contact the NEDA Helpline at 1-800-931-2237 or text “NEDA” to 741741 to speak with a trained volunteer who can provide short-term support and point you in the right direction for professional help. Second, educating yourself on the signs and symptoms can increase your understanding of eating disorders, and using empathetic responses can validate your loved one’s experiences. Third, there are several opportunities to get involved in the cause such as volunteering or participating in a NEDA walk in your local community.
Regardless of your experience with eating disorders and the level of support you can provide, making an ongoing commitment to explore your own relationship with food and biases related to eating disorders can help to further increase self-awareness and reduce stigma.