One topic i have not addressed more clearly is the person who has no true interest or ability to consider full recovery. The idea that people with eating disorders are sick forever is a common misunderstanding in today’s culture. In fact, it is still surprising for many lay people to hear that recovery is even an option, let alone something that occurs on a regular basis, albeit over a period of time and with very difficult, often excruciating work.
Realistically, many people do live with eating disorders for their entire lives. Many of them get professional help, but with the purpose of seeking emotional support from a knowledgeable clinician and perhaps guidance how to manage the illness and still function in life, not to get well.
The distinction between treatment intended for recovery and management of an eating disorder is significant. As opposed to full treatment, eating disorder management has very different goals: containment of medical conditions associated with the illness, emotional support for the daily struggle of surviving an eating disorder and education about improvements in eating that will manage weight and health within the guidelines allowed by the eating disorder.
Many clinicians refuse to work with people who will not commit fully to recovery. So most of these patients have been ostracized and left to feel alone in their predicament. It’s a mandate for the clinical eating disorder community to commit to helping these people. They shouldn’t be punished because of our lack of effective treatment for the sickest people.
More than anything, people with chronic, intractable eating disorders need compassion. They did not ask for this horrible illness. Many of them have endured long stretches of available treatment with minimal benefit. They deserve kindness and thoughtful care to help them live the best lives available to them. It’s hard to completely ignore my optimistic thought that even in these circumstances, at least partial recovery, if not more, may still be possible. The next post will discuss treatment of these patients more specifically.
I'm curious as to how you would define full recovery. I would probably fit the chronic eating disorder profile - I've had some form of an eating disorder on and off for the past 10 years. I've had long periods when my eating was more or less under control, but even then, I don't eat like a "normal" person, which seems to be how some in the eating disorder community define recovery. If even in good times eating remains abnormal and there is a persistent risk of relapse, what does full recovery look like? And why do psychiatrists get to decide what normal means?
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