One of the hardest question I’m asked about recovery from anorexia is the following: what strategies or concepts are the most effective to combat the anorexic thoughts?
The reason this question is so hard is that there’s no simple or easy answer.
Despite decades of research into the biological underpinning for anorexia, there are no new data to use clinically that makes recovery and regular eating any easier.
Research into all different medications, including psychedelics, don’t show much benefit to make recovery different.
However, the lack of new information doesn’t mean we should disregard the decades of experience we have treating anorexia, nor the fact that treatment is much more nuanced and sophisticated than it was only a few decades ago.
First, we do know that consistent nourishment over an extended period of time will reverse the food and body thoughts for most people. Sometimes these changes are fast and other times slow.
Second, we know that regular food logs and consistent accountability helps people move forward in their lives. Recovery has nothing to do with willpower. Instead, people need external support and reminders to chip away at the power of the eating disorder thoughts.
Third, we know that treatment must include listening carefully to what people with anorexia say, think and feel. No one gets better by treating the illness and not the person. If someone in recovery is moving away from the illness and not moving towards something important to them, the changes won’t last.
Last, the process of recovery needs to center on hope. Any sense of desperation or hopelessness strengthens the illness and derails recovery.
In order to sustain hope, clinicians need to be well versed in the nature of eating disorders and recovery and to understand the ups and downs of the path to get well.
The less we all look for the magic bullet for recovery from anorexia and the more we use the available knowledge and tools, the more successful treatment can and will be.
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