What is the Place of Newer Treatments in Eating Disorder Recovery?

Eating disorder recovery is hard work. It’s the monotony of fighting to eat a meal plan and avoid disordered behaviors. It’s the struggle to ignore and fight disordered thoughts. It’s the pressure to create completely new patterns of eating. And it’s the challenge to find new ways to tolerate life without using the eating disorder.

The hardest part is that recovery just takes time. What feels most difficult changes over months and even years. The progress isn’t linear. There are ups and downs, and the down times make it challenging to remain steadfast and hopeful. Recovery takes patience, diligence and perseverance.

While one day I hope there are clear medical diagnoses and treatments that make recovery easier, those options don’t exist right now. Eating disorders remain under the purview of psychiatry as mental illnesses with some initial indications of medical diseases that may contribute to the disorder. For now, the treatment approaches—as ineffective, and sometimes harmful, as they can be—available are still the gold standard.

There is a current cultural focus on treating mental health while promising prescriptive cures either via medications or targeted therapies. Valuing our psychological stability is a welcome change, but the simplification of healing into a stepwise or time-limited process is very misleading, especially in the realm of eating disorder treatment.

Despite all the newer tools to help people get better, I don’t find recovery to be much different for my patients. The newer forms of treatment increase the likelihood of getting better and seem to mitigate some of the most painful parts of recovery, yet the longterm challenge throughout the process remains.

Consistently looking into and utilizing new ways to help recovery is important for the eating disorder field. Clinical teams need to work together to harness the newest means to help people get well. At the same time, we can’t promise a faster, easier recovery. The path is still long and arduous. It demands people in recovery find a way to trust others and a determination to push through difficult periods.

I don’t mean to make the process of recovery seem hopeless by any means. Instead, I want people to know clearly what it looks like to get better and to prepare for the steps ahead of them while taking advantage of all different kinds of support they need to get well. That path is lined with more ways to get better than ever. Hard work will help people with eating disorders get to a place of being well.

How the Eating Disorder Field can Adapt to the Changing Landscape

The eating disorder treatment field still lives in an old medical system which believes that information spreads primarily through clinicians, books and sanctioned websites. Acting as if these sources are the primary way patients learn about their illness is absurd and only does them a disservice.

We may want to live in an antiquated world with limited access to verified, absolute knowledge, but believing this lie forces patients to look elsewhere for guidance and to trust in the eating disorder field less and less.

The only people who still seem to believe the lumbering eating disorder system are parents who cling to an old way of following guidelines that no longer exists.

People with eating disorders are regularly frustrated and shamed by a system of poorly run treatment programs, unsubstantiated recovery guidelines,

rigid ideas about eating disorders and a willingness to blame the patient when things go wrong.

In addition, the reality of private equity companies running so many of the programs means that for profit entities guide much of the treatment available.

Reasonably, patients look elsewhere for guidance. TikTok is flooded with people with eating disorders sharing ideas about how to get better and about associated medical illnesses the field ignores. Reddit allows patients to discuss all of the knowledge they have amassed to give hope and direction for recovery. Patients use this information to find clinicians willing to help them be stable enough to opt out of a field willing to keep them stuck rather than find creative ways to help them get better.

Sure, clinicians can lament the changes in information dissemination along with technological innovation and change, but to what end? The changes are here, and people with eating disorders need clinicians willing to adapt to our changing world and not pretend we live in an old media universe. What is to be done?

First, acknowledge that social media provides a useful resource for all of us to learn more about our these illnesses. It’s not like eating disorder treatment is wildly successful or else people would accept the help that is offered. Respecting all different experiences can help us find more success in recovery.

Accept that creative approaches to treatment are needed. We need to consider and address medical issues that may be part of or even the cause of an eating disorder. The myth of an eating disorder as chronic stems from our ignorance rather than the idea of an untreatable illness.

Take into account the various financial incentives of bad actors in a field in which so little understood. The combination of capitalism and health care means that rich people take advantage of confusing and ineffective medical care by creating systems that make money off of treatment. The success of the treatment is often at odds with profit. Clinicians need to be mindful of their recommendations to any patent by staying informed.

Educate oneself about new medications and be open to their utility in eating disorder recovery.

Let’s work together to stay on top of an ever-changing system. These changes are neither positive or negative. They are the reality. Acceptance allows for any clinician to use valuable knowledge to improve care and outcomes.

How Someone with an Eating Disorder Can Feel Seen

So many people with eating disorders don’t feel seen and heard in their lives. Eating disorder symptoms provide relief by numbing, comforting and validating parts of themselves. The end result is that the eating disorder can assuage the emotional pain that results from feeling so invisible.

Although this experience is not universal for people with eating disorders, many people feel terribly alone.

I have written many times how the eating disorder can be a salve against this emotional pain and can be a means to feel companionship and reliability as well.

The path to recovery needs to include meal plans, external factors that matter to the person and a team of clinicians who the person trust and who cares for them. But eating disorder recovery needs something more fundamentally human than that too.

People with eating disorders struggle so much with the balance between a professional and personal relationship in therapy. For people who have felt so unloved, they have a hard time balancing what they actually need with the circumscribed, limited therapy relationship. As real as the connection is, it’s hard not to feel even more heartbreak and loneliness as a reaction to the boundaries imposed by the therapy relationship.

Yet the connection and care of the therapy relationship are critical to any true recovery. To do such incredibly hard work, the person needs to know that they matter to someone.

Granted, it’s easy for the therapist to envision the therapy relationship as a springboard to find that kind of love in a relationship without limitations. That’s easier for the therapist to lean on and potentially more satisfying for the patient too.

But that’s just an easy out. The therapy relationship still is meaningful, very real and ultimately the catalyst that leads the way to get better. The limitations and emotional pain that ensue also need to be addressed since this experience in therapy highlights much of what led to the eating disorder in the first place.

The answer isn’t clear. Even if the boundaries exist, the relationship for someone who has never mattered before is a transformative experience and invaluable. Plus, this is an intensely personal relationship. There is no clear advice that makes it any easier. The goal is to find one’s way, value how much the relationship brings and find gratitude to have found a relationship that makes it possible to live in this new way, one where the eating disorder isn’t dominating everything in life. Moreover, hope for the future can pave the way forward.