Stages of Recovery

I often have families ask how their loved on is going to get better. Unfortunately, there is not just one answer for everyone. Eating disorders are complicated as is recovery. What might work for one person doesn't for the next. One moment it seems like you're on the right track only to experience a set back. With that said, what should families expect in treatment?

In my opinion, the very first step in treatment is to stop the progression of the eating disorder. In others words, prevent the behaviors from happening. This is an important first step because eating disorder behavior causes chemical changes in a person's brain which can cause the person to "crave" eating disorder behavior. In essence, the brain likes the chemical changes that occur and wants it to continue. This leads to patients experiencing strong compulsive urges to engage in the eating disorder behavior. For these patients the eating disorder is not about a fear  of gaining weight or losing control over their eating. Instead, it is a biological compulsion that is only satisfied by engaging in the behavior.

Unfortunately, we don't have a quick fix for this. There are some medications that can help decrease the intensity of the urges but overall nothing to make them go away. However, we know that with consistent feedback the brain will change. Thus, the first step in recovery is to give the brain feedback that the eating disorder behavior is not something that we want to continue. When a patient tries to stop his or her behavior the brain reacts strongly because its not getting the chemicals it wants. Thus, the patient experience intense urges to engage in eating disorder behavior. If the patient is able to refrain from giving into these urges the brain gets feedback that it needs to change. Unfortunately, it takes a lot of feedback before the brain actually begins to change.

So the obvious questions is how does someone stop or alter the behavior?  Most patients will not engage in their behaviors in front of others- so be there when your loved one is most likely to engage. In addition, offer loving support as he/she struggles not go give into the compulsion. Reassure him/her that everything will be OK and that you will be by his/her side throughout the entire process.

More to come...

Comments

[Anonymous]

I think something that helps(ed) me not engage in eating disordered behavior is 1) having a plan that I buy into and 2) making sure the meal plan is not that far of a stretch (this helps me buy into it).... Even if it's still not the right amount of food. If the plan includes too much food, it triggers behavior. It's a careful balance where you have to take into consideration both health and triggers I guess. Also, to help stay on the meal plan, I call my dietitian every night to give her a report. Sometimes my messages lead her to call me back the next day, which immediately clears up my thinking. So I guess it's a combination of accountability, a good plan, and frequent checking in. And I guess I'd add trust... trusting that the professionals are not out to make me fat or out of control.

[Joan]

What kind of medications reduce cravings? Anything over the counter? Thanks.

Sometimes the SSRI antidepressants are useful. You might want to cosult with your physician to see if they may be helpful to you.

[Tony Paulson]

Sounds like your dietitian is a big part of that. Have you found having people around helping with with the meal plan in the moment is helpful? I often hear that having a loved one or friend that is willing to sit and be with you during the struggles is often helpful. There is something about the accountability and support that seems to make a difference. Has that been your experience?

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