All Better? What's Your Definition of Recovery?

Does it mean never engaging in disordered eating again?

Does it mean controlling the behavior so it happens only occasionally?

A new study just came out that asked just that question. (details of the study are below). What's interesting is that, in the ED field, there is no clear unified understanding of recovery.

Some research studies loosely define recovery as no longer meeting full criteria for the eating disorder. For example, recovery from AN could involve restoring weight to the point that the person is above 85% of IBW (Ideal Body Weight) and menstruating. Other research studies define recovery from AN as being at 95% of IBW or 100% of IBW and getting regular periods. Bulimia nervosa (BN) recovery is typically defined as abstinence from bingeing and purging, or infrequent bingeing and purging (e.g. once a month).

Dr. Ravin, an ED specialist in Florida offered these suggestions in a recent interview with psychcentral.com

I would say that a person in “strong recovery” has been in treatment for their ED for a while, is weight-restored, has a good handle on her behavioral symptoms and is able to eat properly and independently, demonstrates good judgment and insight, and is very committed to overcoming her ED, but still struggles daily with urges to restrict, binge, or purge, has a poor body image, and suffers from some distorted thinking (but usually resists engaging in ED behaviors).

A person who is fully recovered is weight-restored, does not engage in any ED behaviors, has realistic thoughts and behaviors surrounding food, has a realistic body image and accepts her body (even though she may not like it), practices good self-care, engages in proactive relapse prevention, and does not struggle with ED cognitions or emotions. She is cognizant of her underlying predisposition and thus must avoid dieting, fasting, high-stress environments, etc. She may have a better body image, better eating habits, and better psychological functioning than her peers as a result of her treatment.

All better? How former anorexia nervosa patients define recovery and engaged in treatment , European Eating Disorders Review, 2010 ,Volume 18 Issue 4, Pages 260 - 270

Alison M. Darcy, Shaina Katz, Kathleen Kara Fitzpatrick, Sarah Forsberg, Linsey Utzinger, James Lock

Abstract:

The purpose of this study was to explore how individuals with anorexia nervosa (AN) engage in treatment and define recovery. A mixed methods design was used to triangulate the experience of 20 women with a history of AN. Interview data were analysed thematically to explore frequency of emergent themes and current eating disorder psychopathology was assessed using standardized self-report measures. Participants’ mean age was 29.35 (SD = 12.11). Participants’ scores were indicative of persistent psychopathology.

Those with more involvement in treatment choice had better motivation to change and normalized eating. Participants’ definition of recovery mapped on well to current research conceptualizations, though a substantial proportion of the group expressed some ambivalence around the concept. Results are interpreted in the context of self-determination theory of motivation and suggest that patients should be involved collaboratively in the formulation of shared goals and concepts of recovery in treatment settings