Anorexia nervosa (AN) is more than just a physical illness—it’s a relentless battle that takes a toll on the mind, emotions, and spirit.

The journey toward recovery can often feel lonely and overwhelming. But for individuals struggling with this serious eating disorder, there is hope.

Recovery from anorexia nervosa is possible, and there are important milestones along the way that can help individuals navigate the journey.

In particular, there are four key stages of anorexia recovery, which someone working on this difficult task can use to help stay focused, work through any challenges or setbacks, and reassure themselves that they are on the right path, no matter how hard it may seem.

What is Anorexia Nervosa?

Anorexia nervosa (AN) is a mental health disorder, which manifests as extreme attitudes and behaviors toward weight, food, and eating. The disorder is defined by an extreme limitation of food intake, an unusually low body weight, a distorted view of one’s own body weight, shape, and size, and a strong fear of gaining weight, among other factors.

While once thought to be exclusively a social or environmentally-influenced condition, research has yielded compelling evidence of biological and genetic factors that also contribute to the development and perpetuation of AN. [1]

Thanks to the often complex and overlapping aspects that bring the condition about, recovery from anorexia nervosa is a gradual process, and it often requires patience.

Eating disorder recovery in general typically does not come in a straight line, and it’s possible to see periods of improvement followed by setbacks, or to continue seeing some eating disorder behaviors even after treatment has started, though ideally to a less intense degree as recovery efforts continue.

What are the Stages of Anorexia Nervosa Recovery?

Every eating disorder recovery journey is just as unique as the person with the eating disorder diagnosis. This can make it difficult to measure out straightforward markers of recovery.

But while progress is not always easy to track, there are several key milestones that individuals can expect to encounter as they navigate the recovery process.

It’s important to note that these stages of the recovery process can happen in any order, or happen more than once, especially if someone experiences a setback. But whenever and however they do occur, they can be looked at as signs of an improving condition.

Physical Symptoms Improvement

One of the biggest eating disorder symptoms involved with anorexia nervosa is malnutrition, due to a severely limited diet. And improvement from the physical symptoms and other related ailments caused by malnutrition is a key milestone of recovery.

Adequate nourishment allows the body to start healing, typically decreasing symptoms such as low energy and insomnia. Someone at this stage may also see improvement with other physical symptoms of disordered eating, such as indigestion, bloating, dry or flaky skin, thinning hair, or physical weakness.

Restoration of Hormonal Stability

There is more to physical recovery than just gaining weight. Studies show that anorexia nervosa deeply affects the body’s metabolic and hormonal mechanisms.

When the body begins routinely receiving less energy, nutrients, and minerals in the source of food, it will look elsewhere in the body to mine those resources. This could mean taking nutrients from other areas of the body, or reshuffling the priority of internal processes taking place, in order to preserve energy for the most crucial aspects of survival. [3]

Once these changes have been established, it can be difficult and dangerous to implement changes. Restoring the body’s metabolic and hormonal functions is one of the most important, but one of the most delicate, aspects of AN recovery.

But once the body does begin to come out of starvation mode, there should be a number of noticeable differences, including improved focus, better sleep, overall better mood regulation, and just generally feeling better.

Restoration of metabolic and hormonal stability is also important, as it can help prevent the development of low bone density, amenorrhea, infertility, and other endocrine consequences of AN. [4]

Reduced Preoccupation with Food and Body

Anorexia nervosa may have a huge impact on the body, but the condition is rooted in the mind. As recovery continues, it should help inspire important changes in someone’s attitude toward food, eating, and body image.

Those in the throes of the illness are often preoccupied with these kinds of thoughts, with a fixation on food and body even occurring in an individual’s dreams. [2] But as someone continues to repair their self-esteem, nourish their body, and focus on acceptance, their obsessive thoughts about food and body should begin to decrease.

Improved Mental Clarity and Mood Stabilization

The toll AN takes on body and mind can cause significant emotional distress, including mood swings, difficulty focusing, and trouble with decision-making. However, as individuals progress through recovery, they may find an improvement in these areas.

Mood swings may begin to abate as a result of both increased nutrition and psychological work done through therapy. And access to more food generally leads to more energy in the body, which can help increase mental focus.

Factors Impacting Recovery from Anorexia Nervosa

Anorexia recovery is a complex and multi-dimensional journey that may continue over several years. Qualitative research has identified several critical factors contributing to successful recovery from this disorder, including: [5]

An emotional support network, whether made of family, friends, or others dealing with the condition
A sense of feeling understood
Positive treatment experiences
Nurturing relationships.

Perhaps the most important factor, however, is a genuine desire for recovery. Treatment and therapy can help, but ultimately, the motivation to stay on the path to recovery must come from within the individual.

Tips for Maintaining Anorexia Nervosa Recovery

Recovery from anorexia nervosa is possible, and with the right support and mindset, you can stay on the path of healing and growth.

Still, the journey is generally long, and can be difficult. But there are some tips that may help make it more manageable.

Prioritize Self-Care

Self-care is a critical aspect of recovery, and is helpful even after someone leaves official treatment. The concept generally reinforces the idea that someone is worthy of love no matter what, which runs counter to many of the damaging thoughts equating self-worth with weight loss that often drive anorexia nervosa.

Some ideas for practicing self-care include keeping up with good hygiene, getting enough sleep, engaging in joyful physical activity, and learning how to cook nourishing, healthy foods in a delicious way. Someone may also enjoy treating themselves to other signs of self love, by getting a massage, allowing themselves the time to pursue a hobby or interest, playing music, or doing anything else that generally brings them joy.

Find Support

A strong support network is one of the most important aspects of a sustained recovery. Individuals who have access to those who love and care about them have people they can reach out to during challenging times, rather than resorting to old, unhealthy thoughts or behaviors.

There are a number of anorexia nervosa support groups that can be found, both locally in-person and online. Online databases, eating disorder hotlines, treatment centers, and medical professionals can all help point someone in the direction of a helpful support group.

Practice Mindfulness

Mindfulness is a powerful recovery technique, which can help someone stay grounded and in the present moment. This can then help them better manage stress, anxiety, negative thoughts, and other common relapse triggers.

Additionally, mindfulness-based interventions have been shown to help decrease preoccupation with food and the body. [6]

Practicing mindfulness helps develop a non-judgmental, curious and accepting awareness of present-moment experiences. This enables individuals to respond more positively and adaptively to their thoughts and emotions.

Set Realistic Goals

Recovery is a lengthy and often challenging process. Looking at the entire thing as a whole can feel overwhelming, and contribute to feelings of anxiety or other mindsets that may make someone want to give up.

Setting achievable goals and celebrating small successes is a good way to counteract this kind of dread or self-sabotage. It’s also important to recognize that setbacks and challenges are a normal part of the recovery process, and to not equate a setback with an all-out failure.

Maintaining a positive mindset can help bolster this aspect of recovery. It can be difficult to stay positive, especially in the face of more trying situations, but it can make all the difference. Someone in recovery may look for just one thing a day that they’re grateful for, to start building the habit of looking on the bright side.

How to Find Help for Anorexia Nervosa

If you or a loved one are struggling with anorexia nervosa, it’s imperative to reach out for help.

A primary care physician can help individuals with eating disorders find a treatment team. Depending on the disorder, they may also help determine the appropriate level of care.

A therapist specializing in eating disorders will help work through the underlying issues contributing to the condition. They can also provide coping skills and support for recovery.

In some cases, anorexia nervosa requires more intensive treatment, such as residential or outpatient programs. These programs provide 24/7 support and care and can help you learn the tools and strategies you need to maintain recovery.

If you’re unsure where to start looking for help, you can speak to your therapist, physician, or a trusted medical professional. If you’d rather remain anonymous, it’s possible to contact a number of eating disorder hotlines, which can offer you further information and resources for help and treatment.

Recovery can be hard, but as these milestones begin to appear, bit by bit, it will start to feel better and better, leading to a happier, healthier future.

Resources

Frank GKW, Shott, ME & DeGuzman MC. (2019). Recent advances in understanding anorexia nervosa. F1000Research, 504.
Levinson CA, Brosof LC, Ram SS, Pruitt A, Russell S, & Lenze EJ. (2019). Obsessions are strongly related to eating disorder symptoms in anorexia nervosa and atypical anorexia nervosa. Eating behaviors; 34:101298.
Sidiropoulos M. (2007). Anorexia nervosa: The physiological consequences of starvation and the need for primary prevention efforts. McGill Journal of Medicine; 10(1):20–25.
Schorr M, & Miller KK. (2017). The endocrine manifestations of anorexia nervosa: mechanisms and management. Nature reviews. Endocrinology; 13(3):174–186.
Fogarty S, & Ramjan LM. (2016). Factors impacting treatment and recovery in Anorexia Nervosa: qualitative findings from an online questionnaire. Journal of Eating Disorders; 4:18.
O’Neill J, & Feusner JD. (2015). Cognitive-behavioral therapy for obsessive-compulsive disorder: access to treatment, prediction of long-term outcome with neuroimaging. Psychology Research and Behavior Management; 8:211–223

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Last Updated on April 25, 2023
Published on EatingDisorderHope.com

4 Important Milestones to Be Aware of in Anorexia Recovery