Stepping back into reality: The Progression of Treatment for Eating Disorder Recovery

Article Contributed by Crystal Karges, MS, RDN, IBCLC, Special Projects Director @ Eating Disorder Hope, and Jacquelyn Ekern, MS, LPC, President @ Eating Disorder Hope

You have made the decision to seek out treatment for your eating disorder.  You have worked diligently toward your recovery, obtaining the medical, nutritional, and psychological support you need for healing to occur.  Slowly but surely, you have made progress and have fought persistently to reclaim your life.  Perhaps you have had the support of family and friends throughout your journey, who have steadily come alongside you as you maintain recovery from an eating disorder.  Perhaps you have had the assistance of a treatment center facility, which has helped you establish healthier routines for living and the much needed structure for recovery to take place.  Whatever your recovery journey has looked like thus far, you may soon come to a place where the level of care you are currently receiving will transition.

Recovery from an eating disorder is progressive and unfolds gradually.  Many who have been through this experience before might liken the journey to that of a caterpillar, which undergoes an intense metamorphosis to transition into a beautiful butterfly.  You may feel as though you are progressing well one day, only the next day to feel as though you have collapsed back in the very place in which your journey began.  Recovery is not a linear process but a journey filled with ups, downs, and side-ways caveats leading you through places you thought you would never go.

As difficult as it can be to accept, relapse is actually a natural aspect of recovery.  Relapse, which is defined as returning to a level of disordered eating after a period of full or partial remission from these behaviors, commonly occurs in about 35-60% of individuals recovering from Anorexia or Bulimia [1].  The highest risk for relapse has been identified in the 6-7 months following partial symptom remission, with relapse rates decreased once a full year in remission has been reached [1].  With the understanding that relapse may be a part of your recovery journey, it is important to identify ways to continue to support your healing once you have left the haven of a treatment center or program.

Regardless at what level of care your recovery began, whether inpatient, residential, or outpatient care, planning for the transition to a lower or less restrictive level of care is essential for the preservation and maintenance of eating disorder recovery.  Many treatment centers and eating disorder programs offer several helpful tools to guide you through this process.  Here are some important factors to keep in mind as you make the transition through treatment levels through eating disorder recovery:

  • Follow the guidance of your treatment team:  It is crucial to follow the direction of your treatment team, who will have the best understanding in terms of how you are able to progress.  Your treatment team will be able to determine when and how you can transition to a lower level of care, and it is advisable to always follow their guidance.  Your treatment team will have the knowledge of whether you are medically, nutritionally, and psychologically stable enough to make a transition to a different level of care.
  • Be prepared for possible triggers:  Learning about situations, circumstances, and emotions that trigger eating disorder thoughts and behaviors will be helpful to you in your recovery.  Understanding this about your eating disorder can help you become better prepared for facing these situations outside of treatment.  Establishing healthier coping skills can also help you learn how to work through instances when you feel triggered to engage in your eating disorder.
  • Establish a “9-1-1” Plan:  Just as you know what to do in case of an emergency, it is also important to have a plan for any type of “emergency” in your own recovery.  When you feel helpless, hopeless, or unable to work through eating disorder triggers, have a plan for what to do.  This might be a trusted person you are able to call, such as a mentor or counselor.
  • Know your support:  It is important to know who you can rely on in your eating disorder recovery and who is continuing to support you through your journey.  Know who these people are and ask for accountability to keep you on track.
  • Stay Connected:  Support is crucial to keep you grounded and focused in your recovery.  If you are no longer in a treatment program, stay connected by getting involved in an eating disorder support group.  This can help you have an outlet as you continue in your journey.  You can also help others who may be going through similar experiences.  A support group is a great way to continue your journey.

The journey of recovery from an eating disorder is often unpredictable and at times, uncertain.  Having a plan for transitional periods in your recovery process can help you maintain healing and carry you successfully through any obstacles you may face.  If at any point you have suffered a relapse, be sure to reach out to your treatment team for the support you need to re-establish recovery.  No matter what point you are in your recovery process, you always have the ability to choose hope, healing, and freedom from an eating disorder.




Page Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on April 19, 2014
Published on, Resources and Articles for Eating Disorder Help