5 Things I Wish I Had Known When I Entered Eating Disorder Treatment
At the age of 12, I sat in my pediatrician's office in a paper gown, swinging my legs and staring at the animal-themed wallpaper. I was there against my will — my mom had scheduled an assessment for me after noticing a dramatic weight loss in a short period of time. I was certainly perturbed, but not entirely distressed just yet. I felt confident that I wouldn't be diagnosed with an eating disorder and my doctor would set my mom straight by telling her that she was simply overreacting.
The pediatrician listened to my mom's side, then asked me why I thought I didn't have a problem. "Because people with eating disorders are thin," I asserted, feeling slightly annoyed that I had to explain such an obvious thing to a medical doctor. Needless to say, my answer didn't exactly go over well. I left the doctor's office with a diagnosis of anorexia nervosa and the name of a therapist who specialized in eating disorders.
Like many other eating disorder patients, outpatient therapy wasn't enough to save me, or even help me. I continued to lose weight, and every single meal at home turned into a power struggle with my mom. We both cried all the time — she because she couldn't understand why her only daughter was trying to starve herself to death, and I because I couldn't believe that no one understood how important this weight loss "mission" was to me. Several months after my initial diagnosis, severe medical complications led to my hospitalization in an eating disorders unit.
I won't bore you with the dates, details, and specifics of every hospital stay — some of them have even become a bit blurry to me as I've moved forward with my life. But between the ages of 13 and 24, I was hospitalized seven times in a variety of medical hospitals and residential treatment centers. I spent my fourteenth and nineteenth birthdays hospitalized. I missed out on countless personal, academic, and even professional opportunities because I was fighting to stay alive. I wouldn't wish this experience on anyone — but I also believe in making the best of every life situation we're faced with and I can't deny that I learned a lot during my time in treatment. Although my eating disorder certainly doesn't define me, it's undeniably a part of my history and I refuse to pretend that it never happened — because the things I learned and the relationships I formed during treatment have shaped the person I've become.
To be clear, the recovery process is different for everyone. But, based on my experience, the experiences of close friends and what I've witnessed, here is what I wish I'd known when I began the recovery process.
1. It's Not A Straightforward Path
My mom recalls that, during my first hospitalization in eighth grade, my case worker repeated to her ad nauseam that this would be my first and last time in treatment for two reasons: "She's young" and "You caught it relatively quickly." She understandably felt hopeful and confident that these words were true.
A few weeks into my stay, my mom had a long conversation with the parent of a fellow patient who was in the hospital for the third time. She disclosed the details to me years later, when I was in college and about to enter a residential treatment center in Pennsylvania. "She told me it was going to be a long, rocky road and it would feel never-ending," my mom recalled, "but I tried to not let it discourage me. I pushed her words out of my mind. But, in the end, she was right."
To be clear, some people do recover after one hospitalization and we shouldn't enter the process assuming that it won't work. But 80 percent of people with eating disorders relapse at least once. The reason I think it's important to note this is because relapsing doesn't equal failure, and it sure as hell doesn't mean we should give up. Since many people with eating disorders are perfectionists, we feel like failures when we backslide. Just six months after my release from the hospital, I found myself on medical leave from my freshman year of high school. But it didn't feel like déjà vu —it simply felt humiliating because I knew that I hadn't gotten it "right" the first time.
On my first day back at the same hospital, I tearfully confided these feelings to a nurse I'd bonded with during my initial stay. She assured me that my situation wasn't uncommon and that many patients need to return to treatment. Furthermore, returning to the hospital doesn't erase everything you learned the first time around or mean that your initial treatment was completely pointless — sometimes, it's just the first step in a long process.
2. You're Fortunate To Have Access To Treatment
Unfortunately, many insurance companies fail to provide adequate coverage for individuals with eating disorders — mainly because it remains a misunderstood illness that's stigmatized and minimized. Some families end up in legal battles with their insurance companies, while others resort to tactics like putting down a second mortgage in order to pay for treatment out of pocket. So, even if you don't want to be in treatment, try to put it in perspective — many people wish they could be where you are right now, but are unable to access or afford help.
Even if you're still grappling with whether or not to embrace recovery, take advantage of the individual and group therapy sessions that are offered. Since, at their core, eating disorders are not about food or weight, treatment gives you the opportunity to explore all the underlying issues that triggered your illness in the first place.
3. You'll Meet Lifelong Friends
Another reason to be open to the process is because you'll meet some truly amazing people in treatment. Again, even if you're unhappy or angry about being in the hospital, there are still upsides — and one of them is the friends you'll make. I met one of my very best friends in the hospital and, today, I literally cannot imagine my life without her because she's both the most fun person I've ever met and the one I can call at 4 a.m. on a rough night. Although this particular friendship has changed my life, I've stayed in touch with many people I met in treatment — they keep me motivated and they know me in a way that other people don't. Plus, you know you've found a true friend when they've seen you at your absolute worst (like, for example, crying hysterically as you defiantly throw a weight gain supplement on the floor) and they still want to hang out with you when you're back out in "the real world."
4. But Sometimes, You & Your Friends Will Be In Very Different Places
Recovery is a long, complicated, and messy process for everyone — so it's inevitable that you're not always going to be on the same page as the friends you meet in treatment. This isn't inherently problematic, because it can give you the opportunity to help a friend who is feeling stuck, and vice versa. When you're in a good place with your own recovery, it's an amazing feeling to be able to help someone else. And, when you're in a dark place, no one can understand or help you more than a friend who has been there, too, and gotten through it.
But sometimes, you'll need to create some distance between yourself and your "treatment friends" — especially if you're super committed to recovery and they're less committed, or even (for lack of a better word) anti-recovery. While being in different places is not a reason to end a strong friendship, it's something to be conscious of, because you need to prioritize your recovery. Sometimes, seeing a friend restrict their food intake or simply talk nonstop about their weight is too triggering to handle. It's OK to limit your time with someone if their behaviors and words have a negative impact on your recovery. It doesn't mean you're closing the door on the friendship for good — it just means you're taking care of yourself.
5. The Recovery Process Can Sometimes Be More Painful Than The Eating Disorder Itself At First — But It's So Worth It
Although the causes of eating disorders are extremely complex and vary greatly depending on the individual, the illness is generally a coping mechanism for issues including depression, anxiety, and PTSD. Although I suffered both physically and mentally due to my eating disorder, it had an overall numbing effect that in the short term was incredibly comforting. I was so damn hungry all the time that all I could think about was food — and those thoughts distracted me from my PTSD flashbacks and anxiety. My mind didn't have the space or time to deal with anything other than food or weight, so I was able to block out many incredibly painful emotions, memories, and realities.
When you have your coping mechanism taken away from you, it's jarring because you're suddenly forced to deal with your actual feelings and your true insecurities — and this pain is far more complex than any distress caused by the number on the scale. Many of us feel worse before we feel better, because treatment forces us to eat "normally" and we haven't yet developed new, healthy coping strategies.
But, when we embrace treatment, we can learn how to handle our emotions in a healthy manner. Again, everyone is different — so not every coping strategy is going to work for every eating disordered individual. There may be a period of trial and error and it will probably be frustrating. There will be times when you want to throw in the towel. Please don't do that, because you'll be robbing yourself of all the amazing opportunities life has to offer. Sometimes, it takes a while to find the right therapist, treatment strategy, and medication — but you will find it as long as you don't give up.
I had an eating disorder for over half my life and, at times, I told my therapist that I believed I simply "wasn't meant to recover" and it was time for us both to give up. I couldn't have been more wrong — no one is meant to live with an eating disorder. We all deserve better, and we are all capable of fighting the illness and winning. If it feels excruciating at times, it probably means you're doing something right — and it won't feel that way forever. Be kind to yourself, because eating disorders take a tremendous toll on both your body and your mind. Treatment can be challenging and painful — but, above all, it's so rewarding and worth the hard work .