12 lessons learned from people with long-term eating disorders
One of the recurring questions when discussing eating disorders is how long they will last. Recovery rates can vary widely, but most people recover fully . However, around 20% of people live with the disorder for more than seven years, at which point most experts consider it to be a long-term eating disorder.
Recovery from eating disorders usually takes months, and complete remission can easily take a couple of years, since in addition to resolving the eating symptom, the psychological, personality, and environmental factors that have contributed to it must be addressed, which takes time.
The long-standing eating disorder
The persistence of the disorder makes recovery more difficult, although not impossible. Remission can even occur after 10 or 15 years. It is important, however, to understand that a longer duration of the disorder is a negative prognostic factor.
When an eating disorder lasts for years, it's common to have to live with the symptoms. And that's when worries and fears about the future and whether recovery will be possible overwhelm the person.
We've spoken with people who have a long-term eating disorder, and these are the 12 lessons they've shared with us:
How can I continue without losing my identity despite crises and conflicts?
Keep in mind what defined you, what you liked about yourself before the disorder. Fight for it, fight to reclaim it. Explore what things, even now, despite the eating disorder, make you feel unique and special. Strive to discover and maintain them. Don't forget that, before the eating disorder, you were already a valuable person to those who love you. Try to rediscover and find what is valuable about you, or simply what you liked about who you were before the eating disorder. Self-awareness is very helpful in this area, and therapy can greatly contribute to it.
When we reach a certain age, how do we manage what we are supposed to do according to society's standards?
Society, like any group, is based on the customs of the majority, but there are countless variations of lifestyles that deviate from the mainstream. Don't confuse what's fashionable with what's valid or not according to your own beliefs. Try to cultivate a personality that's a little less subject to social pressure, the opinions of others, and the self-imposed pressure to please everyone.
How can I stop the intrusive, recurring thoughts about eating disorders and connect with the present? How can I live my daily life, be independent, and take on responsibilities as an adult?
If possible, carve out some time in your life where the symptom doesn't interfere. Doing things you enjoy, meeting up with friends, classmates, or colleagues can help. Don't close yourself off to checking in with them from time to time and seeing how they grow and develop, even if you can't keep up with them. Don't isolate yourself from those who care about you. If the recurring thoughts are very intense, consult your healthcare provider.
How to manage negative thoughts in eating disorders
How can I cultivate a positive mindset about my progress? How can I learn to take care of myself and value myself, and believe that I, too, deserve to be better?
Work on your self-esteem. The people around you, including your therapists, can help you recognize and enhance the qualities and aspects that make you a loved and valued person. Identify and appreciate the efforts you make every day to cope despite suffering and anxiety. "Imperfections" are actually what make us unique and original; we must embrace and appreciate them, and learn to tell ourselves that "we are enough."
How can I move forward with my future plans if I have so many fears?
In the process of developing your life plan, many fears may assail you. Will I be capable? Can I be useful and valued? Will I be able to improve my social, professional, and domestic skills? Your fears and doubts are not very different from those of the rest of the population. It is important to study or work in something that motivates and excites you , because that way you will function better.
People with eating disorders often undervalue the things they do well. You need to be aware of what these things are and not obsess over whether they are "good enough." Think of a drawing made by a small child; it may be clumsy, but that doesn't make it any less valuable. Don't give up if you fail a task or an exam. Many people don't find their ideal partner, studies, or job on the first try, and sometimes you have to reconsider whether the path you've chosen is truly the right one for your tastes and abilities. Adjust your expectations to the present moment, being realistic. If you find that your ability to concentrate is failing because of your eating disorder, or your impulses are preventing you from functioning well, find a simpler activity that you feel you can manage. Acknowledge your fears and talk about them.
How can I reconcile my expectations of myself with my reality?
Therapeutic support is very helpful in this regard, because it provides a space to express fears, worries, and thoughts without having to repress them, allowing you to work through them. While it's good to have dreams and hopes, it's also helpful to be realistic and compare our expectations of ourselves with our actual achievements. And, with guidance, we can reflect on why we don't achieve them when they don't, and what isn't working.
How to maintain friendships and forge new ones? How to manage the fear of loneliness and the worry about family?
It's important that you can talk, be in company, and avoid loneliness and isolation. When you're going through a phase where you're having negative thoughts about yourself, it's important not to be alone, even if you don't feel like socializing. It's good to open up to other people, to other conversations, to step outside of yourself. Get together with friends and family at least once a month. Try to see them regularly, at least a minimum. Don't focus on disagreements and points of conflict. Seek to enjoy each other's company, to share experiences . Don't punish yourself further by pushing them away.
Nadia López Chapero
How to set new goals and maintain a sense of control?
It helps to set small, achievable goals . Choosing them helps you maintain a degree of control. For example, going to a concert, buying a book, or fixing something. Nothing too complicated, but something that gives you a sense of accomplishment. Create a basic routine in some area (e.g., study time, organizing your day or your home) to rely on. This will serve as a foundation upon which you can build . Learn and practice a relaxation technique and avoid using drugs or alcohol.
How to gain confidence to take on challenges?
It's more important to dare to start with a simple goal, or to break a pattern of behavior, than to feel confident in doing so. Confidence will come with time, with practice. It's from insecurity and discomfort that the desire for change arises. Start by daring to try something that challenges you, but doesn't pose too much of a challenge.
Living new experiences is incredibly beneficial. They're challenging, but the results can surprise you; you might even love them and want to do them again. You can experience new sensations through travel, leisure activities, trying new or exotic foods... Guilt might creep in, but think of it as a heavy suitcase you have to carry for now.
For example, a person with a long-standing eating disorder began to change their eating habits by eating the same foods, but allowing themselves to eat them hot. They built upon this achievement with others, and very slowly gained freedom. And the feeling is wonderful. The same is true in cases of binge eating: introducing any change, however small, helps reduce the feeling of being out of control. The important thing is to start, and if you can't do it alone, seek professional help.
Could I suffer lasting physical and mental consequences? How can I avoid them?
Most physical and many mental consequences of eating disorders can be reversed, although not all; some may be permanent. It's important not to ignore this. Prolonged absence of menstruation can weaken bones, making them more fragile despite weight regain; fertility can also be affected. If extreme malnutrition and low weight persist for a long time, it can lead to mental health issues in some cases, such as brain atrophy. Persistent vomiting can cause esophageal ulcers, stomach hernias, or indigestion. And binge eating can lead to obesity and its complications (joint stress, hypertension, diabetes, metabolic syndrome).
The way to avoid the consequences of eating disorders is by being aware of them and seeking professional help to receive the appropriate treatment.
How to manage negative feelings and mistakes without falling into the habit of using the eating disorder symptom as an excuse?
This is one of the most difficult challenges to face. The TCA will try to maintain Because resorting to eating symptoms provides a false sense of security. This includes compensatory behavior, constant body checking, food restriction, etc. It provides a false sense of security because it offers momentary relief, but in reality, it traps the problem more and more.
It's scary to let go of the symptoms and revisit those old insecurities. But that doesn't mean they're not still there. You have to accept this way of functioning instead of ignoring it, and look for ways to crack it somewhere, like trying to break down a tall, solid wall and searching for cracks. Don't give up trying, and if you don't succeed, seek professional help. If you can trust despite the fear and relinquish some control, a door will open. What can help you in your daily life? It helps to feel supported. It helps to have family and friends to lean on for whatever you can afford despite the symptoms. It helps to have professionals specializing in the treatment of eating disorders by your side, who can guide you when doubts arise (nutritional and psychological), and who can monitor your weight and physical condition. People with long-standing eating disorders have usually already tried to manage on their own countless times, without success.
And finally, how do you avoid throwing in the towel?
Picking it up again. Thinking about all the good you could lose and how your life could change if you manage to overcome the eating disorder. It might sound cliché, but every relapse offers a lesson that makes us stronger. And if I did it once, I can do it again, and again if necessary, and as many times as it takes.