I can recall speaking to others after I’d been diagnosed with anorexia, whilst deliberating over treatment options, and admitting that I’d probably had an eating disorder for a long time.  I thought it was something that would always be there, but I was accepting of needing help at that moment in time so that I could get myself out of the particularly deep hole I’d got myself into, and learn how to manage it in future.  I didn’t think it was something you can recover from.  I’ve changed my mind.

I believe there are three possible outcomes following treatment.  The worst case scenario is no improvement, i.e. you don’t weight restore and you don’t rewire your brain.  Sadly, I’ve seen this happen in fellow patients on my treatment programme. I think this can happen for several reasons.  Perhaps the person isn’t ready to commit every single cell of their being to recovery.  Recovery is fucking hard work and requires you to be alert to every single one of your thoughts and actions and to challenge where necessary.  Less than 100% just won’t get you there. If you don’t quite grasp the science behind rewiring the brain it will be more difficult because you may not be able to identify which thoughts and behaviours are reinforcing fear of weight gain in order to then be able to ‘think / act opposite’.  Or maybe the eating disorder is serving too much of a purpose in feeding other issues that the person is struggling with which need dealing with alongside.  In someone with deep rooted core beliefs, perhaps being unlovable for example, I think anorexia can serve a purpose in terms of care seeking, and the attention from medical professionals and those directly round the person can provide validation and a sense of being looked after. Whilst the person can genuinely want recovery, if the anorexia is multi-functional and feeding into other illnesses, this can impact commitment to recovery.

Another outcome is weight restoration without recovery from the eating disorder.  It is possible to eat as per the meal plan prescribed by a treatment team, weight restore to a healthy BMI, but once again not rewire your brain.  In my post, ‘Whoa there, Steady On’, I spoke of how I had identified this as potentially happening to me if I don’t ramp things up a gear in terms of recovery focused decisions over the next few weeks.  I have put weight on by eating as directed, yet I know I have some harmful thought patterns that remain such as opting for the smaller slices of bread from the end of a loaf, thus reinforcing that less is safer, resulting in continued fear of weight gain. I appreciate the role of a set meal plan early in treatment; I certainly wouldn’t be eating crisps and biscuits so freely without it.  I do think however, that to achieve full food freedom, there comes a point where the meal plan must be phased out and the individual encouraged to simply eat without restriction.  This is one of my goals for the coming weeks before I return to work: to truly eat what I want, when I want it.  To come out of treatment reliant on the security of a meal plan is disordered eating. I see that this would be ‘maintenance’ and the only outcome I previously thought was possible.

The remaining outcome is full recovery.  Having learned the science behind why and how eating disorders develop, I now believe that if you are successful in both weight restoration and rewiring the fear of weight gain, you will be recovered.  This is where I am determined to be and I honestly feel like it is within the grasps of my fingertips right now.  This does mean being 100% recovery focused in every single decision, and this again is a further goal that I have set myself for the coming weeks.  Of course, should circumstances arise which result in falling once again into energy deficiency, therefore triggering fear of weight gain in those predisposed by genetics, there is always the possibility that anorexia could return.  This is where the vigilance is required by ensuring that periods of illness, grief and stress etc. are nourished with food.  Anorexia can be vamoose, hopefully never to be experienced again.  I guess much like a cold, the flu, a sickness bug….you COULD catch it again but unless you do, you are better.  I will be better!!