A previous post, Is Full Eating Disorder Recovery Possible?, brought up a lot of questions about a common challenge for people pursuing eating disorder recovery that I want to talk about today: partial recovery. I actually like the term qausi-recovery because the word “qausi” can mean both “almost but not fully” as well as “seemingly but not actually”. Though sometimes we are aware we are only partially recovered, other times, we think we are fully recovered when we’re not actually 100 percent there. My personal journey fell into the latter category.
When I relapsed, I had been free of eating disorder behavior for 8 years and believed I was recovered. Slipping back into old behaviors took me by surprise because I didn’t think I was in danger of a relapse since I hadn’t really struggled with my eating disorder for so many years. I didn’t understand why it happened for a while, but eventually came to realize that all those years, I had really been in quasi-recovery.
Some might not agree, and that’s understandable. Part of the difficulty with this topic is that there is no one definition for recovery. Everyone defines it a bit differently, so for our discussion here, I wanted to clarify what I mean by recovery.
What is Full Eating Disorder Recovery?
From a clinical perspective, we would use the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) to see if a person still meets any criteria for an eating disorder. The three most-known are anorexia nervosa, bulimia nervosa, and binge eating disorder. However, many people don’t meet all the criteria for these disorders, but could still be diagnosed with an eating disorder known as Other Specified Feeding and Eating Disorder (OSFED).
OSFED is diagnosed when a person has feeding or eating behaviors that cause clinically significant distress and impairment, but do not meet the full criteria for any of the other disorders. While some people start out with an OSFED diagnosis, some start with a different diagnosis and are later diagnosed with OSFED when they no longer meet criteria for anorexia, bulimia, and binge eating disorder. Some examples include:
- Someone who has restored weight to a “normal” range but continues to significantly restrict
- Someone who binges or binges/purges but not as frequently
- Someone who doesn’t restrict caloric intake anymore, but has become overly conscientious about eating only “healthy” foods (now known as orthorexia)
Anyone who still meets the diagnosis criteria for an eating disorder is still not recovered. I imagine most people would agree with that. But does not meeting criteria mean you’re recovered, as I was those 8 years? Perhaps from a clinical perspective, but I personally believe recovery goes beyond a clinical definition. For me, recovery from an eating disorder is more than just abstaining from eating disorder behaviors—it involves a real healing of the relationship with food and your body.
What Quasi-Recovery Can Look Like
Some signs you might not be fully recovered from your eating disorder include (and during my qausi-recovery stage, I could check several of these boxes!):
- Eating more than you did before but still not consistently honoring your hunger and/or eating an appropriate amount
- Eating more foods than you did before but still labeling food as “good” and “bad” and avoiding “bad” foods much of the time
- Having anxiety around food
- Using exercise to “earn” or “make up” for what you eat
- Having food rules about what, how much, or when you can eat
- Continuing to hate your body and/or fear weight gain
How to Push Through Quasi-Recovery
Being honest with yourself about not having fully healed your relationship with food and your body is an important place to start, if you’re not there already. It’s equally important to believe that full recovery is possible. Don’t settle for believing that this is the best it can be for you, though I understand those feelings as well. I have vivid memories of saying through sobs that I would never be able to make peace with my body and therefore food, even though I wasn’t using explicit behaviors anymore.
But recovery is about rooting out eating disorder thinking just as much as it is about quitting behaviors. So keep doing that internal work to challenge all the eating disorder/diet culture mentality that continues to drive food anxiety and fear of fatness. Here are some great books I recommend:
- Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating by Christy Harrison, RD (also her podcast, Food Psych)
- The F*uck It Diet: Eating Should be Easy by Caroline Dooner (Warning: As you could guess by the name, there is a decent amount of profanity; I don’t curse myself but finally read it anyway and it is good!)
- Intuitive Eating: A Revolutionary Program That Works by Evelyn Tribole
- Body Kindness: Transform Your Health from the Inside Out–and Never Say Diet Again by Rebecca Scritchfield, RD
- Health At Every Size: The Surprising Truth About Your Weight by Dr. Linda Bacon
- Body Positive Power: Because Life Is Already Happening and You Don’t Need Flat Abs to Live It by Megan Jayne Crabbe
- Body of Truth by Harriet Brown
Read these and other anti-diet, fat-acceptance books and follow fat-positive, intuitive eating accounts on social media (sign up for my newsletter and I’ll send you a list of influencers!). Then unfollow, cancel, or otherwise disengage with people and content that continues to keep you in bondage to food issues. What we surround ourselves with influences us in a MAJOR way. Finding community with people who promote true body acceptance and food freedom is vital in changing your mindset. It made all the difference for me and I hear the same from so many others.
Based on my own experience and those of my clients, qausi-recovery is a common stage for many people with eating disorders. So if that’s where you find yourself, that’s totally okay. Please don’t feel like a failure or get discouraged. The journey to full eating disorder recovery is not a straight line, and it’s certainly not easy. Especially considering how disordered our culture’s relationship with food and bodies is! You CAN get there. It might be cliché, but it’s true:
Progress, not perfection, dear one.
I’m Cherie Miller, MS, LPC-S, founder of Nourished Soul Center for Healing and @foodfreedomtherapist on Instagram. We offer therapy and nutrition counseling for chronic dieting as well eating disorders like Anorexia, Bulimia, Binge Eating Disorder, Orthorexia, ARFID, and other food issues. As anti-diet professionals, we are passionate about intuitive eating and Health at Every Size philosophies. Contact us here to schedule a therapy or nutrition appointment.