Please note that this is an Archived article and may contain content that is out of date. The use of she/her/hers pronouns in some articles is not intended to be exclusionary. Eating disorders can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights.

By Nikki Rollo, PhD, LMFT

Recovery is all about choices: making good choices, making the best choice from the options in front of you, and making the next best choice when you slip into an old, but all too familiar eating disorder behavior. This is not always easy. In fact, most of the time, it is downright hard! Sometimes you may feel paralyzed, not knowing what the next best step is. Often times our wants and desires are at odds with the next best choice in front of us. Things may not look very clear ahead. Trusting ourselves when our vision is blurry can feel like a mysterious process. So how do we know which way to go next?

Let’s start with a clear recognition that eating disorders are not lifestyle choices. No one would consciously choose to have an illness that is both physically life-threatening and an emotionally painful experience fraught with anxiety and depression. Sufferers are quite often robbed of joy and experience a terrifying intensity of isolation and shame. This is not something people actively desire or invite willingly into their lives. Eating disorders are a mental illness requiring professional treatment that is guided by compassion, love, and support.

Of course, the challenging thing is that while eating disorders are not a choice, the recovery process is all about choices! There is no treatment that does not involve the person suffering from an eating disorder getting deeply involved and committed to making decisions on a daily basis for their recovery. Each person has a choice to embark on the path of recovery and then continually to make choices that are in service of furthering them along on that path. Making choices in recovery means choosing things that keep you on the path of healing. And when you make a choice that veers off the path (and most like that will happen because it is a totally normal part of the process!), then you make the next best choice to put you back on the path. And you commit to continuing to make the next best choice in front of you- for example at each relational encounter, at each meal and snack, at each opportunity for self-care.

It can be scary to think about making choices towards something else rather than the eating disorder. It has served a purpose, it has had meaning, even if it has been destructive. There is a reason why certain behaviors such as binging, purging, restricting, or over exercising have worked so well as coping tools. Yet, if you are on the path of recovery, there is a good chance these things no longer work in the same way they used to. There are also realized consequences and losses associated with continuing to utilize those behaviors as the first line of coping. It is time for new choices. These new choices may feel uncomfortable or vulnerable. They may not work as quickly to soothe big feelings- in fact they may open space for you to feel even more of the joy and pain of being human. This is recovery.

This process of choice is filled with hope. Having choice means you CAN recover. Recovery IS possible. Becoming fully recovered from an eating disorder occurs through making a succession of difficult choices that do not always feel good in the moment, yet build a foundation of resilience, healing, and deeper connection to one’s values. There may be relapses, there may be tears, there may be challenges in relationships. There will be mistakes. There will also be joy, hope, and peace. Like Pandora’s box, the misfortunes of life will be present – pain and suffering are a part of humanity- but Hope was also present in the box. Hope fills us with expectation about the possibilities in life.

Here are some questions to consider as you are faced with choices in the recovery process:

  • What are my values? What matters to me in life? Does this choice align with these values?
  • What goal am I trying to achieve? What is important to me about this goal? How does it connect to a recovered life? Does this choice move me closer to that goal?
  • Does this choice help me keep my promises to myself and others?
  • Is this choice about instant gratification and how does it impact my future?

In conclusion, consider who can help you along the way and work diligently and relentlessly to establish those connections and relationships. Seeking feedback and guidance about choices during this time is really important. A therapist, dietitian, family member, or recovery-minded peer (or ALL of these people!) is essential to having the support you need to make good choices or the next best choice and to continue to cultivate hope in the face of hopelessness.