Recovery is hard. For most people the process of recovering from an eating disorder takes years – that's right, years. Knowing how much sweat and tears (and money) will go into the process, let's make sure you're not inadvertently sabotaging your recovery. Here are 5 of the most common ways people sabotage themselves that I see in my clinical practice:
1) Not having a full treatment team.
Thinking "I can do this on my own" or "I don't need to see a ___ [therapist, dietitian, psychiatrist, doctor]." Each member of the team brings something different – and important – to the table. Excluding one or more members is like fighting the ED with one hand behind your back. Yes, it's a lot of appointments, and a lot of money, but it's well worth it if it shortens your length of treatment and/or prevents you from needing prolonged or repeated stays at higher levels of care which are infinitely more expensive than outpatient treatment.
2) Not seeing ED specialists.
I get it, you want to use your in-network insurance benefits. The problem is, often times the providers who have received extensive specialized training in eating disorders aren't always in network with your insurance company. This is especially true for therapists and dietitians who are in private practice, because often times the burden of trying to work with insurance companies is so prohibitive to their business that they opt out. With dietitians in particular, most insurance companies won't work with us to begin with, so you're rarely going to find an RD who is in-network because it practically doesn't exist (at least in the Kansas City area, this may vary in other states).
However, let me emphasize the importance of seeing ED specialists. Sadly, numerous times I've seen clients who had unhelpful and even detrimental experiences with therapists, dietitians and doctors who aren't ED-trained. It would be like going to a neurologist when you have a problem with your feet. Yes, the neurologist is very competent in their field and somewhat familiar with podiatry, but that's not who you want treating your feet. You want the podiatrist. So see the specialist. I promise you it's worth it. Practitioners that treat ED's receive extensive ongoing training. For example, as an RD with a master's degree in nutrition, I went on to receive 5 years of ongoing training and supervision from more experienced ED clinicians.
3) A poor support system
People don't recover alone, because you don't live your life in a vacuum separate from the rest of humanity. As human beings are are built for connection and are inevitably reliant on others for support, even in ways that aren't obvious, such as the workers at the electric company who keep your lights on. Individuals with eating disorders tend to be some of the most independent, strong-willed people on earth. They often equate support with weakness, and the ED prefers isolation and secrecy anyway. Not to mention the co-occurring depression that we often see with ED's, which can also increase isolation.
If the eating disorder thrives in isolation, your recovery will thrive with support. Create yourself varying "levels" of support – starting with those who are closest to you and who know about your ED, such as family and friends, as well as your treatment team. They can provide support in so many ways – emotional support, meal support, financial support and so much more. Then there are the people who you see on a regular basis who might not know as many details about your ED but can still be supportive, like your boss, coworkers, teachers, and coaches. They can support your recovery by giving you time off for appointments, checking in if you're having a bad day, and letting your family know if they are concerned about you. Then there are the outer layers of your support system. People who don't even know about your ED, but still enhance your recovery, such as the man who delivers your groceries or your massage therapist. These people at all levels provide crucial support for recovery.
4) Continuing to follow unhelpful social media content
If your social media feeds are constantly showing you posts and images promoting thinness, fitness, food, dieting, even general "health", then you're likely perpetuating your ED without even realizing it. While it seems benign to follow this content, it's not. Your brain is creating and strengthening these neural pathways and filing away the information at a subconscious level. In Figi eating disorders were essentially nonexistant – until westernized media was introduced. Once their citizens were exposed to this content they started developing eating disorders. I'm not saying that the media causes ED's, that's not my point. I'm saying that the images and words we are exposed to DO have an influence on us.
Use this to your favor. Unfollow content that is about food, fitness, health, dieting, weight loss. Then seek out resources that are pr0-recovery. There are a lot of them out there. And also follow content that has nothing to do with the ED or recovery. Give your brain OTHER things to think about. Get a hobby, develop an interest, learn a new skill. We need to expand your horizons.
5) Weighing yourself
Weighing yourself will perpetuate your obsession with your weight and fear that you will get fat. Letting go of the scale is an important part of recovery. You must learn to trust your body and that it will find and maintain a weight that is normal for YOU when you are eating normally. We don't want you to have a total meltdown if you do see your weight at the doctor's office or some other random way, you need to be able to tolerate that information. But you don't need to be weighing yourself on your own. Let the professionals handle it.
Get rid of your scale, or any other tool you use to measure your body (e.g. tape measure, certain clothing items, etc). You can do this ceremoniously if you want. Smash the scale, throw it in the dumpster, turn it into art, whatever empowers you. Simply hiding it in the closet won't do. Nope. It's too easy to dig it out in a moment of desperation or curiosity. You must get rid of it and commit to not purchasing another one or weighing yourself elsewhere like the gym. I don't care if others in your house insist they need a scale to weigh themselves – they don't. And if they won't budge, then they need to keep it somewhere you can't access it or see it.
Initially you will probably be anxious if you stop weighing yourself. But over time most people report they are actually less anxious about their weight when they stop weighing.
You don't have to do all of these at once. Start by taking a hard look at yourself and the ways you are sabotaging your recovery, and then pick one thing to work on.