Even the most experienced professionals in the ED treatment community don't completely agree on a definition of 'recovery', but as RD's there are some goals that we are pretty much universally steering our clients towards as part of recovery. Recovery is hard to quantify, and certainly can't be measured on the scale. So here is an overview of a dietitian's goals with a client (adapted from Dr. Ralph Carson):
- Health enhancement rather than specific weight. Standards like BMI, IBW (ideal body weight calculation) or other arbitrary measures of goal weight are minimally useful. The goal is health, period.
- Nourish body in safe and healthy manner.
- To assist patient in normalizing eating and exercise behaviors. The ED significantly distorts the meaning of normal eating and exercise, so we need to reestablish normal patterns. This is crucial for getting the body's appetite hormones and neurochemicals in the brain back in balance.
- Honoring internal and external hunger, satiety and satisfaction. This means honoring physical and emotional hungers. It also means eating foods that are not only filling but are also satisfying.
- Eat whatever and whenever they want. AND without guilt or anxiety. This takes repetition and will certainly be uncomfortable at first. It is essential that regular, consistent eating patterns have been established prior to this so that eating doesn't become a free-for-all. The consistent eating patterns will recalibrate appetite cues that will allow the individual to eat intuitively.
- Self-acceptance and respect for human diversity. Respecting that we are all unique and that no two bodies are the same. People can be healthy at any size, shape or weight. You are worthy of love and respect regardless of your physical appearance.
- Enjoying a wide range of movement rather than prescribing a rigid routine of regimented exercise. The body was built to move in lots of ways. Exercise doesn't have to be structured, it can also include recreational and leisure activities. Think of ways to play, like children do, they aren't worried about burning calories or getting their cardio in. They move because it's fun.
- To equip patients to leave treatment with these skills and desires. The ultimate goal is to eventually end treatment and be able to live a full vibrant life, free of the ED.