Recovery from an eating disorder happens in stages. It doesn’t always feel like it and the stages will differ for each individual but the basic outline remains the same.
It is beneficial to understand the stages of recovery from an eating disorder, as it helps people to understand where they or where others may be on their road to recovery. These stages look a little different within each person’s recovery process, but the basic outline is as follows: pre-contemplation, contemplation, preparation, action, maintenance and (potentially) relapse.
It shows the journey ahead and gives people ‘permission’ to experience relapse, and move back and forth in their recovery process. It also challenges the idea that an eating disorder is permanent part of the person’s life.
What are the stages of change?
In this stage, an individual is unable to acknowledge problematic behaviour and has no intention to change. A person with an eating disorder may deny there is a problem. Friends and family may pick up on some of the warning signs and symptoms (e.g. restrictive eating, overeating, over-exercising, purging or a pre-occupation with weight and appearance). During this stage, the individual may exhibit hostility, anger or frustration if approached by someone who is concerned.
In this stage, an individual is aware of the problem and beginning to think about getting help. They may be considering some of the benefits of changing their behaviours but are hesitant about the idea of doing so. Consequently, there is no concrete commitment to change during this stage (e.g. “Yes my weight is a concern for me, but I’m not willing or able to begin gaining weight within the next month”). The eating disorder often plays an important role as a coping mechanism for the individual when dealing with the stress and challenges in their life.
In this stage, an individual has intention to change and is planning how this might happen. They may begin to engage in ‘change talk’, e.g. “My weight concerns me; I’m clear that the benefits of change outweigh the drawbacks, and I’m planning to start within the next month”.
In this stage, there is a change in the behaviour, environment and thoughts of an individual. This stage requires commitment to change and to continue to practice new behaviours (e.g. sticking to meal plan, restricting amount of exercise). The person will be trying new is willing to face fears in order for the change to occur.
In this stage, there is a focus on relapse prevention and building on gains and positives from change (e.g. improved health and long-term happiness). In this stage, more stable behavioural changes are observed. The person is proactively practicing new behaviours and new ways of thinking, as well as consistently using both healthy self-care and coping skills. This requires continued commitment and support (e.g. from family, friends and loved ones, support groups, health professionals such as a GP or psychologist) to sustain the new behaviours and support the person as they navigate their pathway to ongoing recovery.
Relapse can also be considered a stage of change, where there is a return to some old patterns of thought or behaviours. Relapse can be an important stage during recovery to see what works well for the individual and what triggers arise. Although relapse can be stressful, it is very common and often helpful to gain insight into patterns of the eating disorder for future
Going through the stages
It can be useful for a person going through the stages of an eating disorder to remind themselves that there is hope and that recovery is possible for everyone. It is important to realise everybody is different and everybody’s experience with an eating disorder is as individual as they are.