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The Not-So-Glamorous Side: Eating Disorder Treatment

Posted January 23, 2018

Tags: awareness

(photography by Brett Godwin)


"...treatment is often a stop along the way, and can be both extraordinarily trying and unspeakably rewarding."


If I had a dollar for every time someone has told me how lucky I was to spend months eating six times a day, staying perfectly sedentary, and focusing on myself, I might earn enough to pay out-of- pocket for a day in eating disorder treatment.

It’s an unfortunate truth that people glorify eating disorders, especially anorexia nervosa—after all, in a society that praises the emaciated for their beauty and willpower, it’s hard not to idealize all the good a skinny body might bring, even if that body is unwell. This
type of thinking is prevalent and pervasive today: for example, Amazon recently attempted to sell a hoodie defining anorexia as “bulimia, except with self-control”. I developed anorexia myself, after a lifetime of being inundated with comments that primed me to equate my worth as a human with my weight and appearance. I spent years of resisting the recommendations of my doctors and dietitians, and eventually had no choice but to enter residential treatment during the summer in between two years of college.

Nothing prepared me for the experience of going to treatment, and, between the nebulous descriptions from my physicians and the inaccurate depictions of rehab in the media, nothing could have. Every treatment center is different, of course, but I can say with relative certainty that a high number of them defy common expectations. The house I entered on the day of my admission had neither the pristine white hospital beds nor the zen gardens and
waterfalls I’d envisioned. Rather, I entered a large, well furnished house, with a small number of other clients and a fair amount of staff. It felt lived-in, and, at times, even comfortable.

This comfort, though, was somewhat ironic: the other clients and I struggled to eat and then sit with our anxieties as we abstained from the behaviors that landed us in treatment in the first place. We attended group therapy sessions multiple times daily, and also had
individual sessions with therapists, dietitians, and psychiatrists. In short, we took time to carry out the self-care acts we had denied ourselves for so long, and then talked about the emotions that consequently came up.

Though these practices are second nature to many people, they are the last things someone with an eating disorder would be inclined to do. I had trained myself to insist that I liked the foods that were lowest in calories, that I wasn’t really hungry, and that yes, I really did enjoy standing up and walking around more than I enjoyed sitting still and hanging out. I, like so many others, had forced myself into a state where the guilt that arose from eating food, resting my body, and enjoying life felt intolerable.

Changing my actions, thoughts, and core beliefs is, by far, the hardest thing I’ve ever done. I’m lucky to have many friends who can appreciate just how difficult the work I did was, but so many others fail to realize that treatment is intense, harrowing, and often isolating. The work that clients do in treatment is mentally taxing and, often, physically painful. Refeeding is the process of starting to eat normally again, after a period of time using disordered behaviors (such as restricting, over-exercising, or purging). It's one of the most uncomfortable processes I’ve experienced, both physiologically and
emotionally. I still get upset when people tell me they envy the time I spent in treatment; they seem to covet the fun they would have sitting, eating, and talking, instead of recognizing the profound personal stress and emotional despair that I and the other clients experienced daily.

The other common misconception among my friends about this type of residential treatment is that anyone who admits as a client will emerge “fixed” soon after. Unfortunately, this is far from the truth: most clients in treatment are not first-timers—not surprising, because eating disorders have a frighteningly high rate of relapse, especially given the woefully inadequate insurance coverage that eating disorder patients receive. Therapy is a process, and,
just as one doesn’t develop an eating disorder overnight, one also does not recover immediately. In fact, many people make some of their most important progress years after they enter treatment.

I won’t pretend this piece can even begin to convey just how distressing going to treatment really is—but I can hope that I’ve helped dispel some of the mistaken beliefs that many of my friends and acquaintances hold about how it feels to work on recovering from an eating disorder. Eating disorders are not choices, and the path to recovery is incredibly difficult; treatment is often a stop along the way, and can be both extraordinarily trying and unspeakably rewarding.


Possible resources someone with an eating disorder might find useful:

(for more information on the above organizations, you can visit TWLOHA)

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