The road to recovery from an eating disorder can be incredibly arduous. It can sometimes take years to recover. To make the journey even more challenging is the ambivalence or resistance towards recovery that is often experienced by the person affected. This is because eating disorder behaviours can be used as a coping mechanism – a go-to when life gets stressful. It can be difficult to let go of behaviours that are relied upon so heavily for emotional regulation.
It can be excruciating for family and friends to watch a loved one fight a seemingly endless battle, day in and day out. At times, it can feel hopeless. But eating disorder experts say that no matter how long it takes, it is vital to never give up hope that full recovery is possible.
During a panel discussion at InsideOut’s Inaugural lecture, University of Sydney’s Professor Stephen Touyz said hope is incredibly important.
“We need to ensure that there is hope, because patients do get better after many, many years. I have seen patients who have been ill for 20 years make a full recovery.”
“I can think of a mum who got sick at 16, and at 38 had a baby and is now happily married with a child, and fully recovered. So hope we should never lose.”
One of the keys to maintaining motivation during recovery is to identify something in life that is more important and more appealing than the eating disorder - and then focus on that. Identify the person’s “hook” or something they are passionate about. For example, finishing a degree, establishing a successful career, having a family, or pursuing an activity or hobby.
Professor Eric van Furth, from Leiden University in the Netherlands, said that if you dig a little deeper, you can always discover something that can be used to motivate a person to get better.
“In the old days, clinicians on my unit would say, ‘oh but she’s not motivated.’ I banned that completely, because everybody is motivated for something. It just depends on what you ask.”
“Individuals with anorexia might not be motivated to increase their body weight, but some will say, ‘I really want to get better.’ People are always motivated for something. You have to ask the question behind the question.”
InsideOut’s Professor Janice Russell, who has more than 30 years experience in eating disorders, said the illness often brings a “tremendous perverse reward” – and that reward needs to be shifted.
“It’s about helping them find something that is more rewarding than what they’re doing. You have to try to find what else they do when they are not being controlled by the eating disorder.”
“They might say, ‘I want to volunteer,’ and you say, ‘Well, it won’t be very helpful if you collapse when you’re volunteering.’ And they might say, ‘Well, okay, maybe I do need to gain a kilo more,’ or, ‘Maybe I do need to eat breakfast before I go out and volunteer.’”
“Sometimes it’s an indirect way to get them motivated. It’s about rearranging the reward.”
Professor Rebecca Park from University of Oxford agrees.
“As people start to get better, other rewarding things start to creep in, to become more important than the self-starvation pursuit.”
So there is a lot that families and friends can do to help people with eating disorders stay motivated to recover, when their motivation ebbs. The key is to see beyond the eating disorder, seek out their “hook” and support them to achieve their goals, and a life free from an eating disorder.
