How Long Does it Take to Recover From Anorexia?

Anorexia Nervosa is one of the most commonly known, and dangerous, eating disorder diagnoses.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, provides the following criteria for a diagnosis of anorexia nervosa:

• “Restriction of energy intake relative to requirements, leading to a significant low body weight in the context of the age, sex, developmental trajectory, and physical health (less than minimally normal/expected).
• Intense fear of gaining weight or becoming fat or persistent behavior that interferes with weight gain.
• Disturbed by one’s body weight or shape, self-worth influenced by body weight or shape, or persistent lack of recognition of the seriousness of low bodyweight [1].”

As the above criteria makes clear, anorexia is both a physical and psychological disorder whose treatment must be as complex and diverse as the disorder itself. No two individuals experience anorexia the same, therefore, no two treatments for anorexia will look the same. This means that having a single, accurate answer to the question of “how long does anorexia recovery take,” ultimately, does not exist.

What is “Recovery?”

Before exploring what aspects contribute to recovery, it is important to explore what exactly “recovery” is. What is considered “recovery” from an eating disorder can be difficult to pinpoint due to the diversity of symptoms and disorder-impact.

One study defines full recovery as patients being able to “find joy in their daily life, free from the physical and psychological effects caused by restrictive dieting [2].” This study also identifies the term “partial recovery” and defines this as “some improvement, but still symptomatic in at least one area: physical health, eating disorder thoughts and behaviors, social functioning or mood [2].”

This definition makes it clear why an exact definition of what is considered recovery is impossible to achieve. Ultimately, recovery will look as different for each person as their eating disorder did, however, it is fair to say that individuals that are stabilized physically, behaviorally, and psychologically from their eating disorder have reached a point of recovery.

Factors that Contribute to the Recovery Timeline

The journey of anorexia nervosa treatment and recovery will be different for everyone, however, some of the factors below can indicate the length of treatment that will be required as well as an individual’s prognosis for recovery or chronic anorexia nervosa.

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Time of Treatment

Whether one meets all or some of the criteria above, engaging in anorexia behaviors, namely severe restriction of nutritional intake, presents a serious danger to the individual. For this reason, accessing treatment as soon as possible is important.

The longer anorexia nervosa symptoms persist, the more an individual’s body, brain functioning, emotional well-being, and personal and professional life are impacted. As one study notes, “spontaneous recovery after more than 10 years of illness duration has been found to be rare [3].”

Treatment must involve a comprehensive look at all of these areas, as they can all mediate anorexia symptoms. The sooner treatment begins and these areas are explored and dealt with, the better the ultimate recovery outcome is for the individual.

Severity of Symptoms

One’s recovery journey is also dictated by the severity of their behaviors and their impact. Individuals whose bodies are severely depleted and whose behaviors have become deeply ingrained will have a much longer road-to-recovery. These individuals will have to take more time to heal themselves physically as their bodies have been ravaged by the impacts of malnutrition.

Often, the psychological work cannot even begin until an individual reaches a certain degree of weight restoration and renourishment. This is because starving the body also starves the brain, making it difficult to perform higher-order thought processes necessary to explore the psychological aspects of eating disorder pathology.

Access to Care

This is where the medical and psychological meets the sociological. Not everyone in the world has immediate or effective access to eating disorder treatment. This might mena going to treatment is prolonged, however, it could also mean that even those that reach out for support cannot access it due to insurance coverage. Beyond this, insurance might cover some but not all levels of care.

Individuals show the most successful rates of recovery when they are able to go through all levels of eating disorder treatment within the timeline recommended by their teams. However, insurance often may not cover a certain level-of-care or may cut an individual from their treatment sooner than their treatment team is recommending.

If an individual cannot complete care as recommended, they may be at a higher risk for relapse and returning to higher levels of care, prolonging their journey toward long-term recovery.

Degree of Support

An individual’s support system plays a huge role in their recovery and can, therefore, impact their recovery timeline.

Support systems provide not only emotional support but accountability. The most effective support-team members are the individuals that will allow the struggling person to cry, vent, and process while also encouraging them to continue seeing their treatment professionals, complying with recommendations, and hold them accountable to what they are being encouraged to do.

Individuals with helpful support systems are more likely to experience long-term recovery, therefore, surrounding yourself with supportive people is important.

The Bottom Line

It is incredibly difficult to be on an emotionally and physically challenging journey and not know when it will “end” for you. The truth is, the journey of eating disorder recovery may never end fully for some.  Others may experience full recovery.  It is an individual journey.  Theremay likely still be days that your automatic eating disorder beliefs pop-in and surprise you. You may not love your body every single day of your life. You might find yourself tempted to return to behaviors at least once.

Even so, this does not mean that living a life where one is not absorbed by the eating disorder is not possible. Many can absolutely find yourself living a life where shadows of the eating disorder are few-and-far-between and where what defines most of your life are things that bring you much more joy and fulfillment.

Whatever your recovery journey looks like, let it be your own and follow it as you need to fight the eating disorder and move toward a life of recovery.

Resources:

[1] American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).

[2] Leigh, S. (2019). Many patients with anorexia nervosa get better, but complete recovery elusive to most. University of California San Francisco. Retrieved from https://www.ucsf.edu/news/2019/11/416006/many-patients-anorexia-nervosa-get-better-complete-recovery-elusive-most.

[3] Speciani, M. et al. (2021). A perspective on chronic and long-lasting anorexia nervosa. Frontiers in Psychiatry.

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