Anorexia Recovery: How the Stages of Change Model Can Help

Eating disorders are serious conditions that impact millions of people worldwide. They involve a range of disordered eating behaviors and attitudes that can result in significant physical and emotional consequences. And one of the most devastating eating disorders is anorexia nervosa (AN).

Due to their complex origins, eating disorders like AN can be challenging to recover from, with the process sometimes taking months or even years. However, those struggling with the recovery process may find hope in the Stages of Change model.

The concept offers a different kind of framework for understanding eating disorder recovery, and can serve as a guide for those progressing through the various stages of anorexia recovery, helping to give them a sense of clarity and insight during an otherwise intense and emotional period.

What Is the Stages of Change Recovery Model?

Eating disorder recovery rarely happens in a straight line. Even when someone is in active eating disorder treatment, it’s not uncommon to experience setbacks.

Regardless, most people conceptualize the recovery process as a linear process, which can make any type of regression feel especially devastating.

The Stages of Change recovery model attempts to challenge that belief by restructuring recovery not as a straight line with a certain order of benchmarks, but as a much more fluid set of stages.

The hope is that redefining this challenging process as one in which there is no “correct” course can help prevent relapse and encourage healthy self care by reinforcing the idea that each recovery process is as unique as the person experiencing it.

The Five Stages of Change

Eating disorder specialists have identified five stages that commonly occur over the course of eating disorder recovery. [1]

Each stage can be experienced at any point during the process, in any order, with patients sometimes revisiting certain stages multiple times. Understanding stages of recovery can also help a patient understand their overall progress.

Pre-Contemplation Stage

While the five stages are not presented in any certain order, the pre-contemplation stage is generally considered the first stage, as it takes place before someone has openly acknowledged that they have a problem.

They may be in denial or unaware of the harmful effects of their behavior, or see the results of their disordered eating as a net good, disregarding any negative consequences.

At this stage, it can be difficult for loved ones to express their concerns about someone’s behavior. The person may be hesitant to respond, shut down in the face of questioning, or react to any discussions with hostility or anger.

It is crucial for loved ones to approach the situation at this point with empathy and avoid blaming or shaming their loved one. Some ways to provide support include: [2]

• Showing compassion towards the person.
• Try to remain calm and understand their perspective.
• Shift the focus away from their eating behavior, interests, and things they might miss out on due to their disorder.
• Encourage them to seek help and offer to assist them in finding resources.

Contemplation Stage

The contemplation stage is a crucial step in the recovery from an eating disorder. During this stage, someone starts recognizing their problematic behaviors and considers making changes.

However, they may also experience internal conflict as they struggle between wanting to change and wanting to maintain their disordered eating habits. This ambivalence can make it challenging for the person to take action, leading to anxiety, guilt, and fear of change.

To support individuals stuck in this stage, take a compassionate and non-judgmental approach such as: [2]

• Encouraging the person to share their thoughts, feelings, and concerns without judgment
• Amplifying the positive steps taken towards change and encouraging them to continue on this path
• Respecting their ideas, particularly those that favor change.

Preparation Stage

During the preparation stage, an individual struggling with an eating disorder actively plans and prepares to make significant changes. They have decided to move away from their disordered eating patterns and are taking steps toward that goal.

These steps involve having conversations about change, seeking treatment options, and making lifestyle adjustments to support their recovery. While this stage can be exciting, it can also be daunting, as individuals may still feel uncertain about the future.

Seeking the assistance of a mental health professional is crucial at this point, as they can help guide someone through any lingering doubts or apprehensions, and even offer an official eating disorder diagnosis, which can open up the doors to insurance coverage for different treatment programs.

Action Stage

The action stage begins when someone starts working toward changing their thoughts and behaviors in earnest. During this stage, individuals let go of old habits and work to establish new coping skills, which can help them deal with their condition in a healthier way.

Often, at this point, someone is working with a treatment team, which may include a therapist, psychiatrist, primary care physician, nutrition counselor, or other medical professionals. Together, this group can help someone make the necessary changes to see real progress.

However, it’s essential to recognize that many people with anorexia nervosa also experience setbacks during the action stage. The care and compassion of loved ones, as well as members of someone’s treatment team, can go a long way toward helping them understand that setbacks don’t represent failure, and that they can keep working on the kind of helpful changes that led to healthier habits.

Maintenance Stage

The maintenance stage is hopefully the most lasting phase in the recovery journey. It represents the point where individuals work to sustain their progress and continue toward ongoing recovery.

At this stage, disordered thoughts and feelings may be reduced in frequency and intensity. Rather than focus on changing behaviors, or even on learning new coping skills, someone at this stage may be more involved in minding for potential triggers, or on practicing self-love and self-care.

Many people in the maintenance stage of recovery find it helpful to stay involved in some form of therapy or support groups to help keep themselves accountable and tuned-in to their thoughts and behaviors.

Yet, even at this stage, setbacks and relapse are possible. As with every phase of recovery, the continued support of loved ones can be an important factor in helping someone swiftly overcome these setbacks.

Finding Help for Anorexia Nervosa

Anorexia nervosa is a serious, dangerous, and potentially deadly disorder. If you or a loved one are struggling with AN, it’s crucial to seek out help.

Various treatment options are available, including different types of therapy, medication, support groups, and hospitalization. Speaking with an eating disorder specialist or other medical professional, including a therapist, dietitian, or primary care physician, can be a helpful and informative step toward finding the right kind of treatment for you or your loved one.

A number of eating disorder hotlines can also help. These services allow callers to remain anonymous, while offering additional information and resources about anorexia nervosa and potential treatments and programs.

If you or your loved one have already received an anorexia nervosa diagnosis, it may also be possible to ask your insurance company for additional help finding a program. Utilizing this route can also help ensure that the treatment you choose is covered by insurance, which can make a big difference in cost and, ultimately, how long you or your loved one can stay in treatment.

Regardless of how or where you look for help, the most important aspect of anorexia nervosa recovery is finding treatment. The journey toward recovery may not be clear-cut, but it’s always possible to overcome these damaging thoughts and behaviors, and start on the path toward a healthier and happier future.

Resources

1. Stages of Recovery. (2022). National Eating Disorders Association. Accessed April 2023.
2. How to help someone with an eating disorder. (2020, July 14). United Kingdom National Health Service. Accessed April 2023.

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The opinions and views of our guest contributors are shared to provide a broad perspective on eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published October 17th, 2023, on EatingDisorderHope.com