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What is treatment like?

The treatment experience is different for each person. Here are some comments about treatment from people who went through treatment.

Mealtimes can be difficult not only during recovery, but for a long time—and even throughout the rest of a patient's life. Family members often aren't sure how to act—should they congratulate the patient for eating food and encourage more eating? Should they take the focus of attention completely off of food and talk about something else? One family found meal planning helpful. They decided with their recovering daughter which foods to eat and when to eat them. This was their only focus on food. They would "eat what was healthy and forget about it."

Staying busy after meals was important to get their daughter's mind off of what she had just consumed. The family would take walks or go shopping. Therapy helped this family work out how best to relate to their daughter. Although they said that it was "not easy to sit with counselors and realize your faults as parents," said the mother, she felt that confronting her own role in the family was important to her daughter's recovery.

Another patient said it took her two years of intermittent treatment before she was truly comfortable at dinners. Mealtimes were tough during those two years; the family wasn't sure how to address the food issue. The patient's feelings towards food changed over time—from wanting to ignore it completely at meals to feeling comfortable talking about it.

The family had difficulty keeping up with the changes. And this caused tension. The patient described it this way. "You're trying not to think about [food], and you're feeling scrutinized about it." The family didn't go to therapy, although the patient felt it would have been helpful. Therapy can help the family and patient "figure out where you are on that continuum" of focusing on food or avoiding it, she said.

Another patient went in and out of treatment centers for five years and met a lot of other people in her situation. She observed that most of the patients, including her, had alienated or lost touch with old friends and bonded with each other in the center. This proved to be a double-edged sword. For this patient, the new-found friends were initially a life line to recovery because they understood each other. But some relationships eventually became a breeding ground for competition on weight loss or who would be the first to relapse and return to the treatment center.

"The intense bonding is just what you need in the moment, but later it can just hold you back," she said.

She felt that staying friends with people who had not progressed as far in recovery as she had was holding back her own treatment. She also noted that because many people with eating disorders have abandonment issues, separating from friends made in treatment centers can be especially difficult. She maintains few relationships made during her recovery, and said that therapy was key to her ability to rebuild most of the friendships she had before starting treatment.

Treatment is a difficult process physically and emotionally. For one patient, the hardest part came after the treatment had started and her symptoms began to subside. She explained that for her, the disorder was about control—controlling her eating that later developed into controlling her emotions. She developed a "numb" feeling that "felt good" as her disorder progressed. However, as her treatment progressed and symptoms disappeared, her emotions returned and the numbness was gone. "The hardest thing was feeling the feelings," she said.

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Bulimia nervosa is an eating disorder in which a person engages in binge eating (eating a lot of food in a short time) followed by some type of behavior to prevent weight gain from the food that was eaten. This behavior can take two forms: self-induced vomiting, misuse of enemas, laxatives, diet pills (called purging) and excessive exercise, fasting, or diabetic omission of insulin (called non-purging). Some people with bulimia nervosa may also starve themselves for periods of time before binge eating again. Bulimia nervosa has important mental, emotional, and physical aspects that require consideration during treatment.

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