What Can I Expect During My Anorexia Recovery Program?
People living with eating disorders such as anorexia have several treatment options, including medication, therapy, and inpatient, outpatient, or online recovery programs. The media may portray inpatient recovery centers as sterile or unhelpful places for people living with psychiatric disorders, but these portrayals are often unfair and inaccurate. Joining an anorexia recovery program may be the most effective treatment option for those with eating disorders who are hoping to move past their diagnosis. Although everyone’s experience will be different, a recovery program may be the right fit for your situation. We’ll be exploring what these recovery programs can look like and how they can be beneficial if you’re living with an eating disorder such as anorexia.
What is anorexia?
Over 28 million people in the United States are living with an eating disorder. Anorexia nervosa is one type of eating disorder that causes people to struggle with their body image and display a strong focus on losing weight or maintaining a low weight, even if they are already underweight. People with anorexia may use various methods to prevent themselves from gaining weight, including severely restricting the amount of food they consume, vomiting after eating or using laxatives and/or diuretics to expel consumed food.
Research on anorexia has mainly focused on women impacted by the disorder, but anyone can experience eating disorders such as anorexia nervosa, bulimia nervosa, or binge-eating disorder. However, men living with an eating disorder may display different symptoms because they are presented with differing cultural standards regarding an ideal body image. Men with anorexia may seek to have a physique that is more muscular and toned, while women may be more likely to idealize extreme thinness.
What to expect at an inpatient anorexia recovery program
If you’re considering joining an inpatient anorexia recovery program, knowing what to expect may help you feel more comfortable getting started with obtaining the care you need. Unlike what’s often shown on television and in the movies, inpatient mental health care is a supportive way to get help moving past your mental health challenges.
After checking in to an inpatient recovery program, the staff will examine your suitcases for laxatives or other harmful substances. It may be useful to contact the facility ahead of time to see what is allowable to bring inside. Packing personal effects, like photos, letters, or other reminders of home, may help you adjust to your new environment.
During your stay, your meals will likely be scheduled, and most programs require regular weigh-ins and labs. Once your treatment plan is established, you may have daily therapy sessions, nutritional counseling, or other medical appointments throughout the day. The goal of an eating disorder treatment is to help you regain a healthy weight and reframe your thinking around food and weight loss.
Other treatment options for anorexia
If an impatient recovery program isn’t the right fit for you, there are several other treatment options available for you to try. The most effective treatment plans vary from person to person, but overcoming anorexia is possible with a specialized plan that considers your needs and circumstances.
Therapy is a common treatment method for anorexia nervosa because it helps individuals with an eating disorder unpack the root cause of the condition. One specific type of therapy, called cognitive behavioral therapy (CBT), may help individuals with anorexia change their ingrained coping mechanisms and reform their opinions and attitudes toward food.
Nutritional counseling can also benefit individuals with anorexia. These programs help encourage healthy eating patterns and guide individuals toward achieving a healthy weight.
As previously mentioned, inpatient anorexia recovery programs are also available. These programs may provide more direct supervision and support for individuals who may have developed serious medical conditions because of their anorexia. These programs have the added benefit of helping those with an eating disorder develop a support group of other individuals with similar challenges. Eating disorder recovery programs may include psychotherapy, group therapy, medication, and nutrition counseling. However, each person is given a unique plan tailored to their symptoms and needs.
Some people living with eating disorders are prescribed antidepressants and anti-anxiety medications to help them cope with comorbid mental health conditions such as depression or anxiety. As of now, there are no medications on the market designed specifically to treat anorexia.
Causes and symptoms of anorexia nervosa
Many factors may contribute to the development of anorexia nervosa, particularly hereditary factors. First-degree relatives of people who have developed anorexia are ten times more likely to develop it themselves. Other factors include an individual’s environment and propensity towards anxious or obsessive-compulsive behaviors. Because thin bodies are highly prized and desired in today’s society, some people, such as young girls, may feel pressure to obtain a certain body image.
Individuals with a history of trauma, including abuse, neglect, or sexual assault, may be vulnerable to experiencing an eating disorder such as anorexia or bulimia. An eating disorder may also be more common in people with post-traumatic stress disorder. Peer pressure or bullying may also drive the development of anorexia.
If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.
Anorexia may negatively impact your mental and physical health. Symptoms may include:
Increased irritability
Constantly weighing, measuring, or examining your body
Difficulty sleeping
A lower sex drive
An emotionless affect
Someone with anorexia may display certain behaviors, such as:
Finding excuses to avoid eating
Displaying an intense fear of gaining weight
Following strict food rituals, such as spitting out food after chewing it
Attempting to cover up the body with layers of clothing
Avoiding eating out in public
Online therapy with BetterHelp
Inpatient anorexia recovery programs may be a helpful option for some people living with anorexia, but if you’re looking for outpatient support, online therapy through BetterHelp can be an effective treatment modality. Online therapy may be particularly beneficial for individuals living with anorexia or other types of eating disorders, such as bulimia or binge eating disorder because it allows them to get supportive care when they need it most. After matching with an online therapist, sessions can be scheduled in advance, and therapists may accept online chat messaging so you can reach out to them in moments you need additional support. Since an individual’s environment, including their social relationships, lifestyle, and home life, may influence their likelihood of developing anorexia, attending therapy from home may help you to get to the root of what caused your anorexia to develop.
The efficacy of online therapy
Online therapy can be an effective method of treatment for a variety of mental health conditions. Early studies into the effectiveness of online therapy for eating disorders are promising, with beneficial effects regarding the prevention of eating disorders, treatment, and relapse prevention. Participants in this study saw improvements in their “drive for thinness and weight concern” by the end of the intervention and at a post-follow-up, showing the efficacy of online-based therapy for treating eating disorders like anorexia.
Takeaway
How long does it take for weight to redistribute?
Many people in recovery from anorexia are concerned when they seem to be regaining weight mostly in their midsections. However, research on the eating disorder recovery process has found that weight distribution typically normalizes within 12-24 months of full weight restoration, provided a healthy weight can be maintained. Following this recovery period, people who have regained weight after anorexia show an average distribution of body fat.
Which eating disorder has the highest mortality rate of any mental illness?
Current evidence indicates that anorexia nervosa has a higher mortality rate than any other mental illness. Many eating disorder behaviors, such as the induced vomiting common in bulimia nervosa, can have negative health consequences. Yet studies suggest that the severely restrictive eating exhibited in anorexia may be particularly harmful, carrying a substantially increased risk of death.
Anorexia is also associated with elevated rates of suicide. If you’re having suicidal thoughts, you can get help from trained and empathetic volunteers through the National Suicide & Crisis Lifeline. They can be reached at any time by dialing 988 or visiting their website.
How much weight do people gain in recovery?
Patients wondering what to expect in eating disorder recovery are often particularly concerned about how much weight gain they should anticipate. Even once you’ve decided to seek treatment, counterproductive eating disorder thoughts can persist, resulting in anxieties about potential increases in weight.
Typical weight gain rates can vary depending on a variety of factors, including:
- Patient age
- Treatment method
- Severity of initial malnourishment
The American Psychiatric Association’s guidelines recommend a recovery goal of 0.9-1.4 pounds regained per week. This target is not always achieved in practice, though. Rates of actual weight gain per week in outpatient treatment programs average around 0.23 pounds for adults and 0.42 for adolescents. Inpatient anorexia treatment appears to be substantially more effective at enabling weight recovery — adults typically regain about 1.18 pounds per week, while adolescents regain about 1.35 pounds.
How long does it take for your metabolism to pick up?
An individual with anorexia may have an underactive metabolism due to the body’s attempts to conserve energy while undergoing starvation. Once a patient begins to regain weight in recovery, their metabolic rate typically increases. This process can take varying amounts of time for different patients, but it often becomes evident as soon as consistent weight gain begins.
How do you know if you have hypermetabolism?
Hypermetabolism refers to a metabolic rate that’s much higher than normal, requiring greater energy inputs to gain and maintain weight. It’s often observed in recovery from severe injury, but can also sometimes occur during anorexia recovery.
The formal criterion for hypermetabolism is a resting energy expenditure (REE) at 110% or more of the normal rate. REE refers to the amount of energy the body consumes when sitting still and not engaged in strenuous activity.
Patients generally can’t measure their own REE directly, though. The usual sign of hypermetabolism is a need to consume unusually high amounts of food — around 2,500-5,000 food calories per day — to achieve and sustain recommended levels of weight gain.
How long does hypermetabolism last?
A person’s metabolic profile may take time to return to former levels following eating disorder recovery. A 2021 study found that individuals engaging in anorexia treatment did not show metabolic profiles similar to healthy controls until after they had fully regained the weight lost due to their disordered eating. The human body may need a prolonged period of weight restoration to return to typical energy use patterns.
How long does it take to shift belly fat?
It’s common for body fat to accumulate more in the belly and waist than in other areas during anorexia recovery. Researchers have found that this skewed distribution of fat usually normalizes 1-2 years after complete weight restoration, though the shift will often begin just a few months into recovery. This process appears to occur naturally as a result of the body’s metabolic processes adjusting to sustained healthy weight.
Some people in the early stages of anorexia recovery may also mistake bloating for belly fat. Swelling and bloating can occur due to slow digestion and water retention. The malnutrition caused by anorexia often leads to a shortage of moisture within the body’s tissues; in an attempt to achieve normal hydration, your system may hold onto more fluid than usual as you begin to recover. Puffiness in the ankles and face can also occur when you gain water weight.
These symptoms will often diminish within a few weeks as your body adjusts to healthier levels of nutrition and hydration.
When you gain weight back, where does it go first?
Weight is often concentrated in the abdominal region — the belly and waist — when you’re first starting to gain it back after chronic dieting or prolonged calorie restriction. Abdominal fat can be important for safeguarding vital organs, so restoring it may be the body’s first priority during recovery. This can lead to an apparent shift in proportions, with more weight than usual around the middle.
As recovery continues, though, most people begin to regain fat in the extremities as well as lean body mass. Given enough time at a healthy weight, individuals in recovery from anorexia typically return to an average body fat distribution.
Why do I weigh more after fat transfer?
The relative distribution of body fat may change following anorexia treatment so that the trunk region no longer retains more fat than other areas. This doesn’t mean your overall weight will go down, though — it may simply mean that your shape is returning to what it would be in the absence of malnutrition.
Recovery from anorexia always involves an increase in total body weight. Though you may initially feel uncomfortable seeing higher numbers on the scale, this can be an important indicator that you are returning to health, overcoming an often deadly psychological illness.
Why does fat take so long to go?
Changes in fat distribution may be slow because the body’s metabolism is managed by homeostatic processes. Similar to the way a thermostat controls temperature, the body tends to shift metabolic speed up when it gets too low and slow it down when it gets too high. This helps to maintain equilibrium and prevent your system from overreacting to short-term changes in the environment.
The human metabolism may respond to anorexia just as it would to other periods of prolonged starvation. It often won’t return to its previous rate until it’s been receiving a supply of adequate nutrition for several weeks at least.
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