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5 Elements of Bulimia Recovery: How Long Does It Take?

Written by: Erica Butler, MA, LMFT
Site Director, The Renfrew Center of North Carolina

Wondering how long the bulimia recovery process could take? Eating disorders do not develop overnight, and neither does recovery. Bulimia nervosa (BN) is often diagnosed in folks that are stuck in a binge-purge cycle and is often accompanied by adverse medical and mental health effects. The good news is, with proper therapeutic and nutrition treatment, many of these effects can be reversed.

While seeking out treatment for bulimia, it is important to recognize that recovery does not happen quickly and is not linear! The stages of recovery for an eating disorder are all an important process of the healing and treatment journey. Often, folks want a very clear-cut answer on how long the recovery process will take, and unfortunately, many factors impact how long one can expect to be in treatment.

How Long Does Bulimia Recovery Take?

In higher levels of care (like a residential program, partial hospitalization program, or intensive outpatient program) we normally advise families and patients to expect at least 4-10 weeks in each level of care. If you suspect you might have BN, a thorough assessment by a qualified eating disorder provider can help you determine which level of care would best matches your medical and psychological needs.

What the Recovery Process Is Like

When providers working with eating disorders mention that recovery isn’t linear, we mean that there very well could be moments of success followed by lapses into disordered eating symptoms – but that does not take away from your hard work and efforts in the process! Your team will process these lapses with you and make connections between your emotions and behaviors, which can prove to be valuable insights towards a full recovery. While you work with your team to navigate your relationship with food and your body (which can be a lifelong endeavor!), they will work with you to identify strategies and supports to manage unhelpful thoughts and distressing emotions associated with eating disorder symptoms.

5 Elements of Bulimia Recovery

While recovery from bulimia nervosa, and any other eating disorders, is a highly personalized and varied journey for everyone, it includes five key elements: nutritional, physical, psychological, functional, and social.

Nutritional

Nutritional recovery includes restoring eating patterns to meet nutritional needs, enjoying various foods from all the food groups, and learning to recognize and honor your body’s hunger and fullness cues. Those in recovery can also hope to learn to eat intuitively and with flexibility, as well as working to eat socially and for pleasure! Nutritional recovery can be impacted by Autism or ADHD diagnoses, individual health factors or chronic illness, cultural norms and traditions, and accessibility needs, so each treatment plan should be highly individualized.

Physical

Physical recovery from bulimia can be seen in improvements in vital signs like blood pressure, lab results, heart rate, and gastrointestinal function.

Psychological

Psychological recovery is just as important as physical recovery! BN is not just about food; it’s also about emotions and the ways we try to avoid them. Eating disorder symptoms, like bingeing and purging, can serve the function of dampening, distracting, or avoiding distressing emotional experiences. Treatment includes mindfully observing emotional patterns, improving emotional tolerance, and changing the way we respond to uncomfortable feelings. It’s not uncommon for those in recovery from bulimia to also be addressing co-existing diagnoses like obsessive-compulsive disorder, post-traumatic stress disorder, substance use disorder, or a mood disorder.

Functional

Functional recovery can look like improved energy levels, improved memory or concentration, better quality of sleep, and improvements in school or work.

Social

Socially, those in recovery from bulimia can see improvement in spontaneity with their friends or peers around social activity as they let go of food rules or exercise regimens that previously halted activities on a whim. Other parts of this work might include deepening connections with others, improving communication, setting boundaries, and asking for support.

What to Expect in Treatment

In higher levels of care for bulimia nervosa, like a residential program, partial-hospitalization program or intensive outpatient program, all of the five elements above are addressed simultaneously. With daily access to a dietitian, the nutritional component is managed, while daily therapeutic groups and individual/family therapy sessions tend to the psychological component.

Physical recovery can be achieved through the guidance of the clinical team as well as the psychiatrist or nurse practitioner overseeing the patient medically. No matter where you seek treatment for your eating disorder, or what stage of recovery you are in, remember that each victory or struggle is a vital part of your recovery journey!

Conclusion: 5 Essential Bulimia Recovery Tips

Continuing to stay engaged in treatment and remembering your “why” can help you navigate this complex journey. Any relapses or setbacks should not be seen as a failure, but an opportunity to learn more about yourself and the emotions that triggered the eating disorder behavior.

  • Develop a support system! Most people who recover from their eating disorder don’t do it alone. Your treatment team, support groups, family members or partners can help you through the rough moments and be cheerleaders for your victories.
  • Embrace Health at Every Size (HAES). HAES is an anti-diet, weight neutral, holistic approach to wellness that recognizes the harmful effects of weight stigma and separates the pursuit of health from morality or obligation. Learning about HAES can be a new approach to caring for your body, enjoying mindful movement, and letting go of the rules about “health” that are focused on changing your body’s shape or size.
  • Ditch the scale! The number on the bathroom scale can determine a good or bad day for folks in recovery from an eating disorder, so getting rid of it can be a huge win.
  • Find an emotional outlet that works for you, such as writing in a journal, meditating, drawing, painting, or singing. Experiment with new skills and strategies to improve your mood and find a space for difficult emotions to be expressed.
  • Give yourself some grace. Congratulate yourself for taking the important step of working towards your recovery and know that the difficult days won’t last forever. You got this!
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