In a prior post, I talked at length about how eating disorder symptoms impact the brain circuitry in ways that produce a response similar to drug or alcohol addiction. These findings represent a major step forward in understanding the complex biology of eating disorders and the challenges associated with both treatment and recovery.
Many patients, professionals and those in recovery have asserted that the 12-step recovery model can’t reliably help with food-related addictions and eating disorders. Their reasoning? We need food to live – we can’t abstain from eating food.
But this misses an important contradiction and is at odds with my experience in treating both addictions and eating disorders. While we do need regular food intake in order to maintain our health, we also need to drink fluids in order to live. In fact, we would die quicker by abstaining from liquids than by starving ourselves. So from that standpoint, people with alcoholism need to keep drinking, but in recovery, they focus their efforts on abstaining from drinking one specific liquid: alcohol.
Similarly, people with eating disorders need to keep eating (or start eating, as the case may be!), and in recovery they focus on abstaining from eating disorder behaviors: starving, restricting, binging, using diet/laxative pills or over-exercising. Many people with eating disorders, particularly those with bulimia nervosa or binge eating disorder, can pinpoint specific trigger foods that functions for them like alcohol or drugs. Those particular foods trigger either a binging cycle or a purging cycle in the same way a sip of alcohol can trigger a substance abuser. This is the challenge for people with eating disorders: they need to continue to eat, yet while in recovery, they must develop tools to resist the urges they feel when encountering or thinking about their “alcohol foods.”
We have found that the 12-step process for recovery from addiction can be equally successful in supporting recovery from eating disorders. One common element among treatment centers utilizing the 12-step approach is holistic attention to the entire person through an integrated focus on the patient’s physical, mental, emotional, social and spiritual needs. By addressing all aspects of their being and learning to tap into a “higher power” that is meaningful for them, patients gain a broader, more objective perspective on the challenges they’ll face in their recovery. The 12-step recovery model also provides tangible tools and supportive resources an individual with an eating disorder can rely on for life – whenever they encounter triggers, or life changes create new pressures to cope.
Many people using the 12-step recovery model for both eating disorders and addiction also benefit from professional help from a comprehensive treatment team. This may include individual, group and family therapists, regular consultation with a psychiatrist and internal medicine specialist, and ongoing work with a nutritionist. Combining medical and psychological treatment with the 12-step model can greatly enhance the set of tools a patient can employ to maintain their recovery and manage the long-term risks their disease may present for their overall health. The promise of recovery for a person with an eating disorder is that her relationship with food will be healed and restored to sanity, and that she will have a fuller living experience with her disease in remission one day at a time for the rest of her life. A common myth associated with 12-step recovery models is that the patients never get better and have to struggle through life battling food (or alcohol)—which couldn’t be farther from the real life experience of the millions of people who have and continue to benefit from 12 step mutual support groups.
For some patients with advanced disorders or with co-occurring conditions that may not have been properly diagnosed, more structured treatment may be required, either in an inpatient, residential, or outpatient setting. But this does not preclude focus on the 12 steps. These may be meetings of Anorexics and Bulimics Anonymous, Eating Disorders Anonymous or Overeaters Anonymous, as well as other 12 step meetings for co-occurring addictions or compulsive behaviors, or family of origin issues. In addition, many sufferers from eating disorders are increasingly finding this type of support and fellowship online, 24 hours a day. Meetings like these are an integral part of each resident’s aftercare program, designed to provide ongoing recovery support when she leaves our treatment center.