Stages of Change in ED Recovery

Understanding the stages of change will help you and those supporting you to better navigate your recovery journey. Where you are currently at within the stages of change will dictate what will best help you to take steps forward in your recovery.

The stages of change are rarely (if ever) a linear progression.

You will likely move around between the stages, and even revisit stages, before moving on to the next. You may even go through the stages for each eating disorder behaviour. For example, you could be in the action stage for restrictive eating while being in the contemplation stage for body image.

This is why recovery from an eating disorder isn’t straightforward and should be individualised.

Let’s dive into each of the stages of change in ED recovery:

• Precontemplation

• Contemplation

• Preparation

• Action, and

• Maintenance

Precontemplation

During the pre-contemplation stage of change, you’ll likely deny (to yourself and others) that your relationship with food, exercise or your body is problematic.

Despite close friends, family members or medical professionals potentially recognising signs (e.g., restrictive eating, weight changes), you could be oblivious that your behaviours and symptoms are characteristic of an eating disorder. Even if, on some level, you recognise that something isn’t “right”, that what you’re experiencing isn’t “normal” or “healthy”, you’ll likely be terrified of change and fiercely protect your eating disorder.

Thoughts you may experience during the pre-contemplation phase include, “I’m just focused on my health” or “there are other people worse than me, so I’m not that bad”.

Contemplation

In the contemplation stage of change, you are willing to admit that you have a problem and can recognise that you need to make changes.

You may begin to weigh the pros vs. cons of recovery and can see that the pros outweigh the cons.

While you may be open to receiving help, you’ll likely be very fearful of implementing changes and unsure of how to start or what to do.

During my eating disorder, I convinced myself that my behaviours, thoughts and attitudes towards food, eating, exercise and my body were normal. I told myself that I was focused on my health. But, if I’m being honest, deep down, I always knew something was wrong.

The normalisation of disordered behaviours by diet culture allowed me to justify many of my behaviours, thoughts and attitudes towards food, eating, exercise and my body. However, over time I started to question; is it healthy to feel overwhelmed by anxiety after eating a “bad” food or skipping a workout? Is it normal to think about food constantly, study menus and meticulously plan all of your meals? Surely not?!

If you are currently experiencing the contemplation stage of change, I encourage you to answer the following questions.

• What are the pros vs. cons of recovering?

• What could your life look like five years from now recovered vs. five years from now still stuck in your eating disorder?

• How does your eating disorder impact your health, relationships, work or study and happiness?

Preparation

If you’re in the preparation stage of change, you’re likely preparing to confront the eating disorder. You may be looking into treatment options, researching online, reading books, listening to Podcasts or reaching out for help.

While you may feel ready to make changes, you’re likely uncertain how to do so. If you can access professional support, ask your treatment team to help create an individualised treatment plan. Your plan should be based on your treatment and recovery goals and incorporate your strengths, healthy coping strategies and support network.

As an eating disorder recovery coach, I focus on the HOW to support my clients to make behavioural changes and move towards their vision of recovery. Clients are supported to identify, set and achieve specific yet flexible goals; flexibility helps to challenge black-and-white thinking, which fuels disordered eating. Text support is provided outside of sessions, allowing clients to access in-the-moment support when they are struggling. While also teaching the skill of reaching out to others instead of relying on the eating disorder.

If you can't access professional support, I want you to know that recovery is possible. There are some great recovery resources available for free online. I encourage you to read through the blogs on my website, and you can reach out to me through my website to request my list of free recovery resource recommendations.

If you are currently experiencing the preparation stage of change, I encourage you to answer the following questions.

• What are your current barriers to recovery, and what could help you to overcome these barriers?

• Who are your supports, and how could your supports help you in recovery?

• What small step towards change could you take at this time?

Action

In the action stage of change, you feel ready to follow through with the steps in your treatment plan. You are actively working towards recovery by challenging the eating disorder and making positive changes.

During the action stage, you must trust in the process.

Unfortunately, in recovery from an eating disorder, you often feel worse before feeling better, as recovery requires facing our fears head-on, and the eating disorder will likely get louder as it fights to try and stay in control. But don't let it win!

If you are currently experiencing the action stage of change, I encourage you to answer the following questions.

• Reflect on what life was like amid your eating disorder. What progress have you made in recovery so far? And what progress might others have noticed?

• What would you like your relationship with food, exercise and your body to look like? What steps could you take to get to where you want to be?

Maintenance

During the maintenance stage of change, you actively challenge the eating disorder thoughts and behaviours and practise new healthy coping strategies. During this stage, to help protect against relapse, you will likely identify your triggers and explore your identity and purpose beyond the eating disorder.

It is normal for slips or lapses to occur during this stage. A lapse (or a slip) is an isolated incident in recovery where you use an eating disorder behaviour.

People can often feel like a failure after experiencing a lapse. I know this firsthand as I experienced slips in my recovery.

Reflecting on these slips and speaking with my supports meant I could learn and grow from my experiences. They allowed me to understand why my eating disorder developed and what steps I needed to take to keep going. I encourage clients to reframe their slips as learning opportunities and remind them that there is no such thing as the perfect recovery. There is a reason why you've likely heard the phrase "recovery isn't linear".

If you are currently experiencing the maintenance stage of change, I encourage you to answer the following questions.

• Are there any common themes or patterns you can identify when you are struggling to maintain your recovery?

• What healthy coping strategies or protective factors could help you maintain your progress and keep moving forward in recovery?

• What kind of routine or structure bests supports your recovery?

• Who can you reach out to when you need support?