The longer you’ve had your eating disorder, the harder it is to change the way you think. This is not to say you can’t recover. It just means the hard business of changing what you do is only the beginning. Fixing broken thinking patterns is where the real work lies. If you can’t do that, you’ll fall back into old behaviours. It’s inevitable.

You don’t notice how broken your thinking is when you’re in the grips of the disease. I started noticing it more once I had solid time in with my behavioural changes. Suddenly, the “fat” thoughts, judgments, and directives were in the spotlight. Before, they were just background chatter, a soundtrack for the actions I took.

Noticing what the eating disorder is saying is a win, absolutely, but only part of the process. The critical step lies in changing those thoughts. Challenging them, countering them, and rewriting them, so they’re more suitable for the non-eating disordered person you’re working on becoming.

I assume the final step is not having eating-disordered thoughts at all. I wish I had a timeline for when that might happen; unfortunately, rewiring neural pathways takes time.

It’s odd how you have all the time in the world for the problem but can’t bear to spend any time on the solution. I gave up decades to my eating disorder, yet I resent the time it’s taking to get better. I want it fixed now. I want recovery to be faster.

I developed my eating disorder at age eleven; I added throwing up to my repertoire at age nineteen. Besides brief respites that occurred while I was in treatment, I continued vomiting multiple times a day nearly every day until five years ago. That’s twenty-five years of purging. I didn’t even abstain during pregnancy, much to my regret.

Five years ago, I went into treatment for what I hope will be the final time. It was an intervention-based decision and the fact that I was at “do or die” contributed to my willingness to accept help. I’ve spent my adult life determined to stop but unable to, even when I ended up in emergency rooms. I knew death was a possible consequence, but the threat didn’t feel real. But things happened, and suddenly, it loomed close.

Get busy living or get busy dying. *

I only threw up twice while I was in treatment. That’s two times in three and a half months, the best I’d managed since nineteen. More importantly, I was able to continue with some of the behavioural changes upon leaving. First, it was not throwing up for a few weeks at a time, then, it was abstaining for a few months. My latest run of vomit-free eating will reach eight months on Friday. I consider that to be a miracle.

The fallout from a prolonged eating disorder is perhaps something health practitioners don’t emphasize enough in the early days. I might have fought harder if I knew the consequences of soft bones, organ problems, and essential toothlessness were pretty much guaranteed. I might have fought harder if they told me the eating disorder was making my depression worse. Or, maybe not. My desire wasn’t qualified; it was thin at all costs. Still, late is better than never. At least that’s what I tell myself.

The eating is reasonably stable, and the purging is pretty much under control, but I get disheartened at times because I still don’t have my brain back. The sobriety that has been so hard-fought for is primarily of the body. I’d say my brain is about forty percent recovered. That is, I think I think like someone without an eating disorder forty percent of the time. The rest of the time is something else.

I still kind of believe I need to be thin to be acceptable. I still struggle to live in a body I vaguely dislike for being imperfect (though “vaguely dislike” is better than the extreme loathing I used to engage in). I still judge my worth by the amount of flesh I carry.

I still worry about my clothing size and my thigh gap and the diameter of my upper arms, and what kind of person I am if I’m physically imperfect. I also worry about what kind of person worries about such a shallow thing.

I also still restrict. Sometimes, I even pretend I think it’s okay. Sometimes, I pretend the eating disorder voice isn’t talking to me. Sometimes, I let it take me where it wants to go. Habit and the sixty percent, I suppose.

I wanted to lose some weight. I’ve maintained a recovery weight for a while; it’s heavier than I’m comfortable with. I wanted to drop a few pounds. I went back and forth with myself for some time.

No, I shouldn’t. Yes, I should. Other people lose ten pounds without getting sick. People recovering from eating disorders probably shouldn’t diet. My legs are too soft and large. I’m an empirically small person. I’m not comfortable being this size. I should get comfortable, not lose weight.

Back and forth, round and round.

I finally decided that trying to lose ten pounds would be okay as long as I improved my diet. Maybe more protein – something that’s hard to re-introduce when you’ve had an eating disorder. More vegetables – I still tend to avoid sides. More fresh fruit.

It seemed like a good idea at the time. I should’ve been more suspicious of my eating disorder’s silence. I should’ve talked about losing weight with my therapists – avoiding discussing the choices you’re making with the experts trying to help you is a sign you should pay attention to. 

At any rate, I went ahead, lost a little weight, cut back on my intake, started wearing baggy clothes, and watched my bones get more defined. I started revelling once again in the feelings of hunger that come from a reduced caloric intake.

Dangerous stuff. Slippery slopes.

I went back to using small bowls without even think about it. It’s a common eating disorder thing. You use small dishes, small cutlery, small portions. It lets you believe the amounts you portion out are normal. You start thinking dinner in a half-cup bowl is a good thing.

Sneaky, sneaky, sneaky. Eating disorders and other addiction-style problems are sneaky. They don’t want you to get unhooked. I get it: where would they go if you were better? They dig in. They mount covert campaigns.

I’m irritated with myself for succumbing. I’m irritated I went ahead with something I knew was a bad idea. However, I’m also chuffed I figured it out before things got out of hand. I recognized dangerous territory before things got dire. That’s a win. Even so, the inside voice still thinks I should lose weight..

The thoughts part is the biggest challenge. It takes the most time. The defective thinking shows up everywhere, infects everything.

My current thinking is better than it has been for most of my adult life. It’s not great thinking, it’s not the thinking of someone who hasn’t had an eating disorder, but I am improving. I still make odd bargains with food, I still eat in dysfunctional ways, and I still obsess over my imperfections.

There are wins. I eat three meals a day. I eat my snacks. I engage in moderate exercise only. I’ve avoided the temptation to eliminate whole categories of food for suspect motivations. I stay away from food fads. I try to say nice things to my hips and thighs, or at least not trash-talk them.

I’m working on liking myself and being comfortable in my skin.

But arguing with the eating disorder thoughts is the most important thing. I counter with logic. I counter with hate (that one might not be therapist-approved). I remind myself that fat isn’t a feeling. I remember that most of the time, I don’t want to end up dead.

I get impatient but rewiring the brain takes as long as it takes. One day, I’ll be able to exercise for twenty minutes and enjoy the experience.

I won’t argue with myself about doing ten minutes more because my body needs serious work.

I won’t consider making the proposed extra ten an extra twenty because, thighs.

I won’t think about how forty minutes every day for a week would mean I could lose five pounds by Sunday, and wouldn’t that be great?

Eventually, my brain will get there. Eventually, I won’t have to reformat my thoughts. Eventually, I’ll order the first food that appeals on the menu without checking out the salads. Until then, you just keep doing the work. You argue with your eating disorder voice. You remind yourself ad nauseum the eating disorder is a liar. You ignore the little voices that tell you it’s too hard and taking too long. You get ready for battle 7,295 because, why not?

What else am I going to do with my time but work on recovery? It’s a reasonable pursuit to engage in (some of the time: don’t make it your life). Besides, I know how re-engaging with my eating disorder ends.

*Paraphrased from the movie version of “The Shawshank Redemption”.