After nearly two years of focused work, with a fair share of bumps along the way, Helena has at last reached what her physician considers a healthy weight for her frame. She is eating nutrition-rich meals and hasn’t resorted to her trusty elliptical machine to ward off anxiety about donuts or job layoffs in more than a year. She has reconnected with the friends who, two years ago, told her that they felt disconnected from her, that they just couldn’t “get in.” Tonight they’re heading out to karaoke, an activity Helena used to adore because she could show off her powerful chops.

Would you call Helena recovered? In recovery? Partially recovered? Still in the grips of an eating disorder?

Think about that for a moment.

Now, would the label you assign change if I told you that Helena still counts calories almost every day? What if she only occasionally read nutrition labels – a former obsession – and only to check the amount of calcium and protein in her food? What if she still hates the way her legs look and cries regularly about not measuring up to her friends? What if instead she doesn’t hate the way that she looks, but is cautiously proud of her body – harboring fear, however mild, that her weight could shoot up? What if her food and weight obsessions were gone, but her perfectionism had translated into other areas of her life – like her work as a financial analyst?

Now what would call Helena? Fully recovered? Partially? In recovery? Nowhere close? If your label changed, think about why. On what did you base you assessment?

Assigning labels to the odyssey that is recovery is a challenge faced by clinical researchers, clinicians treating these individuals, and perhaps most significantly, individuals themselves. At the Academy for Eating Disorders international conference recently, I had the opportunity to hear Anna Bardone-Cone, Ph.D speak about her work in defining recovery.

Dr. Bardone-Cone recognized just how disparate definitions of recovery are across the literature on eating disorders. Looking at how various researchers defined recovery, we see that some do by the simple (though admittedly not so simple) restoration of weight, some by the absence of symptoms (e.g. restricting or binging), and some by more complex rubrics incorporating a person’s thoughts or attitudes. The problem is that when researchers are comparing treatments and other factors based on recovery that is defined differently, we really cannot compare at all.

There are other implications of a lack of consistent recovery definition as well. For one, individuals who struggle want to know what recovery will look like. While every single person’s journey will look different, it provides guidance and hope for individuals to understand just what they are working towards. It’s important, too, for individuals to know that recovery – full recovery, as I define it – is not simply about having a regular period (for females) or stopping their binge eating.

I am someone who believes that the idea of full recovery is real and can be attained by anyone with the right resources. These resources include a commitment to the process and a team of personal and professional support.

So what does full recovery look like? Like I said, the details might look different for different individuals, but I believe that recovery involves three main areas: physical, behavioral, and emotional. What this means is that those in full recovery are physically healthy and medically stable, are not using eating disorder behaviors, and they have developed a healthier attitude toward things like shape, weight, and food.

Does this mean that a person in recovery never bemoans the size of her thighs? Dr. Bardone-Cone says no, and astutely remarked in our workshop that we can’t expect those recovering from eating disorders to be super-people, free from the worries and concerns that are part of normal development and living in our society. We do of course hope that they have the skills to combat those thoughts when they arise, however. Occasional thoughts and concerns don’t mean a person isn’t recovered, just like occasional aches don’t mean that a person who had the flu once still has it.

Others prefer to use the terminology that is often used in circles of those who struggle with substance abuse and addictions and to refer to themselves forever as “in recovery.” Often the idea behind this semantic difference is that one will be aware and mindful of the possibility of returning to old habits in the face of stressors (as a person with a history of alcoholism might always need to be aware of the temptation to drink).  Personally, I respect any perspective on recovery that feels genuine and helpful to a person in maintaining health and happiness.

However you lay it out, the fact is that there is tremendous hope out there for those struggling with eating disorders, and for those who have struggled in the past. Despite recent press that paints a picture of recovery of elusive, it’s not at all. It’s difficult, sure. But it’s also attainable. If you’re still wondering about what recovery might look like, Aimee Liu’s new book, Restoring Our Bodies, Reclaiming Our Lives, is a fantastic resource full of first-person accounts of the recovery process.

Do you believe that full recovery is possible?

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When Diana Spechler, author of the soon-to-be-released novel about a weight-loss camp, contacted me to tell me about a new website she had created, I was decidedly curious. In her email, Diana described the site as a “place where people can anonymously post their feelings about their bodies.”

As I thought about the potential for this body-focused PostSecret-esque venture, I wanted to know what had prompted Diana to create the site, so I asked her to share with me its evolution. “When I was writing Skinny… I was terrified to write about my characters’ body image issues and relationships to food because I worried that the book would get published and everyone would know that I had body image issues… I had to get over that before I could write the book,” she said.

So Diana began pouring out her “secrets” – the dark thoughts about herself and her body that she found so shameful – in the novel.  She recalled, “I had to remind myself a million times along the way to be honest, to stop hiding. It wasn’t easy. But five years later, I feel better. I can talk about my own body image issues and eating issues much more freely. And that’s because I spent so much time telling my secrets in my novel.

Like many others, Diana found healing in sharing what she had perceived as unspeakable. She gave voice to the negative thoughts that plagued her and found that as she shared these thoughts, they became less powerful. They loosened their grip.

“It seemed miraculous to me, and I wanted to find a way to give that gift to others,” Diana told me. “I wanted to tell the world, “Just talk about it! You’ll feel better!”

And so Body Confessions was born. It developed as a place for women to feel connected. Diana feels that “pretending that the problem is something different from what it is harms all of us and compounds the shame we already feel. [It’s] so we can say the things we aren’t supposed to say, and so that other people can read the truth and feel less alone.”

But does connecting over a shared hatred for our bodies really do us any good? Could it be more harmful than helpful? Where is the line between releasing shame and spiraling into negativity drawn?

These the question that began to stir in my mind as I perused the site. What I found saddened me for the women who had written the “confessions.”

Take this one, from an anonymous visitor: There are two possible reasons God did not create me as pretty and beautiful as other women. Either He thought I’d be able to handle it. Or I am just not worthy. I’m leaning towards the latter because I just can’t handle this.

Other confessions are equally heartbreaking (and potentially triggering), ranging from complaints about the size of one’s tummy to struggles with binging and purging to certainty that one’s partner will cheat because of one’s size. There are also the occasional uplifting posts, such as this one: I love myself the way I am. Affirmative posts like this are certainly more the exception than the rule on the site, however.

Personally, I didn’t leave the site feeling any better about my body. I actually didn’t feel much of anything about my own body, but rather a sense of helplessness in wanting to take away the pain of those posting these messages.

However, Diana has found that the site makes people feel less alone. And Glamour recently shared it on own of their blogs.

Interestingly, and perhaps contradictorily, Glamour’s recent piece in its March issue on body image included research suggesting that negative body thoughts actually shape our brains in an unhealthy way, promoting even more negative thoughts.

Ann Kearney-Cooke, Ph.D., a Cincinnati psychologist who was quoted for the article, said, “Neuroscience has shown that whatever you focus on shapes your brain. If you’re constantly thinking negative thoughts about your body, that neural pathway becomes stronger—and those thoughts become habitual,” she explains. “Imagine a concert pianist. Her brain would have stronger neural pathways that support musicality and dexterity than someone who hadn’t spent her life practicing.”

So, what do you think?

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Respond to the poll and then share your thoughts in the comments below. We want to know! Do you feel it’s healing to get those thoughts out of your mind and onto the computer screen, knowing that others have “been there?” Or does it fuel more self-deprecation? Have you found writing your negative thoughts down to be helpful in other ways? What has helped you in overcoming negative body image? Would you ever use this site?

Johanna S. Kandel’s eating disorder story has all the makings of typical memoir or made-for-TV movie. The young, smart daughter of high achieving parents becomes a ballerina and faces the unbearable pressure to be perfect in a world where beauty is currency. She learns that misusing food, alternating between starving and binging, gives her a false sense of control; meanwhile her life is becoming increasingly isolated and chaotic.

But here’s where the story shifts: Kandel doesn’t just find recovery, she becomes founder of a major non-profit and tireless advocate for those struggling with eating disorders. As she briefly outlines in her recent book, Life Beyond Your Eating Disorder (Harlequin, 2010), recovery for Johanna was learning that being a perfect weight wouldn’t make her a perfect person – and that she didn’t even want to be perfect.

Using this and the many other lessons she has learned through her own recovery and that of those she counsels, Life Beyond Your Eating Disorder: Reclaim Yourself, Regain Your Health, Recover for Good is Kandel’s guidebook for anyone struggling with misusing food in dangerous and damaging ways.

Rather than share the gritty details of her the havoc she wrecked on her body, Kandel chose to focus her book on the process of recovery. While there may be a time and place for shock factor used in so many eating disorder books, many in recovery, particularly in the early stages, are not able to use such details for inspiration, but instead fall into a dangerous pattern of comparison. Life Beyond Your Eating Disorder is a book for individuals at any stage of recovery. Kandel recognizes that not everyone reading is ready to jump into a life without the security of a disorder – and she approaches them with a gentle but powerful message of just how wonderful life beyond the disorder can be.

Immensely readable and down to earth, the book offers specific strategies, motivational metaphors, and inspiring profiles of individuals in recovery. With chapters like “Beware of Fake Security Blankets” and “Bridezilla Meets Brideorexia and Other Triggering Occasions,” Kandel gets to the heart of what individuals struggle with and gives them tried-and-true means of staying on top.

In one chapter, Johanna encourages readers to “name your voice,” meaning giving a name to the healthy part of you — the part that sneaks in, even ever so briefly, and tells you that you are good enough. She suggests giving that voice a name and a separate identity so that it can speak to you even when you feel unable to access it. Kandel says, “Walking the road to recovery becomes a lot easier when you have that positive voice walking with you, helping you to put one foot in front of the other.”

At the heart of Life Beyond Your Eating Disorder is a sense of empowerment. Kandel puts the power for recovery into the hands of her readers – nudging them toward it in a voice that is authentic and knowing.

What books have helped you on your journey to recovery?

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