Therefore, as well as including guidelines to help you make the changes to your diet at this first and crucial step (see ADDICTION REHAB CENTERSEATING DISORDERS RECOVERY GUIDEBOOK STAGE 1 abstinent eating), it will also be important to develop a routine, as all changes are easier when they become part of a helpful pattern of new behaviors .
All people with Eating Disorders suffer from the same addiction, although this may seem like a bold statement on the surface. For people with Binge Eating Disorder and Bulimia it is simpler to see the addictive quality of certain foods and their behaviors around it. However, this is also the case with those who are in the Anorexic phase of an Eating Disorder. Most casual observers do not understand that anorexics do feel hungry, that they crave sugar and other foods high in refined carbohydrates such as cakes, bread and biscuits. It is their attempts to control such cravings, their deep-rooted fear of succumbing to them, and the consequences it will have on their bodies and emotions, that drives them to deny food altogether.
This is also reflected in the fact that it is so hard to categorize people with addictions relating to food into specific types of Eating Disorders. People with Bulimia will have experienced anorexia at some point in their lives – often early in their addiction – while anorexics have almost universally binged and purged. Different categories of Eating Disorders really correspond to different phases of the addiction, through which people will pass at any one time, depending on their situations and the way they are trying to cope with their disorder.
It is hardly surprising, therefore, given the fact that Eating Disorders are a form of addiction, that traditional substance misuse is so common among people with Eating Disorders. The most comprehensive study was conducted through the National Center on Addiction and Substance Abuse at Columbia University (CASA) in 2003. The three-year study was jointly released through the president of CASA and the United States Secretary of Health, Education and Welfare. In it, they learned that just about one-half of those who struggle with an Eating Disorder also are involved in drug or alcohol abuse as opposed to the nine percent of the general public who abuse substances. Looking at it from the other direction, close to 35 percent of those who misuse substances also have an eating disorder as compared to around three percent of the general public who suffer with the condition. This means that when a person is discovered to be battling anorexia or bulimia, for example, it is likely that the person is also addicted to smoking, indulges in binge drinking or uses illegal drugs.
Denial of the problem is also a common feature of both substance use and eating disorders. The first stage to Recovery, therefore, is to accept your inability to eat certain foods the way normal eaters can do with impunity. Just as importantly, a person who suffers from an Eating Disorder must accept that their thinking about addictive foods has been so distorted by the disease that their judgment about these foods is unreliable even after they are in recovery.
Just like with all addictions, the first step is to understand your condition. This is why we are explaining it in so much detail here. Recovering from an eating disorder is much like recovery from any addition. Once you have accepted, in your mind and in your heart, that you are suffering from an addiction, not just a willpower problem, and have asked for the help you need, effective treatment begins with following a set of directions.
Addictions all have in common a degree of physical and psychological issues which separate the “addict” from the “non-addict.” It involves the willingness, right from the start, to choose to stop; to become abstinent. From a medical perspective, abstinence refers to the simple cessation of addictive substances, and addictive or compulsive behaviors associated with an eating disorder. On the physical side, a necessary first step is to eliminate or seriously limit refined carbohydrates (e.g. sugar, flour) from your diet and that abstinent eating isn’t just avoiding sugar and refined carbohydrates, but also to eat three balanced regular sized meals a day. It therefore involves both new routines and new content. To be sure, this does not always mean to eat less, it means to eat differently. Not overwhelmingly differently from anyone else who is following a healthy diet. In fact, a good way to look at it is that, except for the avoidance of sugar and white flour, an anorexic and an over eater and a bulimic should all be happy to exchange plates with each other at dinner, and indeed also with other addicts or anyone else.