Resources around Family-Based Therapy (FBT) are getting better for parents who are caring for a child with an eating disorder. This is a very good thing. But for those of us who are adults with the disease, it can be very difficult to find help.
Relapse rate is very high, so knowing how to help oneself is vital.
Below I an gong to give you my step-by-step guide to creating a solid anti-relapse plan. This, by the way, is not for someone in a critical condition or anyone in need of inpatient or hospital treatment. This is more for someone well into recovery. Also, I am not a doctor or a medical professional, so mind you listen to the professionals too.
I still have an anti-relapse plan even today. I always will. Never get complacent about this stuff, eating disorders are nefarious little buggers and if you have the genetic predisposition for one, it can come back at any point in your life.
1.Identify Your “ED Check Person.”
For those of us who are married, your spouse is probably the perfect person. If you are living at home, a parent is a good call. Whomever you choose, this is someone who you trust and who loves you.
Who is the perfect ED Check Person?
Someone who isn’t going to tell you lies in order to be nice to you. Someone who knew you pre-ED (or at least very well) and so knows what is an ED behaviour and what is you. Someone who won’t blink at confronting you.
You’ve already probably butted heads with this person over your ED in the past, as they have already tried to tell you that you are looking unwell, or that you are exercising too much, or that you need to eat more. The crux is, this has to be someone who loves you enough not to be too scared to tell you that you are sick.
In FBT this person is usually the mum or the dad or both of them together. For us adults, sometimes a parent is not the most accessible, so like I said a partner or housemate, or a good friend. (If you don’t have a close friend, partner or relative, then you can go to your GP or medical practitioner and ask for a bi-monthly check up in which your doctor can assess you.)
You probably already have someone in mind for this, and it might even be someone whom you have been avoiding because whenever they see you they tell you things that your ED doesn’t want you to hear. Suck it up. And you’re going to just love what I am going to tell you next … .
2. Establish the No-Argue Zone
Crucial step. In case you were wondering how this ED check person is going to talk to you about your ED. You probably already know you are prone to fly off the handle when confronted with ED stuff. Well, you have to make a vow, that when your ED Check Person tells you something ED related, it is a No Argue Zone. No ifs. No buts.
Argh! It’s so hard at the start!
Initially whenever my long-suffering husband told me I was looking underweight I either: a) totally ignored him and changed the subject; b) rolled my eyes and told him to leave me alone; c) lost my shit and started yelling; or d) told him I would eat more later in order to get him off my case.
Then, when I got savvy enough to realize that he was my biggest ally against Anorexia, I made this rule:
Instead of arguing, I shut up, listen, process, commit to change, then say “thank you.”
In that order. Because if I say “thank you,'” as a reflex without really letting what he is telling me sink in, then I don’t take action on it.
Part of the “no-argue zone” rule is that I have to immediately implement a change. If he tells me I need to put on weight I eat more and do less.
If my husband tells me that he thinks I am looking thin the deal is I do not argue. If I open my mouth it has to be to put some food in. Seriously though, I say thank you for telling me, and I immediately make changes so that I put some weight on. If he is really worried and he wants to check my weight or do anything else like enquire as to how much exercise I am doing. No argument, That is his job as my ED Check Person. It’s actually empowering to give that power to someone else. But it only works if you create a no-argue zone with them.
Suck it up and deal. You can argue with everyone else in your life, but not with your ED Check Person when they tell you something ED related. And obviously this only does as far as ED-related topics. I argue with my husband about everything else 🙂
3. Create an Anti-ED Behaviour List
Do this with your ED Check Person. Sit down and write down all the weird shit eating disorder behaviors that you need to kick. This might be a really long list to start with. Go into detail. This list will also change as you get into recovery — hopefully it will get shorter and less weird as you get more recovered.
Below are some examples. I have purposely kept this example list very general so that it doesn’t trigger anyone or give anyone ideas. The point is you have to create a very honest list that is specific to you.
- No juicing or smoothie drinking rather than eating meals.
- No Nibbling — if you want a biscuit you eat the whole biscuit.
- No Squirrelling — no hiding food.
- No drinking excessive water before meals.
- No cleanses.
- Three meals and three snacks a day regardless of how full you feel.
- Limit fruit to three portions a day. Un-limit chocolate 🙂
- Exercise is limited to X times a week for no more than X minutes at a time.
- Only full-fat dairy versions of yoghurts or cheese.
- Proper cutlery to eat meals with.
- No weird cutting up of food.
- No weird only eating food in a certain order.
Get the idea?
Oh, and if your ED Check Person suggests a list item that you disagree with, guess what? Exactly right. No arguing.
Then you both sign it, and you stick it on the fridge door or somewhere you will see it.
4. Make a Meal Plan
Initially when you are maintaining a recovery a meal plan can be very helpful. Get your ED Check Person or dietitian if you are working with one to help you devise it. It honestly takes all the stress and decision making out of the process for you. I’m not gong to reinvent the wheel here. Dr Lauren Muhlhien has written up a great article on meal plans here that I will defer to.
Once you are recovered you will move away from the meal plan probably, but actually I still tend to plan my meals for the week to make sure I am never caught short.
5.Stick It to ED by Sticking to It!
Stick to the list. Stick to the meal plan. Never skip a meal. If your ED Check Person tells you that you have fallen off track it is imperative that you listen. You cannot be trusted alone when it comes to judging your weight. With exercise too, we can easily fall off the wagon.
What do you think? If you have any tried and tested anti-relapse tips I would love to hear from you!
This blog post is part of a much longer eBook that I created for Adults with Eating Disorders. If you want to read my complete Recovery Plan, you can download it here for freeDownload Now
I hope you will find this information helpful!