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Health Matters 1/29: Finding Hope in Eating Disorder Recovery

By Robbi Alexander, PhD

Roadblocks are common in life and can cause anyone to feel a sense of hopelessness every now and then.

For individuals living with an eating disorder, however, roadblocks can seem insurmountable, and the loss of hope can be a significant barrier to long-term recovery.

At the Princeton Center for Eating Disorders at Penn Medicine Princeton Medical Center, a new nurse-led program helps patients learn how goal setting can offer a renewed sense
of hope and improve their everyday lives.

30 Million People

An estimated 30 million people living in the United States — 20 million women and 10 million men — will experience an eating disorder in their lifetime, according to the National Eating Disorders Association.

And while no one knows for sure what causes eating disorders, a growing consensus suggests there is an interplay of biological, psychological, and sociocultural factors at work.

Eating disorders can affect people of all genders, ages, races, religions, ethnicities, sexual orientations, body shapes, and weights.

Signs and symptoms of an eating disorder can include:

• Preoccupation with weight, food, calories, dieting or body image.
• Development of abnormal, secretive, extreme or ritualized food or eating habits.
• Withdrawal from friends and activities.
• Evidence of binge eating, such as the disappearance of large amounts of food.
• Evidence of purging behaviors, including frequent trips to the bathroom after meals, self-induced vomiting, and laxative abuse.
• Compulsive or excessive exercising.
• Feelings of isolation, depression, anxiety or irritability.

If you or someone you love is affected by an eating disorder, talk to your doctor. The chance for recovery is greater the earlier the condition is diagnosed and treated.

Hope Theory

Research indicates that low levels of hope or hopelessness are among the biggest barriers to recovery for eating disorder patients.

For individuals facing the mental health and chronic physical problems brought on by an eating disorder, feelings of hopelessness can become particularly intense and long lasting.

For example, younger patients with an eating disorder may struggle with concerns about an uncertain future.

Older patients who have lived much of their lives with a disorder may feel they’ve tried everything to address the condition and have lost the support of family and friends. They may have internalized a sense of failure or even burdensomeness.

Further, individuals with eating disorders may have drastically narrowed their goals as they become focused on inflexible ideas about food, weight, and appearance.

These tightly held beliefs about weight and appearance often contribute to a sense of hopelessness.

Recovery from eating disorders involves learning other ways to manage stress and find meaning and worth in life beyond weight and appearance.

Goal-Directed Thinking

Studies have shown that goal-directed thinking and goal setting can help bring a sense of self-worth and accomplishment to those who feel hopeless, including individuals with eating disorders.

In addition, motivation and identifying pathways — and sometimes alternative pathways — to those goals are critical to engendering feelings of hope.

Tips for using this approach to nurture feelings of hope include:

• Exploring your needs.
• Identifying your goals.
• Breaking those goals into smaller goals so they are more manageable and measurable.
• Anticipating roadblocks and creating strategies to find alternative pathways.
• Building on success to continually renew motivation.

A Pathway to Hope

Helping patients develop hope for the future is at the core of a unique research-based inpatient program at the Princeton Center for Eating Disorders.

Led by the nursing team, the four-week psychoeducational group series teaches patients how to gather the tools they need to identify and reach their goals, whether those goals are related to their eating disorder or other areas of their lives.

The groups also help patients develop strategies to address roadblocks, adopt a more flexible approach to goals and realize that the pathway to achieving those goals may not be a straight line.

In order to move forward, they may have to consider alternative pathways and possibly second-tier goals.

In the first week of the series, patients explore their ideas about hope and map out individual goals. They prioritize what’s most important to their quality of life and explore the things they need to have in place to meet their goals.

The second week focuses on the steps that will help them accomplish their goals. By breaking goals into small, attainable steps, goals can feel more realistic and achievable. Nurses use creative approaches, such as creating a vision or storyboard, to offer something tangible to help patients visualize their goals and invoke feelings of success.

The final weeks of the group series are about refining goals, acknowledging and exploring successes, identifying ways to continue to self-motivate, and setting up a support system to foster the ongoing process.

The groups are flexible to meet each patient’s unique needs and are part of a multidisciplinary treatment approach. Most participants attend twice a week, and each session runs between 30 and 60 minutes, depending on the needs of the group.

Finding hope and the support to continually renew motivation allows patients to keep moving forward and get to the next level of healing.

The Princeton Center for Eating Disorders provides inpatient treatment for adults, adolescents and children as young as 8 years old who are suffering from anorexia, bulimia, and other eating disorders.

For more information about Princeton Center for Eating Disorders, call 609-853-7575 or visit princetonhcs.org/eatingdisorders.

Robbi Alexander, PhD, is director of Princeton Center for Eating Disorders at Penn Medicine Princeton Medical Center.


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