Fears that surface during the recovery process from an eating disorder

Recovering from an eating disorder is a process that requires time, consistency, and persistence, despite setbacks. Ultimately, overcoming an eating disorder is a process of rebuilding oneself, of rediscovering oneself. The more one escapes the trap of the symptoms, the more the person reappears and the less the disorder persists.

During this process, many fears can arise , and it's important not to keep them to yourself so they don't become secrets, which only intensifies them and worsens the situation. Many people recovering from an eating disorder have shared these fears with us throughout our extensive professional experience. This is, therefore, a good opportunity to learn about them and try to provide practical guidelines for managing them . We extend our gratitude to all the people we've helped , whose selfless testimonies allow us to help others who may be facing this situation right now.

Ten challenges for people recovering from an eating disorder

I'm afraid I won't look good.

💬 Your reflections

"I'm often afraid of not looking good. For a long time I believed that my worth was solely based on my physical appearance, but over time you realize that the idealized image you desired was unhealthy, and that whatever I look like, my worth lies in many other qualities."

"I have never felt satisfied with my body, even when I was underweight."

"Not feeling good about myself is a consequence of low self-esteem. I not only feel bad physically, but I also don't accept who I am. If I'm so awful, why do I have people around me who appreciate me and love me just the way I am?"

✅ How to manage it

Looking good, in addition to your actual weight (which is often not the same as your perceived weight), depends on self-esteem . If you work on your self-esteem, even if there are parts of your body you don't like, you'll learn to accept them and even make the most of them.

Self-esteem as the foundation of good mental health

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It's important to learn to speak kindly to yourself , to show yourself the same compassion you so often extend to others. Over time, you'll come to see your body simply as another attribute, just like other aspects of yourself, and it will cease to be an end in itself (or even an "instrument of torture").

At first, when self-esteem is very damaged, it helps (as with eating disorders) to distract yourself with things you like that have nothing to do with physical appearance or food.

• Avoid looking at yourself in the mirror or in shop windows until you feel strong enough internally.
• Avoid comparing yourself.
• Avoid isolating yourself. Get together with friends, do things with your family, take care of yourself with something that helps you relax, like music or any other neutral hobby. Little by little, and with the help of therapy, we can rediscover those valuable aspects of ourselves that the eating disorder had silenced.

Self-esteem also depends on perfectionism, on whether we can lower our standards for ourselves. This often works with friends – what excellent friend doesn't have flaws that we tolerate? Is it really the fear of how we're perceived physically, or the fear of being ourselves, that underlies eating disorders?

I'm afraid of losing control of my life

💬 Your reflections

"I feel like I have control with the disorder, but over all these years I've learned that it's the complete opposite, that it's the disorder that leads me to lose control. That's why I'm afraid of losing control from both sides: on the one hand, of letting the disorder in, and on the other, of letting it go away."

"The important thing to change that mindset is to remember what each kilo has meant on an emotional and health level."

"Am I really in control, or is it a false control?"

"Controlling my food, exercise, and everything around me gives me immediate satisfaction." "It makes you get hooked, but it never lasts, and taken to an extreme it ends up getting out of control, making you submissive and you don't know how to stop."

"It's difficult because the eating disorder has given you an identity and you can't imagine a life without it. It helps me to write down on paper the things I want to do (simple and realistic things that I haven't been able to do because of the eating disorder), and to gradually expose myself to them despite the fear, and if necessary, accompanied."

✅ How to manage it

This fear is closely linked to personal insecurities, and also to the fear of the unknown. Eating disorders provide a false sense of security in an object (the body) which, through achieving (or not achieving) weight and figure goals that you become obsessed with, is never truly satisfied, but it masks and buries other underlying insecurities that remain .

When the symptoms subside, these insecurities will return, so the sooner you can talk openly about your fears , acknowledge them, and confront them, the more power they will lose because you will feel understood and supported. Share them with your therapy group or a close friend so you can see that you are not alone and that they also have other fears and insecurities, and that you can tolerate them. We all have fears, especially during adolescence, when we seek to fit into the world beyond our families.

I'm afraid of losing what I've worked so hard to achieve.

💬 Your reflections

"All this effort you achieve thanks to eating disorders only leads to living in and out of hospitals and being a slave to constant discomfort. Nobody sees that effort. What you achieve with eating disorders is to withdraw from life, family, studies, and friends."

✅ How to manage it

Don't get confused. Is it really a certain image you're striving for, or do your true goals lie deeper: to be loved, admired, popular, or successful within your social circle? What lies beneath the surface? What do you like about yourself, and what don't you? Work on this and redirect your efforts toward loving and valuing yourself more holistically, not just for your physical appearance. This achievement ultimately becomes far more motivating because it integrates you into the world instead of isolating you from it.

How to manage negative thoughts in eating disorders

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Consider when you lost yourself and became trapped in the eating disorder. Think about what was happening to you then, your circumstances, where you located problems or suffering before considering changing your diet. Your therapists will accompany you and help you find the reasons that led you to fall into that trap, since there are always underlying reasons that go beyond the physical and food aspects, and it's frightening to face them alone. And fear and overwhelm lead to dwelling on the symptoms, and that's where the trap is set, creating a vicious cycle. It's about rediscovering valuable aspects of yourself that the eating disorder has silenced. It's about bringing your identity back to the surface, but through the work of reconstructing it.

I'm afraid of losing control with my eating.

💬 Your reflections

"Eating the prescribed diet won't make your body fat. In fact, we see others who eat the same (or more) as exactly the same."

"Losing control and eating uncontrollably is a fear that arises when I don't follow dietary guidelines. My body craves certain foods that I don't allow myself, and it does so in the form of looping thoughts."

"If you follow a balanced diet and learn to listen to your body and give it what it asks for, it will self-regulate."

✅ How to manage it

• Let your family and closest friends help you . Eat together and talk. Mealtimes are a daily opportunity to connect, and good company helps you cope with your troubles. Quality human relationships make us happier and even improve our physical health as we age. Ask them about their lives, share dreams and plans. Don't talk about food or body image.
• Once again, talk about these fears with your therapists ; let them out instead of allowing them to fester. Ask for help when anxiety arises or resurfaces about overeating, "overdoing it," unpleasant bodily sensations, and so on. They will teach you to identify when hunger is normal and when it's part of an eating disorder, and how to approach meals with new resources at your disposal.
• Remember that the guidelines in the Day Hospital or during hospitalization are individually supervised for each case by a nutrition professional who provides a varied and balanced diet. Remember that you are in a controlled environment among specialists. It is your own plate and your own body that look (or feel) different, not those of others. And that's something to consider, because it is your own experience and self-esteem that are negative and overload your self-image.
• If you're feeling very stressed, let someone else serve you your meal, because doing it yourself won't make you feel calm. If it's not up to you, the anxiety will gradually subside. It's like when we were served snacks at school or at a children's birthday party.
• After eating, distract yourself by doing a relaxing activity that will keep your mind occupied. Make a phone call, listen to music, or pursue a hobby.

If despite all this you cannot overcome this fear, the Day Hospital offers an absolutely controlled environment where you can face it in company.

The more restrictions or prohibitions you impose on yourself regarding certain foods, the greater the urge to lose control and eat them. Often, people who binge eat combine this behavior with futile attempts at restriction. And it is not uncommon for anorexia nervosa to evolve into bulimia, and this, subsequently, into binge eating disorder.

Tips to motivate yourself and maintain good habits

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So the solution is not to forbid things, but to allow them in a balanced, controlled and, if necessary, supervised way.

At the beginning of treatment for an eating disorder, as eating patterns change, so do habits. It's common to feel fear and anxiety about your body's sensations. Often, you've forgotten how to recognize the original feeling of hunger or satiety. When the sensation of hunger returns, it may be more intense because you've suppressed it for too long, but that doesn't mean it will always be that way. If you follow the therapeutic team's guidelines carefully and have support from your environment, you won't lose control, and after a while, the feeling will subside.

I'm afraid the medication will make me gain weight or disable me.

💬 Your reflections

"The medication helps me not to be so obsessive about eating disorder thoughts, and that's scary when you suddenly feel like you're 'slacking off' and you don't identify with how rigid you've always been, and now 'you don't care about anything.' But thanks to this help, I have more strength to leave the eating disorder thoughts behind and prioritize what I want. Now I can think about other things and be more flexible."

✅ How to manage it

• It's important that you discuss this fear with your psychiatrist. Few psychotropic medications used for eating disorders actually cause weight gain . Generally, sedation isn't necessary to calm down, although it can sometimes be helpful. Most medications used for eating disorders aim to reduce (relieve) obsessive thoughts, balance or improve mood, promote restful sleep, or control cravings, self-harm, or anxiety attacks. Medication is prescribed by a responsible and specialized professional who will find the most appropriate one for each individual case, but if problems arise, it's essential to communicate them so that a solution or alternative can be found.
• Compare the feeling of "not being myself" while having the eating disorder to how you felt before it appeared. Are you truly yourself with the eating disorder, or are you letting it dictate your life?
• If you have taken medication, ask yourself this other question: How much space in your mind do thoughts about food and body occupy with and without medication?
• People with eating disorders often think in extreme, black-and-white, or "all or nothing" ways (either I do it perfectly, or I do it terribly). Giving in to these thoughts and adhering to the prescribed diet disrupts our patterns, but that doesn't put us at the extreme of neglect. Over time, this also balances out, and less extreme, more moderate thoughts emerge. We learn to listen more to ourselves and our bodies . Furthermore, we all have to learn to make mistakes; otherwise, we isolate ourselves and retreat into a bubble because we can't bear to make errors and feel fallible, which, in reality, is very human.
• Medication facilitates cognitive flexibility , helping to find alternative thoughts to obsessive ones, and thus allowing one to be more willing to try other ways of acting and gradually change their personal situation. Many people with eating disorders terribly avoid listening to their emotional needs, either not acknowledging them or denying them, and this distress manifests as symptoms.
• No medication for eating disorders can override our willpower , nor can it force us to do what we don't want to do. It can alleviate the symptoms, but it is our own will that makes the decisions, not the pill.

I'm afraid I won't be able to overcome the eating disorder.

💬 Your reflections

"One piece of advice is to find goals and dreams that will push you to overcome the disorder. This fear should help us to have even more motivation to fight, instead of blocking us and giving in to that fear."

"I believe you can overcome an eating disorder and go back to living your own life, without paying attention to the voice of the eating disorder. Even if it remains in my head, it would no longer have control over me. I want to learn to push it away and listen to my own voice and my desires."

"It helps me to have short and long-term goals, to have a life plan. Eating disorder thoughts may never completely disappear, but I believe that, little by little, they will become less intrusive and have less importance in my daily life."

How to prevent relapses in eating disorders?

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"I'm afraid of being alone. Having the disorder makes people feel closer. You feel more cared for, but in the long run, those who have been there for you get tired of it and end up disappearing from your life. To take care of your relationships, you first have to take care of yourself. That way, relationships will be based on a 50-50 balance; what you give, you also receive."

✅ How to manage it

The fear of not recovering is healthy in a certain sense, as it motivates us to get motivated and follow the guidelines properly. It's a fear based on a possible reality: that of chronic illness.

• As with other fears, it's good to verbalize it.
• Discuss with your therapist what risk factors exist in your case, and analyze what is preventing you from moving forward at a given time.
• Do things that motivate you and help you practice social skills and create and maintain emotional connections, gradually repairing the culture of sacrifice and false social success. This will strengthen your willpower and forge healthy self-esteem. Obligations and pleasures can be balanced in life.
• The need to be taken into account is very natural, but if it's approached from the perspective of the disorder, communicating through the symptom rather than the genuine need for affection, it leads to situations of condescension and limitations imposed by the illness. It would be like requiring an actor to always be a character, unable to be themselves offstage.

I'm afraid of relapsing.

💬 Your reflections

"The moment you notice you're about to relapse, ask for help so they can provide you with the tools to regain control. The worst thing you can do is ignore that relapse, as it will only increase it and the eating disorder will completely control you again."

"It helps me to think that each day is unique and independent of the other days. It's a new opportunity to overcome the disorder. If I can't do it alone, I ask for help from people close to me, people I know will help me move forward and stop focusing on what I've done wrong."

"It helps to understand that you're not in the same place as at the beginning, that you've made a lot of progress and now you have to do some things again, but remember that if you could do it once, you can do it again."

"It's something that terrifies me, honestly, but it helps to focus on the present, the day-to-day , and not so much on the future. If I'm doing well now, I want to enjoy it because I haven't done that for years. Anticipating and worrying now won't solve the problem."

✅ How to manage it

• Acknowledge the setback, but don't give up. You have to be aware that bumps in the road are part of the path to recovery.

• Learn from your mistakes and ask yourself: What has caused the symptom to return? What has happened that makes me need it more again? What underlying problems or emotions am I struggling to manage? Did you have any warning signs? Did you heed them? And if not, why not?
• Identify what achievements you had made before the relapse, in what aspects of your mindset you are progressing, and what others still easily trap you.

I'm afraid of disappointing my family

💬 Your reflections

"Don't confuse concern with disappointment. The best thing to do is talk to the people you think you've disappointed. Talk to them, and ask them how they really feel."

"It's important to understand that recovery often involves relapses, which are all part of the learning process. But you don't go back to the beginning of the process. (...) Once you've forgiven yourself for being disappointed in yourself, it's easier." It's important to appreciate that our family and friends feel concern rather than disappointment. That's why establishing healthy communication with them helps us understand them and for them to understand us.

✅ How to manage it

• Look for aspects of yourself that your family consistently values beyond your physical appearance, nurture those qualities, and allow yourself to be loved, even if you feel you don't deserve it. Family members usually know both our flaws and our strengths well. The affection between parents and children and siblings isn't based solely on the latter; it's about loving the whole person, with all their strengths and weaknesses. Sometimes it's important to be reminded of this.
• Share your fears with your therapists and consider them.
• The family, for their part, must accept that treatment is not a straight road, but an unpaved path, with twists, turns, detours, and occasional setbacks. They learn as they go, and sometimes this includes falling along the way. If a parent had an illness and the treatment didn't agree with them, would you stop trying? Would you blame them for it?
• An eating disorder is also a challenge for families, as it often involves re-evaluating beliefs, for example, regarding perfectionism or communication (or the lack thereof), and working to change things. This sometimes includes parents also reviewing their own value system. As with any crisis, going through the journey together is also important and leaves its mark on our personal growth.

I'm afraid of getting over my eating disorder only to fall into another disorder or addiction.

💬 Your reflections

"I have never tried drugs or other substances because I know I would get addicted. I easily fall into the trap of anything that can make me not think, escape from reality and avoid it."

"Every addiction is a manifestation of what's happening inside us. It's a symptom of how we feel. That's why it's crucial to work on our fears, self-esteem... to overcome them and not go from one disorder to another."

✅ How to manage it

• Often, an eating disorder is more of a coping mechanism for dealing with conflict than an inherent problem with food itself. Work to discover what the addiction gives you: Is it seeking pleasurable sensations, allowing yourself to lose control, escaping, or numbing suffering? Is there a significant trauma in your life?
• Do sports activities (as long as it is not part of the symptom) and relaxation activities.
• Find healthy ways to let off steam. Try new leisure activities, such as karaoke or painting, as long as your symptoms don't contraindicate them.
• Learn to identify your own particular warning signs, those amber lights that sometimes turn on in all of us and that can turn red if we ignore them.

Ultimately, it's about taking yourself into account. When you listen to and meet your inner needs, and heed your warning signs, the need for escape and the symptoms lose their meaning.

I'm afraid I won't be able to develop my life project

💬 Your reflections

"It's better to take small but firm steps."

"The treatment will help you stop giving up parts of your life because of the eating disorder. Furthermore, during the recovery process, you rediscover your true self, what the eating disorder had hidden. Therefore, you don't give up, but rather gain a new life, a new beginning full of possibilities."

"There's a fear of not being accepted, a fear that without the eating disorder you'll lose everything you have, everything you like, everything that attracts others, and that they'll abandon you. But this fear is unrealistic because no one who truly cares about you would want to see you suffering. On the contrary, if you recover and they see you better, both inside and out, they'll be the first to rejoice. We can only control our own actions and thoughts. And others will decide if they want to stay by your side. So we must be real and honest with ourselves."

"The eating disorder gives me many things, but it takes away, limits, and prevents me from doing much more. It's been in my life for so many years that it's become part of my identity, which is why it's scary to leave it behind, because I don't remember or even know who I was without the eating disorder. But having come this far in treatment, I can also give myself the opportunity to get to know myself and fill the void left by the eating disorder with what I truly want."

✅ How to manage it

Remember that there is a better reality beyond eating disorders. Certainly, treatment for an eating disorder isn't short and takes up a significant part of your life right now, but it's so you can fully reclaim it afterward, so you can be freer in the not-too-distant future, and that is truly worthwhile. The symptom itself is already a sacrifice—to give up so many things! And the underlying problem will remain if it isn't addressed.

This is difficult to see, especially in adolescence, when we focus more on the present than the future. Studies (particularly if we plan to pursue a degree) also take up a significant part of our lives, and we see them as essential for self-sufficiency and a good future. It is with this same mindset that you will be better able to approach the treatment of your eating disorder.