Road to Recovery from Eating Disorders

Published: May 30, 2014

A new research study, which is a collaboration between the UNC Center of Excellence for Eating Disorders, Duke University, and Principal Investigator Dr. Anna Bardone-Cone in the UNC Department of Psychology seeks to define recovery in eating disorders. Currently, we have no agreed upon definition of what “recovery” is in eating disorders and often times both practitioners and patients develop their own definitions of what it means to be recovered from an eating disorder. Not having agreed upon definitions of recovery makes it impossible to compare research studies to one another in order to know how many people reach recovery, what recovery looks like, and what helped individuals recover.

In this research, Dr. Bardone-Cone is taking a new and fascinating approach to defining recovery in eating disorders. She is seeking to define recovery from an eating disorder in physical (e.g., weight), behavioral (e.g., binge eating), and psychological terms (how one thinks about her or his body, food, and eating), which challenges the current definitions of recovery often used that tend to focus exclusively on the physical and behavioral aspects of recovery. This thinking is groundbreaking as physical and behavioral recovery from an eating disorder does not guarantee psychological recovery—individuals physically and behaviorally recovered often report still being tormented by eating disorder thoughts. Or as Dr. Bardone-Cone likes to say, “Walking the walk behaviorally, but internally still talking the eating disorder talk.” This psychological component of recovery focuses on just that—the eating disorder talk—or how individuals struggling with eating disorders think about their bodies, food, and eating. As such, Dr. Bardone-Cone proposes that full eating disorder recovery is only achieved when individuals with eating disorders are not only physically (e.g., healthy weight) and behaviorally (e.g., no binge eating or purging) recovered, but are indistinguishable from individuals without eating disorders on these psychological components of eating, food, and body image. While some may view this definition of recovery as unrealistic, Dr. Bardone-Cone has shown previously that in fact, this type of recovery is possible. In a preliminary research study, Dr. Bardone-Cone was able to identify a “fully recovered” group of women with a history of an eating disorder who were physically and behaviorally recovered, who were also indistinguishable on attitudes related to food, weight, and body image from women who had never had an eating disorder. This provides evidence that her proposed definition of recovery is not unrealistic and is entirely attainable, although we do not yet know which individuals are more likely to get to this fully recovered place.

RRED littleThe inclusion of this psychological component is critical. In working with patients, we so often hear that while they may be physically and behaviorally “recovered” from the eating disorder, they still experience eating disorder thoughts. These lingering eating disorder thoughts and attitudes are not trivial, given that body dissatisfaction is a significant predictor of eating disorder relapse. Further, it is also common to hear from patients that they do not “feel recovered” even though their weight is healthy and the eating disorder behaviors have stopped—highlighting the importance of including this psychological component in definitions of eating disorder recovery and not focusing solely on weight and behaviors.

Thus, the Road to Recovery from Eating Disorders (RRED) Study aims to clearly include the psychological piece of recovery. The main goals of this new research study are to gain a better understanding of the course of an eating disorder, to determine what the different stages of recovery look like and how we might best define full recovery, and to identify what is associated with moving down the road to recovery from an eating disorder. RRED is currently recruiting individuals 16 years old or older who have a history of anorexia nervosa or bulimia nervosa; both individuals in some stage of recovery and those currently with an eating disorder may be eligible. RRED has been primarily recruiting from individuals with prior treatment experience for an eating disorder at UNC or Duke who have been out of treatment from these facilities for at least 1 year. They are also recruiting females 16 years old and older who have never had an eating disorder. Participation in RRED includes completing online surveys, participating in interviews, and donating blood. If you are interested in participating in RRED, you can contact the research study staff at 919-843-0974 or More information about the study can also be found on their website:

photo credit: antonychammond via Creative Commons

photo credit: Kuster & Wildhaber Photography via Creative Commons