Eating disorder recovery is often described as “marathon, not a sprint,” and research supports this. Studies show that recovery is absolutely possible, but it’s rarely a straight line, and it depends on more than weight or symptom change alone (Bardone-Cone et al., 2020; Kordy et al., 2002; Miskovic-Wheatley et al., 2023).
Austin Center for Eating Disorders (ACED) is committed to providing evidence-based, highly specialized therapy and nutrition therapy for kids, teens, and adults. We work in-person or virtually in Austin and virtually across Texas.
What Does Recovery from an Eating Disorder Actually Mean?
For a long time, recovery was defined mostly in terms of weight and visible behaviors. More recent work offers a much richer, more nuanced picture.
Bardone-Cone and colleagues argue that full recovery involves:
No current eating disorder behaviors
Normalized eating patterns and weight/medical stability (when relevant)
Marked reductions in body image disturbance and eating disorder thoughts
Improvements in mood, cognition, functioning, and quality of life (Bardone-Cone et al., 2020).
Equally important is a person’s subjective definition of recovery and sense of self outside of the eating disorder. Recovery also includes the person’s identity, agency, and connection with important others, meaningful activities, and with their own self (Kinnaird et al., 2024).
Taken together, the research suggests that recovery is best understood as multidimensional:
Physical and nutritional recovery
Behavioral change (less/no restriction, bingeing, purging, compulsive exercise, etc.)
Cognitive and emotional shifts (less preoccupation, more flexibility and self-compassion, ability to emotionally regulate without the ED)
A reclaimed life: relationships, values, joy, strong sense of self outside of the ED, and a sense of future)
As an aside, large research reviews show that outcome data in eating disorder treatment are still messy. Definitions of “remission,” “recovery,” and “relapse” vary widely, follow-up often ends too early, and some diagnoses have very little long-term research at all (Khalsa et al., 2017; Miskovic-Wheatley et al., 2023).
Why Team-Based Outpatient Care Matters
People with eating disorders often need concurrent support from more than one professional. Serious medical risks, nutrition needs, body image, trauma, anxiety/OCD, emotional distress, and family dynamics can all be part of the clinical picture.
The gold standard recommendation for eating disorders is a team approach, i.e., multidisciplinary care (Yager et al., 2014). Team-based, collaborative care usually includes:
A therapist with eating disorder expertise and specializing in needed co-occurring conditions
A dietitian specializing in eating disorders
A medical provider monitoring safety and medical stability
Sometimes a psychiatrist, school supports, and/or higher levels of care if indicated
What the Research Shows
A multidisciplinary team approach (therapist + dietitian) consistently show reductions in eating disorder psychopathology and also meaningful improvements in mood, anxiety, and overall quality of life, suggesting that team-based care can effectively address comorbidities alongside core ED symptoms (Gaudiani & Sabel, 2016; Peckmezian & Paxton, 2020).
Early, specialized intervention is associated with better clinical outcomes and may reduce the likelihood of needing more intensive levels of care later on, demonstrating the value of timely, coordinated outpatient treatment (Yager et al., 2014; Khalsa et al., 2017).
Active caregiver involvement is associated with improved treatment adherence, better symptom reduction, and greater caregiver confidence in supporting meals and behavior change at home (Byrne et al., 2019; Coelho et al., 2021).
Long-term follow-up data show that relapse is common, and expert groups recommend ongoing outpatient contact and monitoring, which team-based models are well positioned to provide across life transitions (Keel et al., 2005; Khalsa et al., 2017; Miskovic-Wheatley et al., 2023).
For many medically stable clients pursuing eating disorder treatment, outpatient treatment* is not “less serious,” it’s simply the setting where skills are learned and practiced in real time, in real life. Many people prefer to stay entirely in their lives when pursuing treatment, and research supports this, as long as the person is medically stable, meaning that vital signs and lab markers are within a safe range and there is no immediate medical risk that requires a higher level of care.
*Outpatient treatment in this context is the lowest level of care in eating disorders. It means that the person pursuing treatment stays entirely in their life, goes to 1-4 sessions per week depending on need, and goes home.
Making Sense of the Eating Disorder: More Than “Just About Food”
Research and clinical literature increasingly frame eating disorders as complex, multi-determined coping strategies, rather than simple vanity or willpower problems.
Treasure (2004) emphasizes understanding the internal logic of an eating disorder, what it protects against, what emotions it numbs, and how it organizes identity and relationships. This psychoanalytic and attachment-informed perspective helps shift the question from “Why won’t you just eat?” to “What is this doing for you, and how can we meet those needs differently?” (Treasure, 2004).
Other research demonstrates how sociocultural, racial, and gendered forces shape who develops eating disorders, how symptoms appear, and who actually gets diagnosed and treated (Touyz et al., 2007).
Across models, there is growing alignment that effective treatment must:
Address trauma, marginalization, and identity stressors when present
Name and challenge weight stigma, “thin supremacy,” and respectability politics that pathologize certain bodies more than others
Support clients in developing alternative forms of safety, power, and meaning beyond the eating disorder
Eating Disorder Recovery Is Nonlinear: Relapse, Recurrence, and Long-Term Support
Relapse and recurrence are common in eating disorder recovery, and that doesn’t mean treatment “failed.” It means that eating disorders are chronic, relapsing illnesses for many people, and support often needs to be long-term.
What the Data Tells Us
Studies suggest that relapse risk is often highest in the first months to few years after initial improvement, especially when support drops off or treatment stops too soon (Keel et al., 2005; Khalsa et al., 2017; Miskovic-Wheatley et al., 2023).
Research that distinguishes lapses (brief slips) from relapses (sustained return of symptoms) shows that setbacks don’t erase progress. Instead, lapses and relapses can provide important information about triggers, stressors, and unmet needs in the recovery plan (Kordy et al., 2002; Bardone-Cone et al., 2020).
Longitudinal research indicates that major life changes, like moves, school transitions, breakups, job changes, pregnancy/postpartum, or health crises, are common times for symptoms to resurface, suggesting relapse is often tied to stress and transition rather than “lack of willpower” (Keel et al., 2005; Khalsa et al., 2017).
Guidelines emphasize that early detection of returning symptoms, such as renewed food rules, increased body-checking, or social withdrawal, and quick re-engagement with treatment can help people regain ground more quickly and avoid full relapse (Yager et al., 2014).
Family- and caregiver-focused research shows that when parents, partners, or other supports are taught how to spot early warning signs and respond skillfully, they can help interrupt lapses before they become entrenched relapses (Byrne et al., 2019; Le Grange et al., 2010; Lock et al., 2006).
Studies of multidisciplinary models suggest that having an ongoing, coordinated team (therapy, nutrition, medical) provides a “safety net” for checking in during stressful seasons, adjusting plans, and addressing new triggers as life changes (Gaudiani & Sabel, 2016; Chua et al., 2004).
Eating disorder recovery is dynamic, and many people benefit from sustained, flexible support even after the most acute symptoms improve.
Eating Disorder Treatment in Austin, Texas
For people in Austin and across Texas, all of this research translates into very practical questions:
Is my outpatient team truly specialized in eating disorders?
Are my therapist and dietitian talking to each other and to my doctor?
If I’m a parent or partner, am I being invited into the process in a meaningful, supported way?
Does this treatment environment feel safe for my identities and my body?
Austin Center for Eating Disorders
Austin Center for Eating Disorders (ACED) is an outpatient therapy and nutrition practice in West Lake Hills (Austin area), fully specialized in all eating disorders, that is built around these evidence-based principles.
Provides specialized outpatient eating disorder treatment for kids, teens, adults, and families, both in person and virtually across Texas.
Offers eating disorder therapy and nutrition counseling, with clinicians experienced in anorexia, bulimia, binge eating, ARFID, orthorexia, compulsive exercise, body image, and more.
Emphasizes a team approach, where therapists and dietitians collaborate to help clients understand how the eating disorder both “helps and harms,” learn practical coping skills, and reclaim their lives.
A safe space for all bodies, explicitly allied with LGBTQIA+ and gender diverse communities, and oriented toward inclusive, affirming care, aligning with the growing evidence that weight stigma and marginalization worsen outcomes and must be directly addressed in treatment.
Specializes in trauma, anxiety, OCD, neurodivergence (ADHD and Autism), depression, and other commonly co-occurring conditions.
If You or a Loved One Is Struggling with an Eating Disorder
If you see yourself or someone you care about in these descriptions, some possible next steps include:
Scheduling a consultation with a specialized practice to ask questions and get info
Talking with your primary care provider or pediatrician about concerns
Asking explicitly about how the treatment team coordinates care and how families or partners can be involved
Learn more about eating disorders
If you’re worried about medical safety or serious medical complications, a higher level of care may be indicated. In Austin, there are 2 treatment centers for eating disorders at the IOP (intensive outpatient) and PHP (partial hospitalization) levels of care:
Eating Recovery Center https://www.eatingrecoverycenter.com/
Center for Discovery https://centerfordiscovery.com/
Recovery happens every day. It may be nonlinear, and it takes time, but with the right support team, you can reclaim your life, your mental space, your body, and your purpose.
References
Bardone-Cone, A. M., Cass, K. M., Ford, J. A., & Zerwas, S. (2020). Recovery from eating disorders: A review of the literature and a call to action. International Journal of Eating Disorders, 53(4), 483–493.
Berends, T., Boonstra, N., & van Elburg, A. (2018). Relapse in anorexia nervosa: A systematic review and meta-analysis. Current Opinion in Psychiatry, 31(6), 445–455.
Byrne, C. E., Accurso, E. C., Arnow, K. D., & Lock, J. (2019). The role of parents in eating disorder treatment: A systematic review. International Journal of Eating Disorders, 52(11), 1181–1206.
Chua, J. L., Touyz, S., Hill, R., & Lacey, H. (2004). The Royal Children’s Hospital eating disorder program: The way forward. Australasian Psychiatry, 12(4), 386–391.
Coelho, J. S., Suen, J., Kelly, N. R., et al. (2021). Parental experiences with their child’s eating disorder treatment journey. Journal of Eating Disorders, 9, 21.
Gaudiani, J. L., & Sabel, A. L. (2016). Team-based outpatient care in eating disorder recovery: Clinical and cost outcomes. Eating Disorders, 24(2), 145–151.
Gorrell, S., Loeb, K., & Carr, A. (2019). Family-based treatment of eating disorders: A narrative review. Child and Adolescent Psychiatric Clinics of North America, 28(4), 641–656.
Hagan, K. E., et al. (2023). Understanding outcomes in family-based treatment for adolescent anorexia nervosa: A network approach. Psychological Medicine, 53(2), 521–530.
James, P., et al. (2025). What factors do parents/caregivers think impact change in family-based treatment for eating disorders? International Journal of Eating Disorders.
Keel, P. K., Dorer, D. J., Franko, D. L., Jackson, S. C., & Herzog, D. B. (2005). Postremission predictors of relapse in women with eating disorders. American Journal of Psychiatry, 162(12), 2263–2268.
Kinnaird, E., Norton, C., Tchanturia, K., & Stewart, C. S. (2024). Personal recovery and eating disorder symptomatology: Associations in a clinical sample. European Eating Disorders Review, 32(x), xx–xx.*
Khalsa, S. S., Portnoff, L. C., McCurdy-McKinnon, D., & Feusner, J. D. (2017). What happens after treatment? A systematic review of relapse, remission, and recovery in anorexia nervosa. Journal of Eating Disorders, 5, 20.
Kordy, H., Kramer, B., Palmer, R. L., et al. (2002). Remission, recovery, relapse, and recurrence in eating disorders: Conceptualization and illustration of a validation strategy. Journal of Clinical Psychology, 58(7), 833–846.
Le Grange, D., Lock, J., & Loeb, K. (2010). Family-based treatment for adolescent anorexia nervosa: A dissemination study. Eating Disorders, 18(3), 199–209.
Lock, J., Couturier, J., & Agras, W. S. (2006). Comparison of long-term outcomes in adolescents with anorexia nervosa treated with family therapy. Journal of the American Academy of Child & Adolescent Psychiatry, 45(6), 666–672.
Miskovic-Wheatley, J., Bryant, E., Ong, S. H., et al. (2023). Eating disorder outcomes: Findings from a rapid review of over a decade of research. Journal of Eating Disorders, 11, 85.
Peckmezian, T., & Paxton, S. J. (2020). A systematic review of outcomes following residential treatment for eating disorders. European Eating Disorders Review, 28(3), 246–259.
Sala, M., et al. (2023). Predictors of relapse in eating disorders: A meta-analysis. Journal of Psychiatric Research, 158, 43–53.
Touyz, S. W., Lacey, H., & Hay, P. (2007). Eating disorders in the Asia-Pacific region. International Journal of Eating Disorders, 40(S3), S18–S26.
Treasure, J. (2004). Making sense of eating disorders: A psychoanalytic research perspective. International Journal of Eating Disorders, 36(S1), S41–S47.
Treasure, J., & Schmidt, U. (2013). Getting better bite by bite: A survival kit for sufferers of bulimia nervosa and binge eating disorders (2nd ed.). Routledge.
Yager, J., Devlin, M. J., Halmi, K. A., Herzog, D. B., Mitchell, J. E., Powers, P., & Zerbe, K. J. (2014). Guideline Watch (August 2012): Practice guideline for the treatment of patients with eating disorders. Focus, 12(4), 416–431.
Legal disclaimer: The ACED team is comprised of mental health professionals licensed to practice in the state of Texas. Reading our blog does not create a therapist-client relationship between us. Our blog is designed for informational purposes only, and is not intended as a substitute for professional care. The contents of this blog should not be used to diagnose or treat illness of any kind, and before you rely on any information presented here you should consult with a trusted healthcare professional. If you are currently experiencing a mental health emergency please call 911 or the National Suicide Prevention Hotline at 1-800-273-8255.