As I've connected with more and more people who are struggling with an eating disorder, and/or working to find their way to recovery, I hear the question above asked over and over, whether literally, or expressed in their words of pain as they try to understand the steps they need to take to be recovered. There is no one answer. I have asked myself the same question time and time again over the past 40 years. I often wondered, as I felt like I was being swallowed up by the prison of anorexia, "can't there just be a pill that I could take that would make it all go away?".
There are countless factors involved in each person's recovery from their particular eating disorder. Because eating disorders are NOT truly about food, it all comes down to what issues in each person's life need to be addressed in order to find the key to recovery.
The one common element that comes into play is first of all to stabilize your eating, and restore your weight to what is normal for your genetic make-up. The time it takes for this varies dramaatically, depending on what condition your body is in when you begin treatment or recovery.
Going back a bit....many times a person, including myself, will go through multiple recovery attempts, which adds up to years of failed attempts. This adds to both the frustration, and also the complexity of the eating disorder.....which means only more time added to recovery.
After the person's physical status is stabilized, then the emotional work begins. Some common emotional factors that may be contributing to the maintenance of an eating disorder are past (or present)abuse/trauma..including incest, obsessional thinking, the need for control and certainty, grief issues, anxiety, suppressed emotional expression, lack of a clear personal identity without an ED, fear of rejection or criticism, society's emphasis on physical perfection, plus many more possibilities.
Working through any of these issues, or sometimes several together, takes time. If these issues are not addressed in treatment, the likelihood of relapse is very high becsuse the sources have not been dealt with. I like the comparison of recovery to the process of peeling an onion...layers and layers that must be uncovered. It's usually a very painful process.
You can't ignore that compliance with treatment is a huge factor in the time it takes to recover. For me, I repeatedly went in and out of the hospital, into treatment, then I would relapse again. An eating disorder has a way of causing a kind of push/pull between patients and professionals. For me, I did want help, but when someone tried to offer it, or tell me what I needed to do, I would automatically begin to lie and hide food, and do everything I could to fight against it. It was because of my extreme fears, confusion, and I know now, inappropriate treatment efforts.
The final and probably most important point that I'd like to make has to do with how important it is to have an iron-clad follow-up plan in place for a significant amount of time, in order to keep a present accountability factor in place to watch for even that small signal that a relapse could occur.
It's safe to say that the longer that a person has had their ED, the longer it will likely take for that person to fully recover. The ED messages and behaviors become so ingrained into a person's life....that when changes begin to be made, it takes a lot of hard work and time to change your lifestyle and habits. You truly do have to transplant a new healthy identity into the empty space left behind by an eating disorder.