There was a point early on in my eating disorder recovery where I really thought I was “cured” of my illness. After all, I was eating dietitian-approved meals and snacks, and had significantly reduced my time in the gym. What I didn’t know at the time was that I had actually just reached a strange sort of limbo in my recovery: I was doing the “right” things, and it probably looked like I’d gotten a handle on my disease to the outside world. But inside, I was still obsessing over every bite I ate and every treadmill session I didn’t do, and still feeling massive guilt for “defying” my eating disorder. Though I wouldn’t realize it until later, I had entered a common but risky gray area sometimes called “quasi recovery.”

Equip Peer Mentor Jamie Drago had a similar experience in her own recovery. “For me, quasi recovery looked like making a lot of deals with myself and negotiations with the eating disorder,” Drago says. “For example, I’d tell myself, ‘I can eat X but only because I did Y,’ or ‘it’s okay for me to do X as long as I do Y.’ I focused so much on things being ‘not as bad as before’ that I wasn’t able to see how much better things could still have been even from that point.”

This gray area isn’t talked about very much in the recovery discourse, but it’s common, and more harmful than you might think. Read on to learn more about “quasi recovery,” its associated risks, and how to move past it.

What is quasi recovery?

According to Equip Lead Therapist and Clinical Supervisor Brittney Lauro, LCSW, quasi recovery is essentially the act of picking and choosing parts of the eating disorder that a person decides they’d like to get rid of, rather than challenging all parts of the disorder. To those without an eating disorder, this might seem confusing, but remember that eating disorders are often coping mechanisms gone awry, so someone might feel like they need certain behaviors in order to deal with life. What’s more, toward the beginning of recovery, the eating disorder brain is still running the show, and that brain places a high value on certain aspects of the disorder—like weight, dietary restriction, and exercise—and may refuse to let them go.

“When I think of ‘quasi recovery,’ I’m reminded of some of the things I hear people say when they’re starting treatment,” says Lauro. “Statements like, ‘I really want to stop binge eating or purging, but I don’t want to change my healthy eating habits,’ which often means restriction. Or sometimes it’s, ‘I’m willing to gain a few pounds, but I refuse to go past XYZ number.’ Other times it’s, ‘I want to let go of parts of my eating disorder but I don’t want to stop exercising every day.’”

Drago describes this confusing stage as having “one foot in, one foot out” in recovery. For many people navigating recovery, stopping the most dangerous habits associated with their eating disorder might feel like they’ve achieved enough, leaving them clinging to behaviors that are still disordered but aren’t “as bad.” “Maybe eating disorder thoughts are less intrusive and they’re able to live a more flexible life than before,” Drago says. “But there are still some strings attached.” More often than not, living with those attached strings means prolonging the treatment process and impeding true, full recovery.

Why and how do people find themselves in quasi recovery?

Lauro believes that one major reason so many people struggle with quasi recovery is because diet culture has normalized disordered behaviors around restrictive eating and unhealthy exercise. “I feel for folks,” Lauro says. “There’s so much messaging in our society that supports ‘quasi recovery.’ Exercise is praised at all costs with little discussion about rest, and there are constantly new fad diets disguised as ‘lifestyle changes’ or ‘wellness plans.’ It is all so confusing knowing what to do and what to trust.”

Another reason people get stalled on this murky plateau on the way to recovery is our society’s over-evaluation of shape, weight, and control. “There’s what feels like a persistent ‘need’ to look a certain way, or control one’s food or exercise a certain way,” Lauro says. “The over-evaluation refers to a mindset where these things—weight, food control, etc.—are so highly valued, that nothing much else matters. It’s an intensive mindset, and truly is the driving force that sets people with eating disorders apart from folks who experience periods of disordered eating.” In other words, our society as a whole has adopted a mindset that, in an individual person, is usually associated with an eating disorder. Talk about confusing.

Fear can also drive the urge to linger in quasi recovery. “People often mention fearing that their anxiety or depression will get way worse if they gain XYZ amount of weight, back off from their workout regimen, or eat a certain way,” Lauro says. “When eating disorder recovery is done effectively, this simply is not true in the long run. But what is true, is that there is a period of time when we’re initially challenging these behaviors where things like anxiety or depression often do increase. That’s why eating disorders are so unfair in my opinion—people often feel worse in the short-term before they feel better in the long-term.”

The risks of quasi recovery

“The greatest risk of quasi recovery is always relapse,” Lauro says. “And we know that relapse and active eating disorders take away from your ability to live life and fully experience joy. Any time we leave any element of the eating disorder unchecked, we run the risk of reigniting the whole thing. I have seen this numerous times in my practice. It is always best to make sure we leave no stone unturned.”

Relapse can be of particular concern when someone in quasi recovery experiences a major or stressful life event. “If someone hasn’t allowed their body to reach its natural weight set point, for example, or still has a disordered relationship with exercise, they could be at risk for relapse prompted by life events like a wedding or having a child,” Lauro says. “On the flip side, I find that those who have allowed themselves to maintain their natural set point, and have done all of the work to eliminate restriction and all compensatory behaviors, don’t end in relapse despite stressful or major life events.”

Drago says that in her experience with quasi recovery, the biggest risk was succumbing to the slippery slope of increasingly disordered thoughts and behaviors. “As many times as I told myself I would be able to sustain a semi-recovery state, it never stayed that way for very long,” she says. “These are really strong illnesses and even things like ‘cutting corners’ with a meal plan or doing something ‘just a little bit’ eventually sends things downhill every time.”

Lauro says that in her opinion, there simply isn’t enough information published about the hope that comes with full recovery. “Most articles focus on life events that trigger relapse and it's usually painted in a hopeless light,” she says. “The truth is, there is hope. And there’s a strong chance you won’t relapse if you reach full recovery and let go of quasi recovery.”

How to know if you’re in quasi recovery vs. full recovery

While the recovery process looks different for everyone, Drago says the telltale sign that she was still lingering in quasi recovery was the fact that she was constantly negotiating with herself and justifying her decisions.

“If I had rules around what made it ‘okay’ to do certain things, that was a red flag that maybe things weren’t going as well as I thought they were,” Drago says. “Entertaining the idea of engaging in any behaviors, even ‘just a little bit’ is a red flag because, at least in my definition of full recovery, there would generally be an absence of those behaviors and seeing them as not an option.”

Lauro recommends asking yourself some simple questions to determine whether you’re in quasi recovery or full recovery:

  • Am I still being restrictive in my eating?
  • Am I cutting out certain food groups? And if so, am I willing to go through invasive testing to confirm if I have a medical condition that indicates I need to cut out certain foods? (“This can be life-changing for folks, I’ve seen it happen,” Lauro says).
  • Why am I exercising?
  • Do I have rules about what movement does and does not count as exercise?
  • What happens when I skip a day of exercise? Do I get very anxious if I skip exercise? (“If the answer is yes, this means that exercise is still an issue,” Lauro says).
  • What would happen if I let my weight go up?
  • Am I doing anything to suppress my weight or try to make sure that it does not go up?
  • Am I leaning into other markers of health aside from weight?

Moving beyond quasi recovery

While quasi recovery is a place many people on the road to recovery temporarily land, it’s not a place to settle or get stuck. The goal is always to find true freedom from the harmful tethers of the eating disorder—but this can admittedly be a big challenge.

“Getting past the hurdle of partial recovery is really tough, because doing that first half of the work is already hard and scary and exhausting, so the idea of having to do even more can sound out of the question,” Drago says. “To make that final push, you need to sit down and really investigate where you are still seeing eating disorder thoughts, urges, and behaviors popping up.”

In addition to continuously challenging food fears and anxiety-provoking situations or experience, Drago believes constant, clear communication with one’s treatment team is essential to achieving full recovery. “With a lot of our society really encouraging and praising a focus on changing our bodies, and many folks experiencing frequent instances of weight stigma, it’s important to process with your providers how you can care for yourself and support your recovery in the face of that,” she says.

According to Lauro, moving beyond quasi recovery requires particular attention to four key areas: eating, exercise, clothing, and weight:

1. Establish and stick to regular eating patterns. “Don’t be afraid to go back to basics,” Lauro says. “That includes three meals and two to three snacks eaten at regular intervals of time and inclusive of all food groups. Pay attention to be sure that portion sizes align with what your treatment team would have recommended.”

2. Shift your mindset around exercise. “The most effective way to do this is to go cold turkey for a period of time—at least a week or so—without any exercise,” Lauro says. “If this feels unattainable, try to cut back little by little. When you’re ready to re-integrate exercise and movement, start with activities that aren’t linked to your eating disorder. Consider group classes or walking instead of running, etc. If your eating disorder has rules about how much time you should be on an exercise machine, experiment with intentionally stepping off the machine a few minutes early.”

3. Expand your clothing options. “If you’re still only allowing yourself to wear certain clothing styles or colors, consider experimenting with fashion that you genuinely like without a focus on weight or what your body looks like,” Lauro says.

4. Revisit your relationship with the scale. “For some folks, this might mean removing the scale completely from their home and only having weight checked at doctors appointments when it is medically necessary,” Lauro says. “For other folks, the opposite might be true: it might mean reaching back out to their treatment team to work on exposure to seeing a number on the scale. Some folks tend to choose this option as a means of protecting their future selves, so if they are ever in a situation where they will have to see their weight at a medical appointment, they are less likely to be impacted in a negative way.”

While the specific ways someone challenges themselves to move out of this gray area may look different from someone else in the treatment process, it’s important to keep the ultimate goal in mind: total recovery. Quasi recovery is common, but it’s a dangerous place to stay, so recognizing the signs of it and knowing how to move beyond it is essential to achieving true and permanent freedom from an eating disorder.

References
  1. Linardon, Jake. 2016. “Correlates of the Over-Evaluation of Weight and Shape in Binge Eating Disorder and Mixed Eating Disorder Samples: A Meta-Analytic Review.” Eating Disorders 25 (3): 183–98. https://doi.org/10.1080/10640266.2016.1260374.
Michelle Konstantinovsky, MJ
Equip Contributing Editor
Clinically reviewed by:
Brittney Lauro, LCSW, LICSW
Lead Therapist
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