Wednesday 29/01/2025
PHOTO: Katarina Wolnik Vera
TEXT: Lina Camacho
When you start therapy for an eating disorder (ED), it can feel like a big step forward. But sometimes, along the way, things can become overwhelming, and you might feel like giving up. You’re not alone, many people with eating disorders face the same challenges. In fact, eating disorder therapy has one of the highest dropout rates among mental health treatments.
But before you make the decision to quit, it’s important to understand some of the reasons why patients like you might feel the urge to walk away. Recognizing these feelings can help you work through them and give you a better chance at long-term recovery.
1. Ambivalence: A natural part of recovery
When you have an eating disorder, you’re not just fighting against your symptoms, you’re also struggling with a deep, internal conflict. On one hand, you want to get better. On the other hand, you want to stay the same. Recovery may feel terrifying because it often involves facing things you’ve avoided or feared for a long time. This includes things like gaining weight or losing weight, changing your eating habits, and confronting painful emotions. It’s totally normal to feel conflicted.
In fact, many patients with anorexia nervosa, for example, might not even recognize the seriousness of their condition or feel afraid of what recovery will mean for their identity and body. This ambivalence can make therapy seem hard or unappealing, especially in the early stages when progress feels slow or uncomfortable.
What you can do: Instead of thinking about quitting, try to give yourself permission to feel unsure. Recognize that ambivalence is part of the process. It’s okay to feel hesitant, it doesn’t mean you’re failing or that you won’t get better. Let your therapist know how you’re feeling. They can help you work through these mixed emotions.
2. The hard truth about body image and therapy
It’s no secret that eating disorders often involve intense struggles with body image. Therapy may require you to confront how you see your body, how you feel about weight, and how you’ve come to define yourself. These topics can be extremely distressing, especially when you feel disconnected from reality. It’s very common for patients to feel like they’re not ready to deal with these difficult issues, leading to feelings of frustration or a desire to quit.
What you can do: Remember that body image healing is a gradual process. If therapy brings up difficult emotions, that’s a sign you’re touching on something important. Don’t shy away from these moments, they may be signs of growth. Discuss with your therapist if you feel overwhelmed, and explore ways to cope with the emotional intensity that body image work brings up.
3. Perfectionism and unrealistic expectations
If you’ve ever struggled with an eating disorder, you may also be familiar with perfectionism; the feeling that things have to be “perfect” or else they’re not worth doing. This can make it incredibly hard to stick with therapy, especially when progress feels slow or when you make mistakes along the way. You might feel like quitting because you believe you should already be “better” by now, or because things didn’t go perfectly during a session.
What you can do: Recovery is not about perfection it’s about progress, no matter how small. A setback doesn’t mean you’re failing; it just means you’re human. Try to shift your focus from perfect results to small, positive steps. Every session, every conversation with your therapist, and every challenge you face is part of the bigger picture of your recovery.
4. Social pressures and the need for support
The journey to recovery is not just an internal process, it’s also deeply affected by your environment. If you don’t feel supported by family or friends, or if you experience stigma or shame around your eating disorder, it can feel like you’re carrying a heavy weight. You might feel isolated or misunderstood, and that can make therapy feel even more difficult.
What you can do: If you don’t have strong support from those around you, consider reaching out to others who understand your journey. Therapy isn’t just about the work you do with your therapist; it’s about building a network of people who can offer understanding and encouragement. Support groups, online communities, or even talking to others in a therapy group can make a big difference. You don’t have to go through this alone.
5. The realities of slow progress
One of the hardest things about eating disorder recovery is that it’s rarely fast. Recovery often takes time (sometimes a lot of time) and it can feel discouraging when you don’t see quick results. But what might feel like a lack of progress is actually a sign that your brain and body are slowly rebuilding the foundation for long-term healing. Sometimes progress is invisible, it’s happening on the inside, even when it doesn’t look like much on the outside.
What you can do: Be patient with yourself. Take time to acknowledge even the small victories, like attending a session or opening up about something difficult. Don’t define your recovery by how quickly you can get better, but by your commitment to sticking with the process.
6. It’s okay to ask for help
Finally, therapy can feel hard for reasons beyond your control. You might find that your therapist’s approach doesn’t feel like the right fit for you. Or, you may find yourself struggling to access the care you need due to financial or logistical challenges. These external factors can contribute to the impulse to drop out of therapy, but they don’t have to stop you from getting the help you deserve.
What you can do: If you feel your therapist’s approach isn’t working for you, speak up. A good therapist will work with you to find strategies that are more aligned with your needs. If access to therapy is a challenge, talk to your provider about your options, there may be insurance options, or referrals to other services that can help.
Keep Going
It’s completely normal to feel like quitting therapy at times. But it’s important to remember that these feelings are part of the process, not the end of the road. Your eating disorder has been a part of your life probably for a long time, recovery doesn’t happen overnight. The important thing is to keep moving forward, even if that means taking it one small step at a time.
It’s also common to reach moments in therapy where it feels like you’ve hit a standstill, a point where moving forward seems too difficult, or even too scary. If you decide to leave treatment at that point, it’s okay. It doesn’t mean you’ve failed, or that recovery isn’t possible. Sometimes, stepping away can give you the time and space to gather the courage you need to return. When you’re ready, even if you’re not fully “prepared,” you can come back with a bit more openness to change, or a new perspective that might make it feel less overwhelming.
You deserve to find peace with your body and your mind. If you’re feeling tempted to drop out, try reaching out to your therapist to talk through your thoughts. They can help you explore what’s behind those feelings and find ways to stay engaged in your healing journey.
References
- Cash, T. F., & Smolak, L. (2011). The role of body image in the treatment of eating disorders. In T. F. Cash & L. Smolak (Eds.), Body image: A handbook of theory, research, and clinical practice (pp. 277–290). The Guilford Press.
- Dalla Corte, C., et al. (2020). Barriers to treatment in patients with eating disorders. Journal of Eating Disorders, 8(1), 20. https://doi.org/10.1186/s40337-020-00260-4
- Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Psychological features of patients with eating disorders: Implications for treatment. Behavior Research and Therapy, 41(5), 509–528. https://doi.org/10.1016/S0005-7967(02)00024-5
- Hayes, J. F., & Williams, L. (2017). The role of social support in eating disorder recovery. Psychiatry Research, 254, 183–189. https://doi.org/10.1016/j.psychres.2017.04.027
- Van Strien, T. (2018). Challenges in the treatment of eating disorders: A review of barriers to care and suggestions for improvement. Eating and Weight Disorders, 23(1), 1–8. https://doi.org/10.1007/s40519-017-0467-3