A: "I can get down to [blank] pounds/size again. I can do it in a healthy way this time; I can do it for good."
B: "No - I've been at [blank] pounds/size, give or take [medically reasonable amount of lbs./sizes], for the past four years, while doing my damndest to follow the advice of ED treatment professionals. This is where my body wants to be."
A: "I can do it: Cut down to [blank] for breakfast, and [blank] for lunch and dinner. It won't be that hard. I'll take multivitamins and calcium this time; it will be healthier."
B: "No - all these things will happen, instead of losing [blank] pounds: My skin will get dry. My hair will stop growing. I will lose my energy. I will further jeopardize my fertility. I will become boring and obsessed again. I will damage my marriage and relationships. I will build debt on food and diet pills. I know, because I've done it before."
A: "But you don't have to look like this/weigh this. Even the charts say you can be [blank] sizes/pounds lower than you are now and still be 'healthy.' Why not just look like/weigh that? What's wrong with you that you can't stop at the minimum?"
B: "OMG, STFU."
I think in Internet acronyms.
No one in the eating disorders world speaks in hard and fast rules or timelines. You can't say, "After five years of intensive psych and medical treatment and nutritional counseling, Jane Doe will be cured of bulimia or anorexia." You can get your weight as firmly in a stable range as you like, but that doesn't mean the disease itself stops chewing on your brain. I don't know why this is so shocking to some people, including ED patients (and me, of course). You can't any more accurately say, "After five rounds of chemo and radiation, Jane Doe will be cured of non-Hodgkin's lymphoma." More relevantly, you also can't say, "After five years of intensive treatment, John Doe will be cured of major depressive disorder," or "borderline personality disorder." It's not done with more mental illnesses/disorders, nor with most addictions. No one who knows the bare minimum of information expects it.*
And yet, here I am, among millions, wondering where the hell is my cure and what the hell am I doing to avoid it? Five years, two months and two weeks ago I started clinic treatment. (Five years, six months and two weeks ago I started individual counseling.) I figured by this point, surely, I'd be fine. Or, if not fine, then not absorbed in the ED thought process at quite such a frequency. I try my best - most of the time - but I am NOT finding the ease of "act as if" to be a naturally occurring phenomenon for me. Never did, no matter my level of counseling or medication. The pitch and frequency remains just about steady as it was, maybe, four years ago. Perhaps being a facts-oriented personality, rather than some more open-minded type, hinders my conception of the process. However, I can tell you that no matter how much I "act as if" I am secretly thinking as if NOT.
In the ED world five years is not necessarily a long time, especially when you consider that that's when treatment actually begins. My disordered behaviors started closer to twelve years ago, and those "behaviors" matched up and surpassed clinical definitions closer to seven years ago. "They" say that eating disorders are lifestyles that much resemble blood stains: The longer it's there, the better chance that it's never going away completely. I don't believe that. I won't. But that doesn't minimize my frustration and anger at not having an "off" switch for this thing, let alone a general time frame. I can't never eat again (without dying), and I can't never to look at or feel my body again (without bizarre consequences, such as really, really awful makeup and a wardrobe consisting of mumus). There isn't a precise cut-off date, like enrolling for classes each semester.
Let's just say that when President Bush suddenly came up with a timeline for withdrawl from Iraqi cities? I was a little jealous.**
* Except the recovering alcoholic father of a recovering alcoholic/fellow bulimia patient five years ago. He was curious why she was still in our treatment program after 28 days. After all, he reasoned, alcohol rehab had done the trick in that timeframe. Why shouldn't an eating disorder clinic work the same way?
** Considering it used to be tantamount to "setting a date for failure."