'Quasi-Recovery' is a term used widely in the eating disorder community. It's a label or self-diagnosis that I'd estimate around 90% of people with very active eating disorders give themselves. I've never liked the term 'quasi-recovery' as it's used too flippantly and in my view you either have a very active eating disorder and you are actively doing very little to change that, even if you really want to change and are talking the talk about doing so, or you are actively and decisively making hard but necessary changes to overcome the eating disorder.
In my first book, Addicted to Energy Deficit, I put forward the argument that when someone is describing themselves as in, 'quasi-recovery' , they are effectively addicted to 'moderation'. This post provides an abridged version of that section from the book, also adding another slant to it. This is that when you consider an eating disorder to be a form of addiction, then you could compare the state that many label as 'quasi-recovery' to being 'highly functional' but with an active eating disorder, just as someone with a serious alcohol dependence or gambling addiction might be seen to be a very functional member of society, to the point that their addiction isn't known about outside their trusted circles.
Before getting too far ahead though, let me put the topic into context and begin with a definition of 'quasi-recovery'… This is my definition but as there is no 'recognised' diagnosis of a 'quasi-recovery', any definitions you come across will differ.
Defining 'Quasi-Recovery':
Quasi-recovery is a term commonly used in eating disorder communities. It relates to when you have made some progress along the trajectory of overcoming an eating disorder, where fully consumed by the eating disorder is at one end and fully free of it is at the other. Despite your progress, it has now stalled, and you are currently treading water. Prior to this, you made some changes to overcome the eating disorder. Food intake became less restrictive, and other compensatory behaviours or rituals either reduced, switched or stopped. Mental and physical shifts have occurred, but you are by no means at your potential in terms of fully overcoming the eating disorder and living a life free from it.
If you are defining yourself as being in 'quasi-recovery', you are likely to argue that you are now eating more than you were, yet your intake remains restrictive to your body’s needs and hunger. You have possibly gained some weight, and so you and the people around you might consider you to be better, but you remain below your set point, have not allowed for overshoot and remain in energy deficit. Because you aren’t engaging in exercise as much as you were or perhaps you have reduced purging behaviours or even replaced it with daily yoga, you have managed to convince others that things are better. But you are still addictively driven by the compulsions that remain or by those you have switched to.
Highly functional...
When you consider yourself to be in 'quasi-recovery' with an eating disorder, it's likely that you are very effectively engaging in life with work, studies and other pursuits, appearing to be highly functional. However, this 'functional' life is also most likely to be very structured and habitual, and you experience raised anxiety from any small threat to your routine.
On the surface you might be highly functional and appear successful but your reality is that finding pleasure in life remains a challenge; spontaneity is incredibly hard, the concept of fun largely unknown. Overall, in quasi-recovery, you still have an active eating disorder and continue to live a narrow and addicted life, even if a functional one.
In this 'quasi' and functional state, you will resist making any more changes that will impact on your ability to pursue your usual fix from energy deficit (keeping your weight suppressed by restriction and/or compensatory behaviours) because that fix is numbing, calming and allows you to remain as functional as you are. Without that 'fix' from the eating disorder and the benefits it brings, life feels chaotic and you feel out of control… and of course that is a terrifying concept.
How do you reach a 'quasi-recovery' state?
As I said above, I'd estimate that around 90% of people with active restrictive eating disorders label themselves as being in 'quasi-recovery'. And this is because, at least 90% of people with active eating disorders, including people who are on the edge of crisis point, remain very highly functional in other aspects of their life which allows them to believe that 'everything is ok really and it's not as bad as all that', convincing those around them that this is the case too. No one can continue to slide back with an eating disorder without hitting a crisis point and so the majority of people with active eating disorders catch themselves from the ongoing slide and have to work hard to tread water where they are or stabilise themselves a little but then remain paralysed and seemingly incapable of going further forwards.
Accepting that you still have a very active eating disorder
Effectively, in quasi-recovery, you still have a strong addiction to energy deficit and a very active eating disorder. It might be manifesting differently to when it started but it needs to be recognised for what it is. Your restrictive intake might not be as significant as it has been in the past, but what remains is just as addictive. There may be less compensatory behaviours or a change from one type to another, but those that are still present remain just as compulsive. Perhaps you have gained some weight but you are not at your natural set weight and remain in a state of energy deficit. Therefore, your addiction to a state of energy deficit is still present; it just has different behavioural patterns driving it, but it's still life limiting. Over the months and years, it's likely that you have adapted the eating disordered behaviours to prevent yourself hitting a complete crisis situation but that you continue to engage in them at a moderated level.
When you continue to engage with the addictive behaviours, even in a moderated way, you are continuing to create a deeper dopamine deficit in your brain. You are also continuing to use and strengthen the deeply embedded eating disordered brain networks, not allowing them to be unwired and replaced by circuits driving an eating disorder free life. In this way, quasi-recovery is a state of being addicted to moderation.
In other addictions and even in eating disorders, reduced engagement with the drug, applying moderation, is a tool used by medical teams to minimise the risk of harm that can arise from them. Unfortunately, this doesn’t take from the fact that the overall addiction remains, massively impacting on quality of life. While the eating disorder is still active, there is also a significant ongoing risk of further decline.
Living a moderated life or a life of 'quasi-recovery' is exhausting
When you are addicted to slightly moderated but still compelling eating disordered behaviours, trying to stay afloat and not slide back can be exhausting. In fact, it's less exhausting to be fully entrenched in the eating disorder because when you are, you don’t have to apply conscious thought; you just follow the compulsively driven, miserable but numbing habits.
On the flip side, fully engaging in overcoming the eating disorder through abstinence is also less exhausting because you are in a determined and 'going for it' state of mind.
A lot more mental effort is necessary when you are In 'quasi-recovery' and stuck in a life of moderation, as you aim to eat restrictively but not too restrictively or allow yourself to engage in some compensatory behaviours but prevent them from escalating. This can be a constant juggling act, especially when you are also having to present to the world a functioning, smiling, capable person, despite feeling like you are crumbling inside.
Fostering hope!
If you can identify with this state of being, take heart—there is so much hope to nurture!
At some point, you did leave the starting line and you have proof from the past that you can make changes. Maybe now the time is right to get from where you are to the end of the line and finally fully overcome the eating disorder.
Moving Forwards
To move forwards from this 'quasi' state, or position of being highly functional with a very active eating disorder, means making some significant changes but those changes will be so worthwhile if you commit yourself to them. At this point you do the same as anyone who wants to fully overcome a restrictive eating disorder needs to do. You apply abstinence to all your behaviours and restrictive eating. You make space in your life for the focus and hard work this will take, seek support and pull on any resources you can find. You trust yourself and your abilities, develop skills in self-empowerment and new coping skills for when life gets tough, which it will.
Studies carried out on people with alcohol and drug dependence demonstrate that those who have overcome an addiction through abstinence have a higher quality of life and greater feelings of self-trust and self-worth than those who have recovered using a moderation approach. It’s beyond a doubt that this is true for people with eating disorders too.
Perhaps it is time to accept that considering yourself in 'quasi-recovery' is just hiding the fact from both yourself and those around you that you have a very powerful, addictive and complicated eating disorder, that you are terrified of working to overcome but that you also desperately want to overcome.
Accept that the eating disorder is real, valid and just as horrific for you as an eating disorder is for anyone else, even if you remain very 'functional' with a successful career, family and educational accolades despite it. Maybe now is the time to show yourself the compassion that you deserve and give yourself the best chance to have a life that is not half-lived and one in which you can thrive as your truly amazing and authentic self… But it does take courage to take those steps and to make yourself vulnerable, ask for help, perhaps even crumble for a while so that you can then build yourself back from the ground up. If there is one thing that I know to be true though, that is that if you have been strong enough to live with an eating disorder for this long, you are definitely strong enough to now beat it.
**For more information on eating disorders and how to overcome one, please don't miss my newly available books,
And,
The information for this post was largely taken from Addicted to Energy Deficit.
If you like to listen, as well as (or instead of read!) then this blog post is the transcript of a podcast episode which you will find on my podcast series,
available on this website, all mainstream podcast platforms and on YouTube.