What to Expect in Early Eating Disorder Recovery
Early stage eating disorder recovery is a stressful time
Starting eating disorder treatment is a huge first step. For many parents, it comes after a long period of research, worry, and effort to find the right care for their child. Once treatment begins, it’s common to wonder: “What happens now?” “What should I be watching for in these early weeks?” and “How long will all this take?” These questions are very common, and most parents feel overwhelmed as they step into this new phase of care.
Early recovery often feels like stepping into unfamiliar territory. There’s no clear-cut roadmap, and every individual’s journey will look a little different. It’s natural to have hopes, fears, and expectations about how things should progress, but in reality, early eating disorder recovery can feel messy, unpredictable, and emotionally draining. This post will walk you through what parents can often expect in the early stages of treatment, as well as what not to expect, so you feel a little more prepared for what may come.
Early Physical Changes In Eating Disorder Recovery
In many cases, especially when malnutrition is present, the first priority is medical stabilization. This may involve:
Frequent monitoring of weight, vitals, and heart rate
Routine lab work to track electrolytes, hydration levels, and organ function
Monitoring for vital signs of cardiac instability (such as bradycardia or low blood pressure)
Careful assessment of hydration status and fluid balance during nutritional rehabilitation
Close observation for complications during refeeding
One of the biggest concerns in this phase may be refeeding syndrome, which is a serious but rare risk that your child’s team will monitor closely. It involves potentially dangerous shifts in fluids and electrolytes as nutrition intake increases early on in recovery, in severely malnourished patients. With careful medical oversight from a team experienced in eating disorder care, this risk can be effectively managed.
Beyond stabilization, you may see a variety of physical symptoms emerge as your child’s body begins healing. These may include:
Extreme fullness or discomfort after meals
Bloating, abdominal cramping, or constipation
Fatigue or low energy
GI changes as digestion normalizes
Additionally, weight restoration tends to happen in the abdominal area first and foremost. This is completely natural and occurs because of the body’s biological attempt to prioritize the protection of our vital organs. However, as you might imagine, this can be incredibly distressing and scary for kids in recovery, who may already have body image concerns. The good news is that research consistently indicates this weight distributes to the other areas of the body over time. But in the interim it can cause severe body image distress and dysmorphia.
For parents, all of these physical symptoms and along with their child’s distress around increased weight can feel very alarming and concerning. But it’s important to know that these symptoms are a normal part of the body adjusting to increased nourishment. After a period of malnutrition or restriction, the digestive system often needs time to recalibrate. Most of these discomforts gradually improve with consistent, adequate nutrition.
Staying in close communication with your child’s treatment team during this time can offer ongoing reassurance and help address any questions that come up along the way.
Emotional Ups and Downs In Eating Disorder Treatment
In addition to physical discomfort, emotional distress often intensifies in early recovery. This seems counterintuitive. But, as eating disorder behaviors are interrupted, anxiety often increases. Your child may feel intense fear, shame, anger, or hopelessness as their eating disorder loses control.
It’s common to see:
Heightened anxiety before and after meals
Tearfulness or emotional breakdowns
Anger, defiance, or withdrawal
Outbursts of frustration as body changes occur
Many parents describe this phase by saying, “It feels like things are getting worse.” And in a way, that’s true, because the eating disorder is being directly challenged and that feels horrible to your child.
You might notice your child becoming more emotionally reactive to situations that previously seemed manageable. Small disappointments or schedule changes may feel overwhelming to them. Mealtimes can become highly charged, with tears, refusal, bargaining, and even throwing food.
These emotional waves are temporary and will settle with continued consistency and support. Remember, emotional dysregulation is a normal response to the discomfort of losing eating disorder behaviors that once felt like safety. As your child adapts to new routines and their brain begins receiving adequate nutrition, emotional regulation often improves. In fact, many parents observe that once their child’s brain is adequately nourished, their emotional range stabilizes in ways that hadn’t been possible during active restriction or purging.
Meals feel intense for people with eating disorders
The Intensity of Mealtimes
In early recovery, mealtimes often feel like the most stressful part of the day. Sitting down for a meal can trigger significant anxiety, bargaining, tears, or even refusal to eat. Parents often feel like every meal is a battle. While extremely challenging, these moments are a direct part of breaking the eating disorder’s hold. Over time, with consistency and support, mealtimes often become less intense as your child begins to trust the process and their body starts to heal.
It’s also important to recognize that your child may express strong anger or frustration toward you as the parent, especially if you are involved in providing structure around meals. This is not a reflection of your parenting or what your relationship will be like long-term. It’s a reflection of the eating disorder fighting for control. Many families experience this as one of the most challenging parts of early recovery, but these intense reactions typically soften over time.
Other Common Challenges in Early Recovery
In addition to the physical and emotional ups and downs, there are several other patterns that parents commonly observe during early eating disorder recovery:
Regression in Functioning
As anxiety and distress increase, many kids and teens temporarily regress in other areas of life. You may notice your child struggling with school, pulling back from social activities, becoming more dependent on parents, or having difficulty managing daily routines like sleep, hygiene, or time management. For parents, this can be confusing and frustrating. You might think "We finally got them into treatment, why does everything else seem to be falling apart?"
This regression is temporary. Think of it as your child’s nervous system being overwhelmed by the immense demands of recovery. As their anxiety decreases and their brain receives steady nutrition, their ability to manage responsibilities gradually returns. For now, meeting them where they are and lowering expectations in non-critical areas, can help keep the focus on healing.
Increased Reassurance-Seeking and Rigidity
You may find your child repeatedly asking for reassurance. This might sound like
"Are you sure this is enough food?"
"What if I gain too much weight?"
"What if I can’t stop eating?”
This is not them just being dramatic. These questions are driven by genuine fear and the eating disorder’s desperate need to maintain control. You may also see new rigid rules or rituals begin to emerge as your child tries to create a sense of safety during such an uncomfortable transition.
Common examples include:
Cutting food into small pieces
Taking excessively long to eat
Requesting precise preparation of meals
Checking labels or calorie counts even when discouraged
Over time, as your child gains trust in the recovery process, these rigid behaviors often decrease. The treatment team can help you navigate when and how to gently challenge these emerging rules and can help teach your child positive coping skills to manage the discomfort of doing so.
Parental Anxiety and Hypervigilance
Parents often feel like they have to be “on” at all times: constantly monitoring intake, behaviors, mood shifts, and compliance with treatment. It’s easy to become hypervigilant, and feel like you are constantly walking on eggshells. This level of anxiety is understandable but exhausting and not sustainable. Seeking support for yourself, through therapy, support groups, or online parent communities can be crucial for your own wellbeing and allows you to stay steady as you guide your child through recovery.
Family Dynamics
Eating disorder recovery doesn’t happen in a vacuum, it deeply impacts the entire family system. So, involving loved ones in the process can make a significant difference both for your child’s healing and for your family’s overall wellbeing. When multiple family members actively participate in treatment, it not only strengthens your child’s support system but can also help prevent caregiver burnout and compassion fatigue (both of which can be serious concerns due to the prolonged nature of eating disorder recovery).
Whenever possible, consider inviting other family members to:
Attend educational sessions to better understand eating disorders
Join therapy appointments when appropriate
Participate in supervised meal support sessions
Learn skills such as validation, co-regulation, and setting healthy boundaries at home
Involving siblings can also be incredibly valuable. Depending on their age and maturity, siblings may benefit from:
Attending family therapy sessions
Receiving age-appropriate education about eating disorders
Learning how to provide emotional support and encouragement in day-to-day interactions
At the same time, it’s important to acknowledge that sibling relationships may feel strained during early recovery. Siblings may feel confused, frustrated, or resentful about the attention and energy required to support their brother or sister. They may struggle with fear, anger, or confusion. These feelings are normal and valid. Family therapy can provide space to process these emotions, set healthy expectations, and help siblings feel seen and supported throughout the recovery process. Open, honest communication within the family can foster greater understanding, reduce feelings of isolation, and create a united front as you navigate recovery together.
How long does eating disorder recovery take?
How Long Does Early Recovery Last?
Every child’s timeline looks different. For many families, this early phase of eating disorder recovery can last several months. Some children stabilize more quickly, while others may take longer depending on the severity and chronicity of their illness, medical complications, or co-occurring conditions.
It’s important for parents to remember that early stabilization is only the beginning. While some physical symptoms may resolve relatively quickly, emotional regulation, flexibility around food, and true cognitive shifts around body image and eating often take more time. This early period, though intense, lays the critical foundation for long-term healing.
Staying in Communication With Your Team
One of the most valuable things parents can do during early recovery is to stay connected with your child’s treatment team. Don’t be afraid to ask questions, express concerns, seek clarification, or provide updates.. The more collaborative your communication with the team, the more supported you’ll feel navigating this process. Your day-to-day observations at home give the team crucial insight that allows them to adjust treatment recommendations as needed.
Open, ongoing communication between parents and providers creates a collaborative partnership that can help you feel supported and empowered as you navigate this process.
What Early Recovery Is NOT
Parents often hope that once treatment begins, everything will progress quickly. They expect their child to receive treatment and then immediately return to “normal,” when their weight is stable or they are no longer bingeing or purging. While some families do experience fairly steady progress, it’s very common for recovery to feel slow, or even backwards at times. Ups and downs are actually the “norm” and the process of recovery is usually a long-term journey.
Early recovery is not:
A quick return to “normal” eating habits
Instant weight or body acceptance
Smooth, conflict-free mealtimes
Immediate emotional stability
A simple, straight-forward process
Managing your own expectations for your child should be an ongoing process.
Early Recovery is Hard, But It Gets Better
Early eating disorder recovery can feel overwhelming for everyone involved. The physical symptoms, emotional outbursts, family stress, and daily ups and downs can easily leave parents feeling exhausted and discouraged. But often, these intense moments are a sign that the eating disorder is starting to lose some of its grip. With time, consistency, support from the treatment team, and ongoing family involvement, your child’s brain and body begin to heal, and slowly, things start to feel more manageable. Little by little, the intensity of early recovery eases, and you’ll start to see glimpses of stability return.
Recovery is rarely linear. There will be hard days, but progress is absolutely possible.
You Don’t Have To Do This Alone
Join our free Facebook group The Parent Support Network for Eating Disorder Recovery — a safe, compassionate space where you can connect with other parents, share experiences, and get expert guidance as you support your child’s healing journey. You don’t have to do this alone!